Imaging prices at Mosaic Medical Center - Maryville

Maryville, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $340 $400 3.9×
Abdomen 2 views (74019) $425 $500 4.1×
Ankle 2 views (73600) $382.50 $450 4.4×
Arthrogram hip (73525) $1,020 $1,200 2.9×
Arthrogram Wrist (73115) $850 $1,000 2.4×
Bone age studies (77072) $391 $460 3.7×
Bone Imaging 3 Phase (78315) $2,125 $2,500 5.3×
Bone Imaging Limited Area (78300) $1,105 $1,300 2.8×
Bone Imaging Whole Body (78306) $1,870 $2,200 4.7×
Chest 1 view (71045) $361.25 $425 4.1×
Chest 2 views (71046) $382.50 $450 4.4×
Chest 4 or more views (71048) $595 $700 5.7×
Clavicle complete (73000) $382.50 $450 4.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $255 $300 2.4×
Contrast X-Ray Of Elbow (73085) $935 $1,100 2.7×
CT abdomen and pelvis without and with contrast (74178) $3,825 $4,500 10.9×
CT abdomen and pelvis without contrast (74176) $2,125 $2,500 8.9×
CT abdomen w contrast (74160) $2,550 $3,000 14.5×
CT abdomen w wo contrast (74170) $3,060 $3,600 17.4×
CT abdomen w/o contrast (74150) $1,870 $2,200 17.9×
CT Angio Abdomen and Pelvis (74174) $3,315 $3,900 9.5×
CT Angio Chest (71275) $2,975 $3,500 16.9×
CT Angio Head (70496) $2,975 $3,500 16.9×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,975 $3,500 16.9×
CT Angio Neck (70498) $2,975 $3,500 16.9×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,975 $3,500 16.9×
CT cervical spine w/o contrast (72125) $2,125 $2,500 20.3×
CT cervical spine w/wo cont (72127) $2,720 $3,200 15.5×
CT chest w contrast (71260) $2,720 $3,200 15.5×
CT chest w/wo contrast (71270) $2,975 $3,500 16.9×
CT head/brain with contrast (70460) $2,550 $3,000 14.5×
CT head/brain without and with contrast (70470) $2,720 $3,200 15.5×
CT heart no contrast quant eval coronry calcium (75571) $42.50 $50 0.5×
CT iac w contrast (70481) $2,550 $3,000 14.5×
CT l-spine w&w/o contrast (72133) $2,805 $3,300 16.0×
CT lower ext w/o (73700) $2,125 $2,500 20.3×
CT lower extremity w/contrast material (73701) $2,550 $3,000 14.5×
CT lumbar spine w contrast (72132) $2,550 $3,000 7.3×
CT lumbar spine w/o contrast (72131) $2,125 $2,500 20.3×
CT maxillofacial w contrast (70487) $2,550 $3,000 14.5×
CT maxillofacial wo contrast (70486) $1,955 $2,300 18.7×
CT neck tissue combo (70492) $2,720 $3,200 15.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,720 $3,200 15.5×
CT orbits w/o contrast (70480) $1,955 $2,300 18.7×
CT pelvis w&w/o contrast (72194) $2,295 $2,700 13.1×
CT pelvis w/o contrast (72192) $1,785 $2,100 17.0×
CT scan of leg combo (73702) $2,720 $3,200 15.5×
CT scans face/jaw combo (70488) $2,690.25 $3,165 15.3×
CT soft tissue neck w contrast (70491) $2,550 $3,000 14.5×
CT soft tissue neck w/o contrast (70490) $1,955 $2,300 18.7×
CT thoracic spine w contrast (72129) $2,720 $3,200 15.5×
CT thoracic spine w/o contrast (72128) $1,700 $2,000 16.2×
CT thorax w/o contrast (71250) $2,125 $2,500 20.3×
CT upper ext wo (73200) $1,700 $2,000 16.2×
CT upper extremity w/o & w/contrast material (73202) $2,550 $3,000 14.5×
CT upper extremity with contrast (73201) $2,125 $2,500 6.1×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,975 $3,500 16.9×
Cta Abdomen (74175) $2,975 $3,500 16.9×
CTA pelvis (72191) $2,975 $3,500 16.9×
Doppler Echo Fetal Spectral Display Complete (76827) $488.75 $575 4.7×
Dxa Bone Density Axial (77080) $425 $500 4.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $276.25 $325 3.2×
Esophagram (74220) $680 $800 3.9×
Fetal Biophys Profile W/Nst (76818) $807.50 $950 7.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $680 $800 6.5×
Fluoroscopy up to 1 hr (76000) $1,020 $1,200 4.3×
Foot 2 views (73620) $382.50 $450 4.4×
Forearm 2 views (73090) $425 $500 4.9×
Gastric emptying imaging study (78264) $1,870 $2,200 4.7×
Hand 2 views (73120) $382.50 $450 3.7×
Hepatobil Syst Image W/Drug (78227) $2,125 $2,500 3.9×
Ht Muscle Image Spect Sing (78451) $1,232.50 $1,450 1.0×
Hysterosalpingogram (74740) $850 $1,000 3.6×
Knee 3 Views (73562) $467.50 $550 5.4×
Lung Ventilat&Perfus Imaging (78582) $2,125 $2,500 3.9×
Lymph System Imaging (78195) $1,955 $2,300 3.6×
Magnetic Image Jaw Joint (70336) $2,125 $2,500 8.9×
Magnetic Resonance Elastography (76391) $1,003 $1,180 4.2×
Meckels Divert Exam (78290) $1,365.95 $1,607 3.4×
Mr safety determination physician/other qhp (76016) $403.75 $475 4.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $112.20 $132 3.9×
Mra Head W/O & W/Contrast Material (70546) $2,125 $2,500 6.1×
MRA head w/o contrast (70544) $2,380 $2,800 10.0×
MRA head with contrast (70545) $2,380 $2,800 6.8×
MRA neck w contrast (70548) $2,210 $2,600 6.3×
Mra Neck W/O &W/Contrast Material (70549) $3,060 $3,600 8.8×
MRA neck w/o contrast (70547) $2,550 $3,000 10.7×
MRI abdomen w/o contrast (74181) $2,125 $2,500 8.9×
MRI any jt lower extrem w/contrast material (73722) $2,550 $3,000 3.2×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,400 $4,000 9.7×
MRI any jt upper extremity w/contrast matrl (73222) $2,975 $3,500 3.8×
MRI brain functional w/o physician admnistration (70554) $1,003 $1,180 4.2×
MRI cervical spine w contrast (72142) $2,550 $3,000 7.3×
MRI cervical spine w/o cont (72141) $2,125 $2,500 8.9×
MRI chest w/o contrast (71550) $2,550 $3,000 10.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,400 $4,000 9.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,380 $2,800 10.0×
MRI lumbar spine w contrast (72149) $2,550 $3,000 7.3×
Mri Neck Spine W/O & W/Dye (72156) $3,485 $4,100 10.0×
MRI orbit face &/neck w/o contrast (70540) $1,275 $1,500 5.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,655 $4,300 10.5×
MRI pelvis w/o & w contrast (72197) $3,400 $4,000 9.7×
MRI pelvis w/o contrast (72195) $2,550 $3,000 10.7×
MRI spectroscopy (76390) $374 $440 4.3×
MRI thoracic spine w/o contrast (72146) $2,125 $2,500 8.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,380 $2,800 10.0×
Mri Uppr Extremity W/O&W/Dye (73220) $3,400 $4,000 9.7×
MRI, abdomen, combo (74183) $3,315 $3,900 9.5×
MRI, dorsal spine combo (72157) $3,485 $4,100 10.0×
MRI, dorsal spine contrast (72147) $2,550 $3,000 7.3×
MRI, joint upper extrem (73221) $2,380 $2,800 10.0×
MRI, joint upper extrem combo (73223) $3,400 $4,000 9.7×
MRI, lumbar spine combo (72158) $3,485 $4,100 10.0×
Myocardial Spect Multiple Studies (78452) $4,590 $5,400 3.5×
Neck soft tissue (70360) $425 $500 4.9×
Nonvascular Shunt X-Ray (75809) $531.25 $625 5.1×
Parathyroid Planar Imaging (78070) $1,700 $2,000 4.2×
Pelvis 1 or 2 views (72170) $361.25 $425 3.5×
PET image w/CT, full body (78816) $7,310 $8,600 5.1×
PET imaging CT attenuation skull base mid-thigh (78815) $6,630 $7,800 4.6×
Pulmonary Perfusion Imaging Particulate (78580) $1,445 $1,700 3.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $595 $700 5.7×
Radex abscess/fistula/sinus tract rs&i (76080) $1,105 $1,300 2.0×
Radex Ankle Complete Minimum 3 Views (73610) $340 $400 3.9×
Radex Calcaneus Minimum 2 Views (73650) $340 $400 3.9×
Radex elbow complete minimum 3 views (73080) $510 $600 5.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $510 $600 4.9×
Radex fingr minimum 2 views (73140) $382.50 $450 4.4×
Radex foot complete minimum 3 views (73630) $340 $400 3.9×
Radex Hand Minimum 3 Views (73130) $340 $400 3.9×
Radex lower extremity infant minimum 2 views (73592) $425 $500 4.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $425 $500 4.9×
Radex Ribs Unilateral 2 Views (71100) $425 $500 4.9×
Radex shoulder complete minimum 2 views (73030) $425 $500 4.9×
Radex Sternum Minimum 2 Views (71120) $425 $500 4.9×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $510 $600 5.9×
Radex Toe Minimum 2 Views (73660) $382.50 $450 4.4×
Radex upper extremity infant minimum 2 views (73092) $289 $340 2.8×
Radex Wrist Complete Minimum 3 Views (73110) $340 $400 3.9×
Radiolog exam mandible compl minimum 4 views (70110) $510 $600 4.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $595 $700 5.7×
Radiologic exam colon double contrast study (74280) $1,105 $1,300 6.3×
Radiologic exam colon single contrast study (74270) $1,020 $1,200 5.8×
Radiologic exam knee complete 4/more views (73564) $510 $600 4.9×
Radiologic exam pelvis compl minimum 3 views (72190) $510 $600 4.9×
Radiologic Exam Small Int Single Contrast Study (74250) $935 $1,100 5.3×
Radiologic exam swallow function contrast study (74230) $722.50 $850 4.1×
Radiologic exam upr gi trc double contrast study (74246) $1,275 $1,500 7.3×
Radiologic examination femur minimum 2 views (73552) $425 $500 4.9×
Radiologic examination knee 1/2 views (73560) $382.50 $450 4.4×
Radiologic examination tibia & fibula 2 views (73590) $382.50 $450 4.4×
Ribs bilateral 3 views (71110) $531.25 $625 5.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,400 $4,000 6.3×
Scapula (73010) $425 $500 4.1×
Screening Digital Breast Tomosynthesis Bi (77063) $85 $100 3.6×
Shoulder 1 view (73020) $361.25 $425 4.1×
Shoulder Arthrography (73040) $1,105 $1,300 3.2×
Skull less than 4 views (70250) $425 $500 4.1×
Stereotactic Body Radiation Delivery (77373) $5,525 $6,500 3.1×
Thoracic spine 2 views (72070) $425 $500 4.1×
Thoracic spine 3 views (72072) $510 $600 4.9×
Thoracolumbar 2 views (72080) $425 $500 4.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,870 $2,200 4.7×
Ultrasound Breast Limited (76642) $510 $600 5.9×
Ultrasound Exam Aaa Screen (76706) $510 $600 4.9×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $680–$935 $800–$1,100 varies
Unlisted fluoroscopic procedure (76496) $510 $600 5.9×
Upper gi w/o kub (74240) $1,020 $1,200 5.8×
Us breast unilateral complete (76641) $765 $900 7.3×
Us chest (76604) $616.25 $725 5.9×
Us complete joint (76881) $850 $1,000 8.1×
Us exam, pelvic, limited (76857) $595 $700 5.7×
Us kidney transplant (76776) $935 $1,100 8.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $765 $900 7.3×
Us ob limited 1 or more fetuses (76815) $637.50 $750 6.1×
Us ob transvaginal (76817) $807.50 $950 7.7×
Us pelvic non ob complete (76856) $1,020 $1,200 9.7×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $595 $700 5.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $510 $600 4.9×
Us retroperitoneal limited (76775) $595 $700 5.7×
Us spinal canal and contents (76800) $935 $1,100 8.9×
Us thyroid (76536) $680 $800 6.5×
Us transrectal (76872) $425 $500 4.1×
Wrist 2 views (73100) $382.50 $450 4.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $340 $400 3.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $425 $500 4.9×
X-Ray Exam Breast Specimen (76098) $935 $1,100 1.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $637.50 $750 6.1×
X-Ray Exam Hip Uni 1 View (73501) $361.25 $425 4.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $340 $400 3.9×
X-Ray Exam Hip Uni 4/> Views (73503) $595 $700 5.7×
X-Ray Exam Hips Bi 2 Views (73521) $510 $600 4.9×
X-Ray Exam Hips Bi 5/> Views (73523) $850 $1,000 8.1×
X-Ray Exam L-S Spine Bending (72114) $807.50 $950 7.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $510 $600 5.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $680 $800 6.5×
X-Ray Exam Unilat Ribs/Chest (71101) $510 $600 4.9×
X-ray eye for foreign body (70030) $510 $600 5.9×
X-ray humerus (73060) $425 $500 4.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $425 $500 4.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $425 $500 4.1×
X-ray nose-rectum child f.b. (76010) $340 $400 3.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $552.50 $650 5.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $510 $600 4.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $425 $500 4.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $510 $600 5.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $531.25 $625 5.1×
X-Rays Bone Length Studies (77073) $637.50 $750 6.1×
X-Rays Bone Survey Complete (77075) $680 $800 6.5×
Xr c-spine 4 or 5 views (72050) $531.25 $625 5.1×
Xr orbits complete 4 views (70200) $510 $600 4.9×

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.