Imaging prices at Oklahoma Spine Hospital

Oklahoma City, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $115 $234 1.4×
Abdomen 2 views (74019) $140 $264 1.4×
Ankle 2 views (73600) $115 $234 1.4×
Arthrogram hip (73525) $460 $1,493 1.4×
Arthrogram Wrist (73115) $460 $1,504 1.4×
Chest 1 view (71045) $115 $252 1.4×
Chest 2 views (71046) $115 $272 1.4×
Chest 3 views (71047) $115 $292 1.4×
Chest 4 or more views (71048) $140 $292 1.4×
Clavicle complete (73000) $115 $234 1.4×
Contrast X-Ray Of Elbow (73085) $460 $983 1.4×
Contrast X-Ray Of Knee Joint (73580) $460 $2,993 1.4×
CT abdomen and pelvis without and with contrast (74178) $460 $2,413 1.4×
CT abdomen and pelvis without contrast (74176) $315 $1,530 1.4×
CT abdomen w contrast (74160) $235 $1,397 1.4×
CT abdomen w wo contrast (74170) $235 $1,628 1.4×
CT abdomen w/o contrast (74150) $140 $1,019 1.4×
CT Angio Chest (71275) $235 $1,764 1.4×
CT Angio Head (70496)
range across 2 matching MRF lines		 $235 $446–$1,645 1.4×
CT Angio Neck (70498) $235 $2,171 1.4×
Ct Angio Upr Extrm W/O&W/Dye (73206) $235 $3,369 1.4×
CT cervical spine w/ contrast (72126) $460 $1,245 1.4×
CT cervical spine w/o contrast (72125) $140 $1,019 1.4×
CT cervical spine w/wo cont (72127) $235 $1,245 1.4×
CT chest w contrast (71260) $235 $1,397 1.4×
CT chest w/wo contrast (71270) $235 $1,628 1.4×
CT head/brain with contrast (70460) $235 $1,397 1.4×
CT head/brain without and with contrast (70470) $235 $1,628 1.4×
CT iac w contrast (70481) $235 $1,019 1.4×
CT l-spine w&w/o contrast (72133) $235 $1,628 1.4×
CT lower ext w/o (73700) $140 $1,019 1.4×
CT lower extremity w/contrast material (73701) $235 $1,397 1.4×
CT lumbar spine w contrast (72132) $460 $1,245 1.4×
CT lumbar spine w/o contrast (72131) $140 $1,200 1.4×
CT maxillofacial w contrast (70487) $235 $1,019 1.4×
CT maxillofacial wo contrast (70486) $140 $1,019 1.4×
CT neck tissue combo (70492) $235 $1,628 1.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $235 $1,628 1.4×
CT orbits w/o contrast (70480) $140 $1,019 1.4×
CT pelvis w&w/o contrast (72194) $235 $1,671 1.4×
CT pelvis w/o contrast (72192) $140 $1,019 1.4×
CT scan of leg combo (73702) $235 $1,628 1.4×
CT scans face/jaw combo (70488) $235 $1,628 1.4×
CT soft tissue neck w contrast (70491) $235 $1,397 1.4×
CT soft tissue neck w/o contrast (70490) $140 $1,019 1.4×
CT thoracic spine w contrast (72129) $235 $1,245 1.4×
CT thoracic spine w/o contrast (72128) $140 $1,019 1.4×
CT thoracic spine w/wo cont (72130) $235 $1,628 1.4×
CT thorax w/o contrast (71250) $140 $1,019 1.4×
CT upper ext wo (73200) $140 $1,019 1.4×
CT upper extremity w/o & w/contrast material (73202) $235 $1,019 1.4×
CT upper extremity with contrast (73201) $460 $1,019 1.4×
Discography Cerv/Thor Spine (72285)
range across 2 matching MRF lines		 $242–$417 $1,450–$2,500 varies
Diskography lumbar (72295)
range across 2 matching MRF lines		 $242–$417 $1,450–$2,500 varies
Dxa Bone Density Axial (77080) $140 $187 1.4×
Dxa bone density study 1/>sites appendiclr skel (77081) $115 $152 1.4×
Esophagram (74220) $235 $477 1.4×
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines		 $315 $426–$442 1.4×
Foot 2 views (73620) $115 $234 1.4×
Forearm 2 views (73090) $115 $234 1.4×
Hand 2 views (73120) $140 $234 1.4×
Knee 3 Views (73562) $115 $254 1.4×
Mr safety determination physician/other qhp (76016) $115 $154 1.4×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $40 $43 1.4×
Mr safety implt electronics prepj supvj phys/qhp (76018) $130 $161 1.4×
Mr safety med physics xm customization plng&mntr (76017) $315 $423 1.4×
MRA head w/o contrast (70544) $315 $1,921 1.4×
MRI abdomen w/o contrast (74181) $315 $1,307 1.4×
MRI any jt lower extrem w/contrast material (73722) $1,035 $2,273 1.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $460 $2,273 1.4×
MRI any jt upper extremity w/contrast matrl (73222) $1,035 $2,273 1.4×
MRI cervical spine w contrast (72142) $460 $2,273 1.4×
MRI cervical spine w/o cont (72141) $315 $1,921 1.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $460 $2,273 1.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $460 $2,784 1.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $315 $1,921 1.4×
MRI lumbar spine w contrast (72149) $460 $2,273 1.4×
Mri Neck Spine W/O & W/Dye (72156) $460 $2,784 1.4×
MRI orbit face &/neck w/o contrast (70540) $315 $1,921 1.4×
MRI orbit face neck w contrast (70542) $460 $2,273 1.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $460 $2,779 1.4×
MRI pelvis w contrast (72196) $460 $2,273 1.4×
MRI pelvis w/o & w contrast (72197) $460 $2,784 1.4×
MRI pelvis w/o contrast (72195) $315 $1,921 1.4×
MRI thoracic spine w/o contrast (72146) $315 $1,921 1.4×
MRI upper extremity oth than jt w/contr matrl (73219) $460 $2,273 1.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $315 $1,921 1.4×
Mri Uppr Extremity W/O&W/Dye (73220) $460 $2,784 1.4×
MRI, abdomen, combo (74183) $460 $2,199 1.4×
MRI, dorsal spine combo (72157) $460 $2,784 1.4×
MRI, dorsal spine contrast (72147) $460 $2,273 1.4×
MRI, joint upper extrem (73221) $315 $1,921 1.4×
MRI, joint upper extrem combo (73223) $460 $2,784 1.4×
MRI, lumbar spine combo (72158) $460 $2,784 1.4×
Myelogram cervical (72240) $164 $490.58 0.2×
Myelogram Lumbar (72265) $159 $477.38 0.2×
Myelography thoracic (72255) $175 $524.99 0.2×
Myelograpy 2/more regions rs&i (72270) $220 $661.60 0.3×
Nm csf leak detection (78650) $640 $3,816.57 0.5×
Nonvascular Shunt X-Ray (75809) $140 $354 1.4×
Pelvis 1 or 2 views (72170) $140 $234 1.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $140 $396 1.4×
Radex Ankle Complete Minimum 3 Views (73610) $115 $234 1.4×
Radex Calcaneus Minimum 2 Views (73650) $115 $234 1.4×
Radex elbow complete minimum 3 views (73080) $115 $234 1.4×
Radex Facial Bones Complete Minimum 3 Views (70150) $140 $254 1.4×
Radex fingr minimum 2 views (73140) $115 $234 1.4×
Radex foot complete minimum 3 views (73630) $115 $254 1.4×
Radex Hand Minimum 3 Views (73130) $115 $254 1.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $115 $254 1.4×
Radex Ribs Unilateral 2 Views (71100) $115 $234 1.4×
Radex shoulder complete minimum 2 views (73030) $115 $254 1.4×
Radex Sinuses Paransl < 3 Views (70210) $115 $234 1.4×
Radex Spine 1 View Specify Level (72020) $115 $263 1.4×
Radex Sternum Minimum 2 Views (71120) $115 $234 1.4×
Radex Toe Minimum 2 Views (73660) $115 $234 1.4×
Radex Wrist Complete Minimum 3 Views (73110) $115 $254 1.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $140 $469 1.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $140 $303 1.4×
Radiologic exam colon single contrast study (74270) $235 $730 1.4×
Radiologic exam knee complete 4/more views (73564) $140 $354 1.4×
Radiologic exam pelvis compl minimum 3 views (72190) $140 $254 1.4×
Radiologic Exam Small Int Single Contrast Study (74250) $235 $477 1.4×
Radiologic examination femur minimum 2 views (73552) $115 $254 1.4×
Radiologic examination knee 1/2 views (73560) $115 $234 1.4×
Radiologic examination tibia & fibula 2 views (73590) $115 $254 1.4×
Ribs bilateral 3 views (71110) $140 $354 1.4×
Scapula (73010)
range across 5 matching MRF lines		 $34–$140 $100–$254 varies
Shoulder Arthrography (73040) $460 $1,493 1.4×
Skull less than 4 views (70250) $140 $303 1.4×
Sternoclavicular joints (71130) $115 $303 1.4×
Thoracic spine 2 views (72070) $140 $234 1.4×
Thoracic spine 3 views (72072) $140 $254 1.4×
Thoracolumbar 2 views (72080) $115 $234 1.4×
Ultrasound Exam Aaa Screen (76706) $80 $457 0.8×
Us retroperitoneal complete (76770) $205 $1,219 2.0×
Vertebral fracture assessment via dxa (77086) $115 $152 1.4×
Wrist 2 views (73100) $115 $234 1.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $115 $234 1.4×
X-Ray Bend Only L-S Spine (72120) $140 $1,530 1.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $115 $234 1.4×
X-Ray Exam Entire Spi 1 Vw (72081) $115 $469 1.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $140 $469 1.4×
X-Ray Exam Entire Spi 4/5 Vw (72083) $140 $469 1.4×
X-Ray Exam Hip Uni 1 View (73501) $115 $234 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $115 $254 1.4×
X-Ray Exam Hips Bi 2 Views (73521) $140 $354 1.4×
X-Ray Exam L-S Spine Bending (72114) $140 $396 1.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $115 $303 1.4×
X-Ray Exam Neck Spine 6/>Vws (72052) $140 $396 1.4×
X-Ray Exam Unilat Ribs/Chest (71101) $140 $303 1.4×
X-ray eye for foreign body (70030) $115 $234 1.4×
X-ray humerus (73060) $115 $254 1.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $115 $254 1.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $115 $254 1.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $140 $303 1.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $140 $396 1.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $140 $254 1.4×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $140 $234 1.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $115 $234 1.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $115 $303 1.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $140 $396 1.4×
X-ray thoracic spine 4 vw (72074) $140 $303 1.4×
X-Rays Bone Length Studies (77073) $140 $234 1.4×
Xr c-spine 4 or 5 views (72050) $140 $396 1.4×
Xr facial bones less than 3 views (70140) $115 $254 1.4×
Xr orbits complete 4 views (70200) $140 $300 1.4×

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.