Imaging prices at Nemaha Valley Community Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $399.60 $444 4.2×
Acute gastrointestinal blood loss imaging (78278) $1,068.30 $1,187 2.9×
Ankle 2 views (73600) $208.80 $232 2.6×
Arthrogram shoulder (73040) $476.10 $529 1.5×
Bone &/Joint Imaging Limited Area (78300) $918 $1,020 2.5×
Bone &/Joint Imaging Multiple Areas (78305) $1,058.40 $1,176 2.9×
Bone &/joint imaging whole body (78306) $1,328.40 $1,476 3.6×
Bone age studies (77072) $222.30 $247 2.3×
Bone Imaging 3 Phase (78315) $1,544.40 $1,716 4.2×
Brain image w/flow 4 + views (78606) $969.30 $1,077 1.9×
Brain Imaging Minimum 4 Static Views (78605) $908.10 $1,009 1.8×
Cardiac MRI w/w/o contrast & further seq (75561) $1,789.92 $1,988.80 5.6×
Cervical spine 2 or 3 views (72040) $263.70 $293 3.3×
Chest 1 view (71045) $218.70 $243 2.7×
Chest 3 views (71047) $352.35 $391.50 4.4×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $330.30 $367 2.0×
Clavicle complete (73000) $250.20 $278 3.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,557.90 $1,731 16.2×
CT abdomen and pelvis without and with contrast (74178) $2,499.75 $2,777.50 7.8×
CT abdomen and pelvis without contrast (74176) $2,100.15 $2,333.50 9.6×
CT abdomen w contrast (74160) $1,655.10 $1,839 10.3×
CT abdomen w wo contrast (74170) $1,764 $1,960 10.9×
CT abdomen w/o contrast (74150) $1,557.90 $1,731 16.2×
CT c-spine w/o contrast (72125) $1,557.90 $1,731 16.2×
CT cervical spine w&w/o contrast (72127) $1,764 $1,960 10.9×
CT cervical spine with contrast (72126) $1,655.10 $1,839 5.2×
CT chest w/wo contrast (71270) $1,746.90 $1,941 10.8×
CT chest with contrast (71260) $1,638.90 $1,821 10.2×
CT head/brain with contrast (70460) $1,655.10 $1,839 10.3×
CT head/brain without and with contrast (70470) $1,764 $1,960 10.9×
CT heart no contrast quant eval coronry calcium (75571) $90 $100 1.1×
CT iac w contrast (70481) $1,655.10 $1,839 10.3×
CT limited/localized follow up study (76380) $809.10 $899 10.1×
CT lower ext w/o (73700) $1,557.90 $1,731 16.2×
CT lower extremity w wo contrast (73702) $2,504.70 $2,783 15.5×
CT lower extremity with contrast (73701) $2,354.85 $2,616.50 14.6×
CT lumbar spine w & w/o contrast (72133) $1,764 $1,960 10.9×
CT lumbar spine w/o contrast (72131) $1,557.90 $1,731 16.2×
CT lumbar spine with contrast (72132) $1,655.10 $1,839 5.2×
CT maxillofacial w contrast (70487) $1,655.10 $1,839 10.3×
CT maxillofacial w/o contrast (70486) $1,557.90 $1,731 16.2×
CT maxillofacial w/wo contrast (70488) $1,764 $1,960 10.9×
CT neck soft tissue w contrast (70491) $1,655.10 $1,839 10.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,764 $1,960 10.9×
CT orbits w/o contrast (70480) $1,557.90 $1,731 16.2×
CT pelvis w & w/o contrast (72194) $1,764 $1,960 10.9×
CT pelvis w/o contrast (72192) $1,557.90 $1,731 16.2×
CT soft tissue neck w/o & w/contrast material (70492) $1,764 $1,960 10.9×
CT soft tissue neck w/o contrast (70490) $1,557.90 $1,731 16.2×
CT thoracic spine w/contrast (72129) $1,655.10 $1,839 10.3×
CT thoracic spine w/o contrast (72128) $1,557.90 $1,731 16.2×
CT thoracic spine w/wo contrast (72130) $1,764 $1,960 10.9×
CT thorax w/o contrast (71250) $1,542.60 $1,714 16.0×
CT upper extremity w/o & w/contrast material (73202) $2,504.70 $2,783 15.5×
CT upper extremity w/o contrast rt (73200) $2,216.25 $2,462.50 23.0×
CT upper extremity with contrast (73201) $2,354.85 $2,616.50 7.3×
CTA abdomen pelvis (74174) $2,124.90 $2,361 6.6×
CTA chest (71275) $2,025 $2,250 12.6×
Cta Head (70496) $1,380.60 $1,534 8.6×
CTA lwr ext w&w/o contrast (73706) $2,025 $2,250 12.6×
Cta Neck (70498) $1,640.70 $1,823 10.2×
Cystography minimum 3 views rs&i (74430) $512.10 $569 1.6×
Dxa bone density study 1/> sites axial skel (77080) $355.50 $395 3.7×
Esophagus (74220) $262.80 $292 1.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $770.40 $856 8.0×
Fluoroscopy up to 1 hr (76000) $303.30 $337 1.4×
Foot 2 views (73620) $208.80 $232 2.6×
Forearm 2 views (73090) $241.20 $268 3.0×
Gated Heart Planar Single (78472) $1,828.80 $2,032 5.0×
Hand 2 views (73120) $222.30 $247 2.3×
Hand 3 views (73130) $241.20 $268 3.0×
Heart Infarct Image (78466) $921.60 $1,024 2.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,058.40 $1,176 2.1×
Hepatobiliary syst imaging including gallbladder (78226) $969.30 $1,077 2.6×
Ht muscle image spect sing (78451) $2,848.50 $3,165 2.4×
Humerus Min 2 Views Left (73060) $241.20 $268 3.0×
Hysterosalpingogram (74740) $632.70 $703 2.9×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $237.60 $264 2.5×
Kidney funcj study non-img radioisotopic study (78725) $1,129.50 $1,255 3.1×
Kidney imaging morphology (78700) $939.60 $1,044 2.6×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,318.50 $1,465 2.6×
Kidney img morphology vascular flow 1 w/rx (78708) $1,677.60 $1,864 3.4×
Knee 3 views (73562) $286.20 $318 3.6×
Liver & spleen imaging static only (78215) $908.10 $1,009 2.5×
Liver & Spleen Imaging W/Vascular Flow (78216) $969.30 $1,077 2.6×
Liver imaging w/vascular flow (78202) $364.50 $405 0.7×
Lung perf&ventilat diferentl (78598) $2,080.80 $2,312 4.2×
Lung Ventilation Imaging (78579) $939.60 $1,044 2.6×
Lymphoscintigraphy (78195) $1,049.40 $1,166 2.1×
Meckels Diverticulum (78290) $939.60 $1,044 2.6×
MRA head w & w/o contrast (70546) $1,535.04 $1,705.60 4.8×
MRA head w/o contrast (70544) $1,535.04 $1,705.60 7.0×
Mra Neck W/O &W/Contrast Material (70549) $1,918.80 $2,132 6.0×
MRA neck w/o contrast (70547) $1,504.80 $1,672 6.9×
MRI abdomen w contrast (74182) $1,789.92 $1,988.80 5.6×
MRI abdomen w/o & w/contrast material (74183) $2,305.44 $2,561.60 7.2×
MRI abdomen w/o contrast (74181) $1,789.92 $1,988.80 8.2×
MRI bone marrow blood supply (77084) $1,789.92 $1,988.80 8.2×
MRI c-spine with contrast (72142) $1,789.92 $1,988.80 5.6×
MRI cardiac w/o contrast (75557) $1,789.92 $1,988.80 8.2×
MRI cervical spine w/o contrast (72141) $1,789.92 $1,988.80 8.2×
MRI chest w/o & w/contrast material (71552) $2,305.44 $2,561.60 7.2×
MRI chest w/o contrast (71550) $1,789.92 $1,988.80 8.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,789.92 $1,988.80 5.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,754.64 $1,949.60 8.0×
MRI orbit face &/neck w/o contrast (70540) $1,789.92 $1,988.80 8.2×
MRI orbit/face/neck w&w/o cont (70543) $2,305.44 $2,561.60 7.2×
MRI pelvis w contrast (72196) $1,981.44 $2,201.60 6.2×
MRI pelvis w/o & w/contrast material (72197) $2,305.44 $2,561.60 7.2×
MRI pelvis w/o contrast (72195) $1,789.92 $1,988.80 8.2×
MRI scan of arm joint before and after contrast (73223) $2,260.08 $2,511.20 7.0×
MRI scan of leg joint before and after contrast (73723) $1,869.12 $2,076.80 5.8×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,869.12 $2,076.80 5.8×
MRI spinal canal lumbar w/contrast material (72149) $1,789.92 $1,988.80 5.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,869.12 $2,076.80 5.8×
MRI spinal canal thoracic w/contrast matrl (72147) $1,789.92 $1,988.80 5.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,869.12 $2,076.80 5.8×
MRI thoracic spine w/o contrast (72146) $1,789.92 $1,988.80 8.2×
MRI tmj (70336) $1,789.92 $1,988.80 8.2×
MRI upper ext joint w/o contrast (73221) $1,789.92 $1,988.80 8.2×
MRI upper extrem other than jt w/o & w/contras (73220) $1,869.12 $2,076.80 5.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,789.92 $1,988.80 8.2×
Myelogram Lumbar (72265) $4,512.60 $5,014 6.3×
Myocardial Spect Multiple Studies (78452) $3,045.60 $3,384 2.6×
Neck soft tissue (70360) $263.70 $293 3.3×
Nm gastric emptying study (78264) $1,301.40 $1,446 3.5×
Nuclear medicine study of kidney and blood flow (78701) $1,129.50 $1,255 3.1×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $706.50 $785 7.3×
Osseous survey infant (77076) $803.70 $893 8.4×
Osseous survey limited (77074) $1,101.60 $1,224 11.5×
Parathyroid imaging (78070) $1,162.80 $1,292 3.2×
Pelvis 1 or 2 views (72170) $286.20 $318 3.0×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,869.12 $2,076.80 5.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,598.40 $1,776 3.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $407.70 $453 5.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $426.60 $474 4.4×
Radex mastoids compl minimum 3 views pr side (70130) $311.40 $346 3.2×
Radiolog exam mandible compl minimum 4 views (70110) $279.90 $311 2.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $379.35 $421.50 4.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $399.60 $444 4.2×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $250.20 $278 3.1×
Radiologic exam colon single contrast study (74270) $1,313.10 $1,459 8.1×
Radiologic Exam Esophagus Double Contrast Study (74221) $262.80 $292 1.6×
Radiologic exam upr gi trc double contrast study (74246) $711.45 $790.50 4.4×
Radiologic exam upr gi trc single contrast study (74240) $693.45 $770.50 4.3×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $353.70 $393 4.4×
Radiological examination surgical specimen (76098) $100.80 $112 0.2×
Rp loclzj tum plnr whole body single day imaging (78802) $1,612.80 $1,792 3.2×
Rp loclzj tum spect 1 area single day imaging (78803) $1,724.40 $1,916 3.5×
Salivary gland imaging (78230) $860.40 $956 2.3×
Scanogram (77073) $361.80 $402 3.8×
Scapula complete (73010) $245.70 $273 2.6×
Screening digital breast tomosynthesis (77063) $90 $100 3.8×
Sella turcica (70240) $298.80 $332 3.7×
Shuntogram indwelling nonvascular shunt rs&i (75809) $515.70 $573 5.4×
Sialogram (70390) $412.20 $458 1.9×
Small bowel series (74250) $565.20 $628 3.5×
Spine thoracic 3 views (72072) $257.40 $286 2.7×
Spleen imaging only (78185) $908.10 $1,009 2.5×
Testicular Imaging With Vascular Flow (78761) $849.60 $944 2.3×
Thoracolumbar 2 views (72080) $247.50 $275 3.1×
Thyroid Imaging With Vascular Flow (78013) $990.90 $1,101 2.7×
Thyroid uptake measurement (78012) $990.90 $1,101 2.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $734.40 $816 2.0×
Ultrasound, abdomen limited (76705) $230.40 $256 2.4×
Unlisted Diagnostic Radiographic Procedure (76499) $286.20 $318 3.6×
Upper Extremity Infant (73092) $203.40 $226 2.1×
Urethrocystography retrograde rs&i (74450) $325.80 $362 1.5×
Urethrocystography voiding (74455) $641.70 $713 2.9×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $336.15 $373.50 2.1×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $581.40 $646 3.6×
Us abdl aorta screen aaa (76706) $706.50 $785 7.3×
Us breast unilateral complete (76641) $639 $710 6.6×
Us breast unilateral limited (76642) $270 $300 3.4×
Us chest (76604) $276.30 $307 2.9×
Us compl joint r-t w/image documentation (76881) $541.80 $602 5.6×
Us infant hips dynamic (76885) $541.80 $602 6.8×
Us ob transvaginal (76817) $557.10 $619 5.8×
Us pelvic non ob complete (76856) $763.20 $848 7.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $337.50 $375 3.5×
Us pregnancy ltd (76815) $100.80 $112 1.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $586.80 $652 6.1×
Us retroperitoneal complete (76770) $810.90 $901 8.4×
Us retroperitoneal limited (76775) $706.50 $785 7.3×
Us scrotum and contents (76870) $763.20 $848 7.9×
Us soft tissue head/neck (76536) $495 $550 5.1×
Us spinal canal and contents (76800) $541.80 $602 5.6×
Us transrectal (76872) $685.80 $762 7.1×
Us transrectal prostate volume (76873) $763.20 $848 7.9×
Us xtr non-vasc lmtd (76882) $353.70 $393 3.7×
Vascular flow imaging (78445) $747 $830 2.0×
Venography extremity unilateral rs&i (75820) $517.50 $575 0.4×
Venography venous sinus/jugular cath rs&i (75860) $675 $750 0.2×
Wrist 2 views (73100) $208.80 $232 2.6×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $396 $440 4.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $290.70 $323 3.6×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $236.70 $263 3.0×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,313.10 $1,459 8.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $208.80 $232 2.6×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $241.20 $268 3.0×
X-ray exam entire spi 4/5 vw (72083) $450 $500 4.7×
X-ray exam hip uni 1 view (73501) $286.20 $318 3.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $326.70 $363 4.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $365.40 $406 3.8×
X-ray exam of femur 1 (73551) $326.70 $363 4.1×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $311.40 $346 3.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $279.90 $311 3.5×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $241.20 $268 3.0×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $250.20 $278 3.1×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $360.90 $401 3.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $250.20 $278 3.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $191.70 $213 2.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $239.40 $266 2.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $420.30 $467 4.4×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $264.60 $294 2.8×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $247.50 $275 3.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $311.40 $346 3.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $311.40 $346 3.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $250.20 $278 3.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $415.80 $462 4.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $223.20 $248 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $250.20 $278 3.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $243.90 $271 3.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $311.40 $346 3.9×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $279.90 $311 3.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $311.40 $346 3.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $279.90 $311 2.9×
X-Ray Spine One View - Xr Spine (72020) $407.70 $453 5.1×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $415.80 $462 5.2×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $250.20 $278 3.1×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $262.80 $292 2.7×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $250.20 $278 3.1×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $241.20 $268 3.0×
Xr c-spine 6 or more views (72052) $378.90 $421 3.9×
Xr chest 4+ views (71048) $415.80 $462 4.3×
Xr finger(s) 2+ views (73140) $241.20 $268 3.0×
XR Mastoids < 3 Views Bilateral (70120) $279.90 $311 2.9×
Xr optic foramina (70190) $298.80 $332 3.7×
Xr shoulder 1 view (73020) $205.20 $228 2.6×
Xr spine cervical 4 or 5 views (72050) $360 $400 3.7×
Xr tibia/fibula 2 views (73590) $241.20 $268 3.0×
Xray knee 1 or 2 views rt (73560) $250.20 $278 3.1×