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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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $425 $500 4.1×
Ankle 2 views (73600) $382.50 $450 4.4×
Arthrogram elbow (73085) $935 $1,100 2.7×
Arthrogram hip (73525) $1,020 $1,200 2.9×
Arthrogram shoulder (73040) $1,105 $1,300 3.2×
Arthrogram wrist (73115) $850 $1,000 2.4×
Bone &/Joint Imaging Limited Area (78300) $1,105 $1,300 2.8×
Bone &/joint imaging whole body (78306) $1,870 $2,200 4.7×
Bone age studies (77072) $391 $460 3.7×
Bone Imaging 3 Phase (78315) $2,125 $2,500 5.3×
Bone survey complete (77075) $680 $800 6.5×
Cervical spine 2 or 3 views (72040) $510 $600 5.9×
Chest 1 view (71045) $361.25 $425 4.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $722.50 $850 4.1×
Clavicle complete (73000) $382.50 $450 4.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $255 $300 2.4×
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 angiography upper extremity lt (73206) $2,975 $3,500 16.9×
CT c-spine w/o contrast (72125) $2,125 $2,500 20.3×
CT cervical spine w&w/o contrast (72127) $2,720 $3,200 15.5×
CT chest w/wo contrast (71270) $2,975 $3,500 16.9×
CT chest with contrast (71260) $2,720 $3,200 15.5×
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 lower ext w/o (73700) $2,125 $2,500 20.3×
CT lower extremity w wo contrast (73702) $2,720 $3,200 15.5×
CT lower extremity with contrast (73701) $2,550 $3,000 14.5×
CT lumbar spine w & w/o contrast (72133) $2,805 $3,300 16.0×
CT lumbar spine w/o contrast (72131) $2,125 $2,500 20.3×
CT lumbar spine with contrast (72132) $2,550 $3,000 7.3×
CT maxillofacial w contrast (70487) $2,550 $3,000 14.5×
CT maxillofacial w/o contrast (70486) $1,955 $2,300 18.7×
CT maxillofacial w/wo contrast (70488) $2,690.25 $3,165 15.3×
CT neck soft tissue w contrast (70491) $2,550 $3,000 14.5×
CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) $2,720 $3,200 15.5×
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 extremity w/o & w/contrast material (73202) $2,550 $3,000 14.5×
CT upper extremity w/o contrast rt (73200) $1,700 $2,000 16.2×
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 abdomen pelvis (74174) $3,315 $3,900 9.5×
CTA chest (71275) $2,975 $3,500 16.9×
Cta Head (70496) $2,975 $3,500 16.9×
CTA lwr ext w&w/o contrast (73706) $2,975 $3,500 16.9×
Cta Neck (70498) $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 study 1/> sites axial skel (77080) $425 $500 4.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $276.25 $325 3.2×
Esophagus (74220) $680 $800 3.9×
Fetal biophysical profile non-stress testing (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×
Functional MRI brain by tech (70554) $1,003 $1,180 4.2×
Hand 2 views (73120) $382.50 $450 3.7×
Hand 3 views (73130) $340 $400 3.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $2,125 $2,500 3.9×
Ht muscle image spect sing (78451) $1,232.50 $1,450 1.0×
Humerus Min 2 Views Left (73060) $425 $500 4.9×
Hysterosalpingogram (74740) $850 $1,000 3.6×
Knee 3 views (73562) $467.50 $550 5.4×
Lymphoscintigraphy (78195) $1,955 $2,300 3.6×
Meckels Diverticulum (78290) $1,365.95 $1,607 3.4×
Mr elastography (76391) $1,003 $1,180 4.2×
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 & w/o contrast (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 & w/contrast material (74183) $3,315 $3,900 9.5×
MRI abdomen w/o contrast (74181) $2,125 $2,500 8.9×
MRI any jnt lwr ext with con lt (73722) $2,550 $3,000 3.2×
MRI any jt upper extremity w/contrast matrl (73222) $2,975 $3,500 3.8×
MRI c-spine with contrast (72142) $2,550 $3,000 7.3×
MRI cervical spine w/o contrast (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 contr matrl (73718) $2,380 $2,800 10.0×
MRI orbit face &/neck w/o contrast (70540) $1,275 $1,500 5.3×
MRI orbit/face/neck w&w/o cont (70543) $3,655 $4,300 10.5×
MRI pelvis w/o & w/contrast material (72197) $3,400 $4,000 9.7×
MRI pelvis w/o contrast (72195) $2,550 $3,000 10.7×
MRI scan of arm joint before and after contrast (73223) $3,400 $4,000 9.7×
MRI scan of leg joint before and after contrast (73723) $3,400 $4,000 9.7×
MRI spectroscopy (76390) $374 $440 4.3×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,485 $4,100 10.0×
MRI spinal canal lumbar w/contrast material (72149) $2,550 $3,000 7.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,485 $4,100 10.0×
MRI spinal canal thoracic w/contrast matrl (72147) $2,550 $3,000 7.3×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,485 $4,100 10.0×
MRI thoracic spine w/o contrast (72146) $2,125 $2,500 8.9×
MRI tmj (70336) $2,125 $2,500 8.9×
MRI upper ext joint w/o contrast (73221) $2,380 $2,800 10.0×
MRI upper extrem other than jt w/o & w/contras (73220) $3,400 $4,000 9.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,380 $2,800 10.0×
Myocardial Spect Multiple Studies (78452) $4,590 $5,400 3.5×
Neck soft tissue (70360) $425 $500 4.9×
Nm gastric emptying study (78264) $1,870 $2,200 4.7×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $510 $600 4.9×
Parathyroid imaging (78070) $1,700 $2,000 4.2×
Pelvis 1 or 2 views (72170) $361.25 $425 3.5×
PET image w/CT, skull-thigh (78815) $6,630 $7,800 4.6×
PET imaging for CT attenuation whole body (78816) $7,310 $8,600 5.1×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $3,400 $4,000 9.7×
Pulmonary Perfusion Imaging Particulate (78580) $1,445 $1,700 3.6×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,125 $2,500 3.9×
Radex abscess/fistula/sinus tract rs&i (76080) $1,105 $1,300 2.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $637.50 $750 6.1×
Radex hips bilateral with pelvis 2 views (73521) $510 $600 4.9×
Radiolog exam mandible compl minimum 4 views (70110) $510 $600 4.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $340 $400 3.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $595 $700 5.7×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $382.50 $450 4.4×
Radiologic exam colon single contrast study (74270) $1,020 $1,200 5.8×
Radiologic exam upr gi trc double contrast study (74246) $1,275 $1,500 7.3×
Radiologic exam upr gi trc single contrast study (74240) $1,020 $1,200 5.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $425 $500 4.9×
Radiological examination surgical specimen (76098) $935 $1,100 1.7×
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×
Scanogram (77073) $637.50 $750 6.1×
Scapula complete (73010) $425 $500 4.1×
Screening digital breast tomosynthesis (77063) $85 $100 3.6×
Shuntogram indwelling nonvascular shunt rs&i (75809) $531.25 $625 5.1×
Small bowel series (74250) $935 $1,100 5.3×
Spine thoracic 3 views (72072) $510 $600 4.9×
Stereotactic body radiation delivery (77373) $5,525 $6,500 3.1×
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, abdomen limited (76705) $807.50 $950 7.7×
Unlisted fluoroscopic procedure (76496) $510 $600 5.9×
Upper Extremity Infant (73092) $289 $340 2.8×
Us abdl aorta screen aaa (76706) $510 $600 4.9×
Us breast unilateral complete (76641) $765 $900 7.3×
Us breast unilateral limited (76642) $510 $600 5.9×
Us chest (76604) $616.25 $725 5.9×
Us compl joint r-t w/image documentation (76881) $850 $1,000 8.1×
Us kidney transplant (76776) $935 $1,100 8.9×
Us ob transvaginal (76817) $807.50 $950 7.7×
Us pelvic non ob complete (76856) $1,020 $1,200 9.7×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $595 $700 5.7×
Us pregnancy ltd (76815) $637.50 $750 6.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $595 $700 5.7×
Us retroperitoneal limited (76775) $595 $700 5.7×
Us soft tissue head/neck (76536) $680 $800 6.5×
Us spinal canal and contents (76800) $935 $1,100 8.9×
Us transrectal (76872) $425 $500 4.1×
Us xtr non-vasc lmtd (76882) $765 $900 7.3×
Wrist 2 views (73100) $382.50 $450 4.4×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $595 $700 5.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $340 $400 3.9×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $340 $400 3.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,105 $1,300 6.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $425 $500 4.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $510 $600 5.9×
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 5/> Views (73523) $850 $1,000 8.1×
X-ray eye for foreign body (70030) $510 $600 5.9×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $510 $600 4.9×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $340 $400 3.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $340 $400 3.9×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $510 $600 4.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $425 $500 4.9×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $425 $500 4.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $425 $500 4.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $807.50 $950 7.7×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $425 $500 4.9×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $340 $400 3.9×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $510 $600 4.9×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $510 $600 4.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $425 $500 4.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $510 $600 4.9×
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 Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $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-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $425 $500 4.1×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $425 $500 4.9×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $425 $500 4.1×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $382.50 $450 4.4×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $340 $400 3.9×
Xr c-spine 6 or more views (72052) $680 $800 6.5×
Xr chest 4+ views (71048) $595 $700 5.7×
Xr finger(s) 2+ views (73140) $382.50 $450 4.4×
Xr shoulder 1 view (73020) $361.25 $425 4.1×
Xr spine cervical 4 or 5 views (72050) $531.25 $625 5.1×
Xr tibia/fibula 2 views (73590) $382.50 $450 4.4×
Xr tmj bilateral (70330) $510 $600 5.9×
Xray knee 1 or 2 views rt (73560) $382.50 $450 4.4×