Imaging prices at Molokai General Hospital
Kaunakakai, HI · every code in this section with a posted price and a Medicare benchmark.
180 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) range across 2 matching MRF lines |
$350–$360.50 | $500–$515 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$430.50–$443.10 | $615–$633 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$218.40–$240.10 | $312–$343 | varies |
| Bone age studies (77072) | $247.10 | $353 | 2.0× |
| Bone survey infant (77076) | $254.80 | $364 | 2.1× |
| Cat Scan Follow-Up Study (76380) | $611.80 | $874 | 6.0× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$367.50–$700 | $525–$1,000 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$350–$367.50 | $500–$525 | varies |
| Chest 3 views (71047) | $387.10 | $553 | 3.8× |
| Chest 4 or more views (71048) | $361.90 | $517 | 2.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$350–$360.50 | $500–$515 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$287–$315.70 | $410–$451 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,902.90–$3,047.80 | $4,147–$4,354 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,023–$2,124.50 | $2,890–$3,035 | varies |
| CT abdomen w contrast (74160) | $1,863.40 | $2,662 | 9.0× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,109.80–$2,215.50 | $3,014–$3,165 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,566.60–$1,645 | $2,238–$2,350 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,987.60–$3,077.20 | $4,268–$4,396 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,103.50–$2,166.50 | $3,005–$3,095 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,022.30–$2,123.10 | $2,889–$3,033 | varies |
| CT angio hrt w/3d image (75574) | $2,174.90 | $3,107 | 5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,153.90–$2,218.30 | $3,077–$3,169 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,032.80–$2,134.30 | $2,904–$3,049 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $875.70 | $1,251 | 4.2× |
| CT bone density (77078) | $483.70 | $691 | 4.7× |
| CT cervical spine w/ contrast (72126) | $2,380 | $3,400 | 5.8× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,775.20–$1,864.10 | $2,536–$2,663 | varies |
| CT cervical spine w/wo cont (72127) | $1,599.50 | $2,285 | 7.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,747.20–$1,834.70 | $2,496–$2,621 | varies |
| CT chest w/wo contrast (71270) | $2,480.10 | $3,543 | 12.0× |
| CT colonography screening (74263) | $2,811.90 | $4,017 | 10.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,062.20 | $2,946 | 10.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,332.10 | $1,903 | 10.8× |
| CT head/brain with contrast (70460) | $1,864.80 | $2,664 | 9.0× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,887.20–$1,981.70 | $2,696–$2,831 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $1,371.30 | $1,959 | 3.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,914.50 | $2,735 | 18.6× |
| CT hrt w/3d image congen (75573) | $476.70 | $681 | 1.2× |
| CT iac w contrast (70481) | $1,759.80 | $2,514 | 8.5× |
| CT l-spine w&w/o contrast (72133) | $2,483.60 | $3,548 | 12.0× |
| CT lower ext w/o (73700) | $1,324.40 | $1,892 | 10.7× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,618.40–$1,666.70 | $2,312–$2,381 | varies |
| CT lumbar spine w contrast (72132) | $2,797.90 | $3,997 | 6.8× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,634.50–$1,683.50 | $2,335–$2,405 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,626.10–$1,707.30 | $2,323–$2,439 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,393.70–$1,463.70 | $1,991–$2,091 | varies |
| CT neck tissue combo (70492) | $987.70 | $1,411 | 4.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $987.70 | $1,411 | 4.8× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,437.10–$1,509.20 | $2,053–$2,156 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,677.90–$1,845.90 | $2,397–$2,637 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,424.50–$1,467.20 | $2,035–$2,096 | varies |
| CT scan of leg combo (73702) | $2,171.40 | $3,102 | 10.5× |
| CT scans face/jaw combo (70488) | $2,490.60 | $3,558 | 12.0× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,661.10–$1,744.40 | $2,373–$2,492 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,437.10–$1,509.20 | $2,053–$2,156 | varies |
| CT thoracic spine w contrast (72129) | $3,199 | $4,570 | 15.4× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,591.10–$1,638.70 | $2,273–$2,341 | varies |
| CT thoracic spine w/wo cont (72130) | $2,486.40 | $3,552 | 12.0× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,527.40–$1,603.70 | $2,182–$2,291 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,310.40–$1,376.20 | $1,872–$1,966 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,841 | $2,630 | 8.9× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$4,300.80–$4,429.60 | $6,144–$6,328 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,296–$2,364.60 | $3,280–$3,378 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,224.60–$2,447.20 | $3,178–$3,496 | varies |
| CTA pelvis (72191) | $2,325.40 | $3,322 | 11.2× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$430.50–$473.90 | $615–$677 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $256.90 | $367 | 2.5× |
| Echo exam of fetal heart (76825) | $949.90 | $1,357 | 1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $732.20 | $1,046 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$429.80–$472.50 | $614–$675 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $422.80 | $604 | 3.4× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$350–$360.50 | $500–$515 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$241.50–$266 | $345–$380 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$287–$315.70 | $410–$451 | varies |
| Infusion Ivp (74410) | $397.60 | $568 | 1.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$341.60–$352.10 | $488–$503 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$347.20–$357.70 | $496–$511 | varies |
| Ob us nuchal meas 1 gest (76813) | $335.30 | $479 | 2.7× |
| Optic foramina (70190) | $72.80 | $104 | 0.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$287–$295.40 | $410–$422 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$492.80–$500.50 | $704–$715 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$284.20–$292.60 | $406–$418 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $256.20 | $366 | 2.5× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$285.60–$294 | $408–$420 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $384.30 | $549 | 3.1× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$266.70–$274.40 | $381–$392 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$284.20–$312.90 | $406–$447 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$277.20–$305.20 | $396–$436 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $777.70 | $1,111 | 7.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $350.70 | $501 | 2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$227.50–$250.60 | $325–$358 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $298.20 | $426 | 2.9× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$350–$360.50 | $500–$515 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$183.40–$201.60 | $262–$288 | varies |
| Radex Spine 1 View Specify Level (72020) | $219.10 | $313 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $355.60 | $508 | 3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $409.50 | $585 | 4.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$233.10–$245 | $333–$350 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $450.80 | $644 | 3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$275.80–$551.60 | $394–$788 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $366.10 | $523 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$430.50–$443.10 | $615–$633 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $444.50 | $635 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $509.60 | $728 | 2.5× |
| Radiologic examination femur 1 view (73551) | $193.90 | $277 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$557.90–$574.70 | $797–$821 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$350–$360.50 | $500–$515 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $236.60 | $338 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$284.20–$292.60 | $406–$418 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $455 | $650 | 0.7× |
| Ribs bilateral 3 views (71110) | $321.30 | $459 | 2.6× |
| Scapula (73010) range across 2 matching MRF lines |
$367.50–$404.60 | $525–$578 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $101.50 | $145 | 4.3× |
| Sella turcica (70240) | $266.70 | $381 | 2.6× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$350–$385 | $500–$550 | varies |
| Skull less than 4 views (70250) | $450.80 | $644 | 3.7× |
| Sternoclavicular joints (71130) | $374.50 | $535 | 3.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$294–$308.70 | $420–$441 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$352.80–$363.30 | $504–$519 | varies |
| Thoracolumbar 2 views (72080) | $351.40 | $502 | 3.4× |
| Ultrasound Breast Limited (76642) | $448.70 | $641 | 4.4× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$429.80–$472.50 | $614–$675 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$546–$600.60 | $780–$858 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $340.20 | $486 | 3.3× |
| Unlisted us procedure (76999) | $239.40 | $342 | 2.3× |
| Us chest (76604) range across 3 matching MRF lines |
$438.90–$483 | $627–$690 | varies |
| Us complete joint (76881) | $313.60 | $448 | 2.5× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$359.10–$369.60 | $513–$528 | varies |
| Us kidney transplant (76776) | $387.80 | $554 | 3.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$350–$385 | $500–$550 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$626.50–$689.50 | $895–$985 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$374.50–$412.30 | $535–$589 | varies |
| Us ob transvaginal (76817) | $402.50 | $575 | 3.3× |
| Us pelvic non ob complete (76856) | $448.70 | $641 | 3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $455.70 | $651 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $682.50 | $975 | 5.5× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$638.40–$657.30 | $912–$939 | varies |
| Us retroperitoneal limited (76775) | $421.40 | $602 | 3.4× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$399.70–$439.60 | $571–$628 | varies |
| Us spinal canal and contents (76800) | $291.90 | $417 | 2.4× |
| Us thyroid (76536) range across 2 matching MRF lines |
$492.10–$506.80 | $703–$724 | varies |
| Us transrectal (76872) | $1,123.50 | $1,605 | 9.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$233.10–$245 | $333–$350 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $408.10 | $583 | 4.0× |
| X-Ray Bend Only L-S Spine (72120) | $385 | $550 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$247.10–$271.60 | $353–$388 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $321.30 | $459 | 3.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$415.80–$457.10 | $594–$653 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$151.90–$167.30 | $217–$239 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$319.20–$329 | $456–$470 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $294 | $420 | 2.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $387.10 | $553 | 3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$615.30–$633.50 | $879–$905 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $920.50 | $1,315 | 7.5× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$443.10–$456.40 | $633–$652 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$231.70–$254.80 | $331–$364 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $422.10 | $603 | 3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$430.50–$443.10 | $615–$633 | varies |
| X-ray eye for foreign body (70030) | $252.70 | $361 | 2.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$264.60–$272.30 | $378–$389 | varies |
| X-ray IV pyelogram (ivp) (74400) | $555.10 | $793 | 2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $217 | $310 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$322–$354.20 | $460–$506 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$330.40–$363.30 | $472–$519 | varies |
| X-ray nose-rectum child f.b. (76010) | $422.10 | $603 | 4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $311.50 | $445 | 2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$207.90–$228.90 | $297–$327 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $222.60 | $318 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$270.20–$297.50 | $386–$425 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $289.80 | $414 | 2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $422.80 | $604 | 3.4× |
| X-Ray Stress View (77071) | $236.60 | $338 | 2.3× |
| X-ray thoracic spine 4 vw (72074) | $374.50 | $535 | 3.0× |
| X-Ray Tmj Unilat (70328) | $72.80 | $104 | 0.7× |
| X-Rays Bone Length Studies (77073) | $88.20 | $126 | 0.7× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$761.60–$837.90 | $1,088–$1,197 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$426.30–$447.30 | $609–$639 | varies |
| Xr facial bones less than 3 views (70140) | $221.20 | $316 | 2.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $88.20 | $126 | 0.7× |
| Xr orbits complete 4 views (70200) | $450.80 | $644 | 3.7× |
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.