Imaging prices at North Valley Hospital

Tonasket, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $151.50 $303 1.3×
Ankle 2 views (73600) $151.50 $303 1.6×
Arthrogram ankle (73615) $852.02 $1,704.05 2.2×
Arthrogram elbow (73085) $852.02 $1,704.05 2.2×
Arthrogram hip (73525) $852.02 $1,704.05 2.2×
Arthrogram knee (73580) $852.02 $1,704.05 2.2×
Arthrogram shoulder (73040) $893.50 $1,787 2.3×
Arthrogram wrist (73115) $852.02 $1,704.05 2.2×
Bone age studies (77072) $151.50 $303 1.3×
Bone survey complete (77075) $253.50 $507 2.2×
Cervical spine 2 or 3 views (72040) $151.50 $303 1.6×
Chest 1 view (71045) $227.25 $454.50 2.3×
Chest xray 3 views (71047) $151.50 $303 1.6×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $295 $590 1.5×
Clavicle complete (73000) $151.50 $303 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $276.25 $552.50 2.4×
Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) $244.50 $489 2.5×
Contrast Xray Throat/Cerv Esopha (74210) $295 $590 1.5×
CT abdomen and pelvis without and with contrast (74178) $1,375 $2,750 3.5×
CT abdomen and pelvis without contrast (74176) $625.50 $1,251 2.4×
CT abdomen w contrast (74160) $1,050 $2,100 5.4×
CT abdomen w wo contrast (74170) $1,123.50 $2,247 5.7×
CT abdomen w/o contrast (74150) $657 $1,314 5.6×
CT angio lwr extr w/o&w/dye (73706) $1,949 $3,898 10.0×
CT angiography upper extremity lt (73206) $1,177.50 $2,355 6.0×
CT c-spine w/contrast (72126) $1,000.50 $2,001 2.6×
CT c-spine w/o contrast (72125) $657 $1,314 5.6×
CT cervical spine w&w/o contrast (72127) $1,123.50 $2,247 5.7×
CT chest w contrast (71260) $1,000.50 $2,001 5.1×
CT chest w/wo contrast (71270) $1,123.50 $2,247 5.7×
CT head/brain with contrast (70460) $1,000.50 $2,001 5.1×
CT head/brain without and with contrast (70470) $1,123.50 $2,247 5.7×
CT iac w contrast (70481) $1,000.50 $2,001 5.1×
CT limited/localized follow up study (76380) $657 $1,314 6.8×
CT lower ext w/o (73700) $657 $1,314 5.6×
CT lower extremity w wo contrast (73702) $1,123.50 $2,247 5.7×
CT lower extremity w/contrast material (73701) $1,000.50 $2,001 5.1×
CT lumbar spine w & w/o contrast (72133) $1,123.50 $2,247 5.7×
CT lumbar spine w/contrast (72132) $1,000.50 $2,001 2.6×
CT lumbar spine w/o contrast (72131) $657 $1,314 5.6×
CT maxillofacial w contrast (70487) $1,000.50 $2,001 5.1×
CT maxillofacial w/wo contrast (70488) $1,123.50 $2,247 5.7×
CT maxillofacial wo contrast (70486) $657 $1,314 5.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,123.50 $2,247 5.7×
CT orbits w/o contrast (70480) $657 $1,314 5.6×
CT pelvis w/o contrast (72192) $657 $1,314 5.6×
CT pelvis w/wo contrast (72194) $1,123.50 $2,247 5.7×
CT scan of arm combo (73202) $1,123.50 $2,247 5.7×
CT soft tissue neck w contrast (70491) $1,000.50 $2,001 5.1×
CT soft tissue neck w/o & w/contrast material (70492) $1,123.50 $2,247 5.7×
CT soft tissue neck w/o contrast (70490) $657 $1,314 5.6×
CT thoracic spine w/contrast (72129) $595.95 $1,191.90 3.0×
CT thoracic spine w/o contrast (72128) $657 $1,314 5.6×
CT thoracic spine w/wo contrast (72130) $1,129 $2,258 5.8×
CT thorax w/o contrast (71250) $657 $1,314 5.6×
CT upper ext wo (73200) $657 $1,314 5.6×
CT upper extremity with contrast (73201) $1,112.50 $2,225 2.9×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,092.50 $2,185 5.6×
Cta Abdomen (74175) $1,867.25 $3,734.50 9.6×
CTA abdomen pelvis (74174) $939 $1,878 2.4×
CTA chest (71275) $1,147 $2,294 5.9×
Cta Head (70496) $1,092 $2,184 5.6×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,250 $4,500 5.8×
Cta Neck (70498) $817.75 $1,635.50 4.2×
Cta Pelvis (72191) $1,123.50 $2,247 5.7×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $185.75 $371.50 1.6×
Doppler Echo Fetal Spectral Display Complete (76827) $183.90 $367.80 1.6×
Dxa bone density study 1/> sites axial skel (77080) $244.50 $489 2.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $98.50 $197 1.0×
Esophagus (74220) $295 $590 1.5×
Facial bones min 3 views (70150) $151.50 $303 1.3×
Fetal biophysical profile non-stress testing (76818) $328 $656 2.8×
Fluoroscopy up to 1 hr (76000) $412.50 $825 1.6×
Foot 2 views (73620) $151.50 $303 1.6×
Forearm 2 views (73090) $151.50 $303 1.6×
Hand 2 views (73120) $151.50 $303 1.3×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $151.50 $303 1.3×
Knee 3 views (73562) $194.50 $389 2.0×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,428 $2,856 1.6×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,295.33 $2,590.65 3.3×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $2,000 $4,000 5.1×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $151.50 $303 1.6×
MRA head w & w/o contrast (70546) $1,803.50 $3,607 4.6×
MRA head w/o contrast (70544) $1,177.50 $2,355 4.4×
MRA head with contrast (70545) $1,428 $2,856 3.7×
Mra Neck W/O &W/Contrast Material (70549) $1,803.50 $3,607 4.6×
MRA neck w/o contrast (70547) $1,177.50 $2,355 4.4×
MRI abdomen w contrast (74182) $1,428 $2,856 3.7×
MRI abdomen w/o & w/contrast material (74183) $1,803.50 $3,607 4.6×
MRI abdomen w/o contrast (74181) $1,177.50 $2,355 4.4×
MRI any jt lower extrem w/contrast material (73722) $1,428 $2,856 1.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,803.50 $3,607 4.6×
MRI c-spine with contrast (72142) $1,428 $2,856 3.7×
MRI cervical spine w/o contrast (72141) $1,177.50 $2,355 4.4×
MRI chest w/o & w/contrast material (71552) $1,803.50 $3,607 4.6×
MRI chest w/o contrast (71550) $1,177.50 $2,355 4.4×
MRI chest with contrast (71551) $1,428 $2,856 1.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,428 $2,856 3.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,803.50 $3,607 4.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,177.50 $2,355 4.4×
MRI orbit face &/neck w/o contrast (70540) $1,177.50 $2,355 4.4×
MRI orbit face neck w contrast (70542) $1,428 $2,856 3.7×
MRI orbit/face/neck w&w/o cont (70543) $1,803.50 $3,607 4.6×
MRI pelvis w/contrast (72196) $1,428 $2,856 3.7×
MRI pelvis w/o & w/contrast material (72197) $1,803.50 $3,607 4.6×
MRI pelvis w/o contrast (72195) $1,177.50 $2,355 4.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,803.50 $3,607 4.6×
MRI spinal canal lumbar w/contrast material (72149) $1,428 $2,856 3.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,803.50 $3,607 4.6×
MRI spinal canal thoracic w/contrast matrl (72147) $1,428 $2,856 3.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,803.50 $3,607 4.6×
MRI temporomandibular joint (70336) $1,177.50 $2,355 4.4×
MRI thoracic spine w/o contrast (72146) $1,177.50 $2,355 4.4×
MRI up ext w/o contrast (73218) $1,177.50 $2,355 4.4×
MRI upper ext joint w/o contrast (73221) $1,177.50 $2,355 4.4×
MRI, joint upper extrem combo (73223) $1,803.50 $3,607 4.6×
Myelogram Cervical (72240) $1,640.50 $3,281 1.9×
Myelogram Lumbar (72265) $1,640.50 $3,281 1.9×
Myelogram thoracic (72255) $1,640.50 $3,281 1.9×
Myelography 2 or more regions (72270) $1,640.50 $3,281 1.9×
Neck soft tissue (70360) $151.50 $303 1.6×
Osseous survey limited (77074) $253.50 $507 2.2×
Pelvis 1 or 2 views (72170) $151.50 $303 1.3×
Radex Ankle Compl Minimum 3 Views (73610) $175 $350 1.8×
Radex Calcaneus Minimum 2 Views (73650) $151.50 $303 1.6×
Radex Elbw Compl Minimum 3 Views (73080) $151.50 $303 1.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $253.50 $507 2.6×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $253.50 $507 2.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $307.50 $615 2.6×
Radex fingr minimum 2 views (73140) $151.50 $303 1.6×
Radex Foot Compl Minimum 3 Views (73630) $151.50 $303 1.6×
Radex Hand Minimum 3 Views (73130) $151.50 $303 1.6×
Radex Hip Unilateral With Pelvis 1 View (73501) $144.42 $288.82 1.5×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $307.50 $615 2.6×
Radex Hips Bilateral With Pelvis 2 Views (73521) $151.50 $303 1.3×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $307.50 $615 2.6×
Radex Humerus Minimum 2 Views (73060) $151.50 $303 1.6×
Radex Kne 1/2 Views (73560) $151.50 $303 1.6×
Radex Kne Compl 4/More Views (73564) $151.50 $303 1.3×
Radex Mndbl Compl Minimum 4 Views (70110) $151.50 $303 1.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $151.50 $303 1.6×
Radex Pelvis Compl Minimum 3 Views (72190) $151.50 $303 1.3×
Radex Sho Compl Minimum 2 Views (73030) $151.50 $303 1.6×
Radex Sinuses Paransl < 3 Views (70210) $151.50 $303 1.6×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $253.50 $507 2.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $151.50 $303 1.6×
Radex Toe Minimum 2 Views (73660) $151.50 $303 1.6×
Radex upper extremity infant minimum 2 views (73092) $151.50 $303 1.3×
Radex Wrst Compl Minimum 3 Views (73110) $151.50 $303 1.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $307.50 $615 2.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $151.50 $303 1.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $307.50 $615 2.6×
Radiologic exam chest 2 views (71046) $227.25 $454.50 2.3×
Radiologic exam colon single contrast study (74270) $295 $590 1.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $477 $954 2.4×
Radiologic exam upr gi trc double contrast study (74246) $295 $590 1.5×
Radiologic exam upr gi trc single contrast study (74240) $295 $590 1.5×
Radiologic examination femur 1 view (73551) $144.42 $288.82 1.5×
Radiologic examination tibia & fibula 2 views (73590) $151.50 $303 1.6×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $253.50 $507 0.4×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $151.50 $303 1.3×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $144.42 $288.82 1.2×
Ribs bilateral 3 views (71110) $151.50 $303 1.3×
Sacroiliac Joints < 3 Views (72200) $151.50 $303 1.3×
Scapula (73010) $151.50 $303 1.3×
Screening Digital Breast Tomosynthesis Bi (77063) $72.80 $145.60 3.1×
Sella turcica (70240) $151.50 $303 1.6×
Shoulder 1 view (73020) $151.50 $303 1.6×
Small bowel series (74250) $295 $590 1.5×
Spine thoracic 3 views (72072) $151.50 $303 1.3×
Thoracolumbar 2 views (72080) $151.50 $303 1.6×
Tmj unilateral (70328) $151.50 $303 1.6×
Ultrasound breast complete (76641) $356.25 $712.50 3.1×
Ultrasound Exam Aaa Screen (76706) $328 $656 2.8×
Ultrasound, abdomen limited (76705) $369.75 $739.50 3.2×
Umbilical-artery Doppler (OB) (76820) $201 $402 1.7×
Unlisted ultrasound procedure (76999) $207.50 $415 2.1×
Urethrocystogram voiding (74455) $578.50 $1,157 2.2×
Urethrocystography retrograde rs&i (74450) $578.50 $1,157 2.2×
Us chest (76604) $411.50 $823 3.5×
Us compl joint r-t w/image documentation (76881) $328 $656 2.8×
Us encephalogram (76506) $210.50 $421 1.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $268 $536 2.3×
Us ob limited (76815) $210.50 $421 1.8×
Us ob transvaginal (76817) $210.50 $421 1.8×
Us pelvic non ob complete (76856) $328 $656 2.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $310.50 $621 2.7×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $327 $654 2.8×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $210.50 $421 1.8×
Us retroperitoneal complete (76770) $328 $656 2.8×
Us retroperitoneal limited (76775) $328 $656 2.8×
Us scrotum and contents (76870) $328 $656 2.8×
Us soft tissue head/neck (76536) $328 $656 2.8×
Us spinal canal and contents (76800) $337.45 $674.90 2.9×
Wrist 2 views (73100) $151.50 $303 1.6×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $253.50 $507 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $144.42 $288.82 1.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $477 $954 2.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $151.50 $303 1.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $187.50 $375 1.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $307.50 $615 2.6×
X-ray exam of femur 2/> (73552) $151.50 $303 1.6×
X-ray eye for foreign body (70030) $164 $328 1.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $151.50 $303 1.6×
X-ray IV pyelogram (ivp) (74400) $578.50 $1,157 3.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $151.50 $303 1.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $151.50 $303 1.6×
X-ray leg, infant (73592) $151.50 $303 1.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $175 $350 1.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $253.50 $507 2.2×
X-ray nose-rectum child f.b. (76010) $151.50 $303 1.6×
X-ray optic foramen (70190) $151.50 $303 1.6×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $151.50 $303 1.3×
X-ray retrograde pyelogram (74420) $578.50 $1,157 1.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $151.50 $303 1.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $151.50 $303 1.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $253.50 $507 2.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $151.50 $303 1.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $151.50 $303 1.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $151.50 $303 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $253.50 $507 2.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $151.50 $303 1.3×
X-Ray Small Bowel Enteroclysis (74251) $477 $954 2.4×
X-Ray Spine One View - Xr Spine (72020) $151.50 $303 1.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $151.50 $303 1.6×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $151.50 $303 1.6×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $151.50 $303 1.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $296 $592 2.5×
Xr c-spine 4 or 5 views (72050) $253.50 $507 2.2×
Xr c-spine 6 or more views (72052) $253.50 $507 2.2×
Xr chest 4+ views (71048) $151.50 $303 1.3×