Imaging prices at Ottawa County Health Center

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $197 $197 2.5×
Abdomen 2 views (74019) $145 $145 1.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $379 $379 1.0×
Ankle 2 views (73600) $151 $151 1.9×
Bone age studies (77072) $206 $206 2.1×
Bone Imaging Limited Area (78300) $485 $485 1.3×
Bone Imaging Multiple Areas (78305) $946 $946 2.6×
Bone Imaging Whole Body (78306) $551 $551 1.5×
Cat Scan Follow-Up Study (76380) $900 $900 11.2×
Chest 1 view (71045) $168 $168 2.1×
Chest 2 views (71046) $210 $210 2.6×
Chest 3 views (71047) $221 $221 2.8×
Chest 4 or more views (71048) $232 $232 2.4×
Clavicle complete (73000) $184 $184 2.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $800 $800 8.3×
CT abdomen and pelvis without and with contrast (74178) $900 $900 2.8×
CT abdomen and pelvis without contrast (74176) $800 $800 3.6×
CT abdomen w contrast (74160) $800 $800 5.0×
CT abdomen w wo contrast (74170)
range across 2 matching MRF lines		 $850–$900 $850–$900 varies
CT abdomen w/o contrast (74150) $850 $850 8.8×
CT Angio Abdomen and Pelvis (74174) $2,450 $2,450 7.6×
CT Angio Chest (71275)
range across 3 matching MRF lines		 $1,600–$1,750 $1,600–$1,750 varies
CT Angio Head (70496) $1,750 $1,750 10.8×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,750 $1,750 10.8×
CT Angio Neck (70498) $1,750 $1,750 10.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,750 $1,750 10.8×
CT cervical spine w/ contrast (72126) $850 $850 2.6×
CT cervical spine w/o contrast (72125) $800 $800 8.3×
CT cervical spine w/wo cont (72127) $900 $900 5.6×
CT chest w contrast (71260) $850 $850 5.3×
CT chest w/wo contrast (71270) $900 $900 5.6×
CT head/brain with contrast (70460) $850 $850 5.3×
CT head/brain without and with contrast (70470) $900 $900 5.6×
CT iac w contrast (70481) $850 $850 5.3×
CT l-spine w&w/o contrast (72133) $900 $900 5.6×
CT lower ext w/o (73700) $800 $800 8.3×
CT lower extremity w/contrast material (73701) $850 $850 5.3×
CT lumbar spine w contrast (72132) $850 $850 2.6×
CT lumbar spine w/o contrast (72131) $800 $800 8.3×
CT maxillofacial w contrast (70487) $850 $850 5.3×
CT maxillofacial wo contrast (70486) $800 $800 8.3×
CT neck tissue combo (70492) $900 $900 5.6×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $900 $900 5.6×
CT orbits w/o contrast (70480) $800 $800 8.3×
CT pelvis w&w/o contrast (72194) $900 $900 5.6×
CT pelvis w/o contrast (72192) $800 $800 8.3×
CT scan of leg combo (73702) $900 $900 5.6×
CT scans face/jaw combo (70488) $900 $900 5.6×
CT soft tissue neck w contrast (70491) $850 $850 5.3×
CT soft tissue neck w/o contrast (70490) $800 $800 8.3×
CT thoracic spine w contrast (72129) $850 $850 5.3×
CT thoracic spine w/o contrast (72128) $800 $800 8.3×
CT thoracic spine w/wo cont (72130) $900 $900 5.6×
CT thorax w/o contrast (71250) $800 $800 8.3×
CT upper ext wo (73200) $800 $800 8.3×
CT upper extremity w/o & w/contrast material (73202) $900 $900 5.6×
CT upper extremity with contrast (73201) $850 $850 2.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635)
range across 2 matching MRF lines		 $800–$1,850 $800–$1,850 varies
Cta Abdomen (74175) $1,775 $1,775 11.0×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,615 $1,615 5.0×
CTA pelvis (72191) $1,750 $1,750 10.8×
Dxa Bone Density Axial (77080) $25 $25 0.3×
Esophagram (74220) $435 $435 2.7×
Fetal Biophys Profile W/Nst (76818) $198 $198 2.1×
Foot 2 views (73620) $151 $151 1.9×
Forearm 2 views (73090) $181 $181 2.3×
Hand 2 views (73120) $179 $179 1.9×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $403 $403 1.1×
Knee 3 Views (73562) $217 $217 2.7×
Liver & Spleen Imaging Static Only (78215) $403 $403 1.1×
Liver & Spleen Imaging W/Vascular Flow (78216) $403 $403 1.1×
Lung Ventilat&Perfus Imaging (78582) $2,851 $2,851 5.7×
MRI any jt lower extrem w/contrast material (73722) $800 $800 1.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $750 $750 2.3×
MRI cervical spine w/o cont (72141) $1,131 $1,131 5.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $700 $700 2.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,190 $2,190 10.0×
MRI thoracic spine w/o contrast (72146) $1,087 $1,087 5.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $770 $770 3.5×
MRI, dorsal spine combo (72157) $4,305.20 $4,305.20 13.4×
MRI, lumbar spine combo (72158) $1,087 $1,087 3.4×
Neck soft tissue (70360) $186 $186 2.3×
Optic foramina (70190) $234 $234 2.9×
Pelvis 1 or 2 views (72170) $185 $185 1.9×
Pulmonary Perfusion Imaging Particulate (78580) $393 $393 1.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $370 $370 3.8×
Radex Ankle Complete Minimum 3 Views (73610) $203 $203 2.5×
Radex Calcaneus Minimum 2 Views (73650) $224 $224 2.8×
Radex elbow complete minimum 3 views (73080) $227 $227 2.8×
Radex Facial Bones Complete Minimum 3 Views (70150) $278 $278 2.9×
Radex fingr minimum 2 views (73140) $152 $152 1.9×
Radex foot complete minimum 3 views (73630) $197 $197 2.5×
Radex Hand Minimum 3 Views (73130) $198 $198 2.5×
Radex lower extremity infant minimum 2 views (73592) $200 $200 2.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $212 $212 2.6×
Radex Ribs Unilateral 2 Views (71100) $194 $194 2.4×
Radex shoulder complete minimum 2 views (73030) $203 $203 2.5×
Radex Sinuses Paransl < 3 Views (70210) $154 $154 1.9×
Radex Spine 1 View Specify Level (72020) $248 $248 3.1×
Radex Sternum Minimum 2 Views (71120) $211 $211 2.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $258 $258 3.2×
Radex Toe Minimum 2 Views (73660) $151 $151 1.9×
Radex upper extremity infant minimum 2 views (73092) $179 $179 1.9×
Radex Wrist Complete Minimum 3 Views (73110) $206 $206 2.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $391 $391 4.1×
Radiolog exam mandible compl minimum 4 views (70110) $305 $305 3.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $214 $214 2.2×
Radiologic exam knee complete 4/more views (73564) $314 $314 3.3×
Radiologic exam pelvis compl minimum 3 views (72190) $185 $185 1.9×
Radiologic Exam Small Int Single Contrast Study (74250) $448 $448 2.8×
Radiologic exam swallow function contrast study (74230) $453 $453 2.8×
Radiologic examination femur 1 view (73551) $254 $254 3.2×
Radiologic examination femur minimum 2 views (73552) $276 $276 3.4×
Radiologic examination knee 1/2 views (73560) $162 $162 2.0×
Radiologic examination tibia & fibula 2 views (73590) $216 $216 2.7×
Ribs bilateral 3 views (71110) $195 $195 2.0×
Scapula (73010) $169 $169 1.8×
Shoulder 1 view (73020) $154 $154 1.9×
Shoulder Arthrography (73040) $490 $490 1.5×
Skull less than 4 views (70250) $207 $207 2.2×
Sternoclavicular joints (71130) $192 $192 2.4×
Thoracic spine 2 views (72070) $194 $194 2.0×
Thoracic spine 3 views (72072) $291 $291 3.0×
Thoracolumbar 2 views (72080) $278 $278 3.5×
Ultrasound Breast Limited (76642) $130 $130 1.6×
Ultrasound Exam Aaa Screen (76706) $207 $207 2.2×
Ultrasound, abdomen limited (76705) $190 $190 2.0×
Us breast unilateral complete (76641) $130 $130 1.4×
Us chest (76604) $152 $152 1.6×
Us complete joint (76881) $160 $160 1.7×
Us exam, pelvic, limited (76857) $141 $141 1.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $166 $166 1.7×
Us ob limited 1 or more fetuses (76815) $198 $198 2.1×
Us pelvic non ob complete (76856) $175 $175 1.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $170 $170 1.8×
Us retroperitoneal complete (76770) $215 $215 2.2×
Us retroperitoneal limited (76775) $166 $166 1.7×
Us scrotum and contents (76870) $168 $168 1.7×
Us thyroid (76536) $675 $675 7.0×
Wrist 2 views (73100) $145 $145 1.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $214 $214 2.7×
X-Ray Bend Only L-S Spine (72120) $336 $336 3.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $183 $183 2.3×
X-Ray Exam Entire Spi 1 Vw (72081) $276 $276 3.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $391 $391 4.1×
X-Ray Exam Entire Spi 4/5 Vw (72083) $391 $391 4.1×
X-Ray Exam Hip Uni 1 View (73501) $198 $198 2.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $243 $243 3.0×
X-Ray Exam Hip Uni 4/> Views (73503) $303 $303 3.2×
X-Ray Exam Hips Bi 2 Views (73521) $276 $276 2.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $391 $391 4.1×
X-Ray Exam Hips Bi 5/> Views (73523) $391 $391 4.1×
X-Ray Exam L-S Spine Bending (72114) $437 $437 4.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $228 $228 2.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $382 $382 4.0×
X-Ray Exam Unilat Ribs/Chest (71101) $290 $290 3.0×
X-ray eye for foreign body (70030) $122 $122 1.5×
X-ray humerus (73060) $201 $201 2.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $240 $240 3.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $162 $162 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100)
range across 2 matching MRF lines		 $25–$252 $25–$252 varies
X-ray nose-rectum child f.b. (76010) $183 $183 2.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $355 $355 3.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $211 $211 2.2×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $200 $200 2.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $206 $206 2.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $290 $290 3.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $305 $305 3.2×
X-Ray Tmj Unilat (70328) $192 $192 2.4×
X-Rays Bone Survey Complete (77075) $731 $731 7.6×
Xr c-spine 4 or 5 views (72050) $330 $330 3.4×
Xr facial bones less than 3 views (70140) $260 $260 3.2×
Xr orbits complete 4 views (70200) $254 $254 2.6×

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.