Imaging prices at Pawnee County Memorial Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $259 $324 2.9×
Abdomen 2 views (74019) $320 $400 2.9×
Ankle 2 views (73600) $186 $233 2.1×
Bone Imaging 3 Phase (78315) $1,644 $2,055 4.0×
Bone Imaging Multiple Areas (78305) $978 $1,222 2.4×
Bone Imaging Whole Body (78306) $1,385 $1,731 3.3×
Chest 1 view (71045) $234 $292 2.6×
Chest 2 views (71046) $282 $352 3.1×
Clavicle complete (73000) $247 $309 2.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $606 $757 5.6×
CT abdomen and pelvis without and with contrast (74178) $4,326 $5,408 11.9×
CT abdomen and pelvis without contrast (74176) $3,202 $4,002 12.9×
CT abdomen w contrast (74160) $2,163 $2,704 11.9×
CT abdomen w wo contrast (74170) $2,510 $3,137 13.8×
CT abdomen w/o contrast (74150) $1,817 $2,271 16.7×
CT Angio Abdomen and Pelvis (74174) $4,560 $5,700 12.6×
CT Angio Chest (71275) $2,726 $3,407 15.0×
CT cervical spine w/o contrast (72125) $1,990 $2,488 18.3×
CT chest w contrast (71260) $2,077 $2,596 11.4×
CT chest w/wo contrast (71270) $2,596 $3,245 14.3×
CT head/brain with contrast (70460) $1,769 $2,211 9.7×
CT head/brain without and with contrast (70470) $2,163 $2,704 11.9×
CT iac w contrast (70481) $1,862 $2,328 10.2×
CT lower ext w/o (73700) $1,817 $2,271 16.7×
CT lower extremity w/contrast material (73701) $2,000 $2,500 11.0×
CT lumbar spine w/o contrast (72131) $1,990 $2,488 18.3×
CT maxillofacial w contrast (70487) $1,714 $2,143 9.4×
CT maxillofacial wo contrast (70486) $1,514 $1,893 13.9×
CT neck tissue combo (70492) $2,250 $2,812 12.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,077 $2,596 11.4×
CT orbits w/o contrast (70480) $1,690 $2,112 15.6×
CT pelvis w&w/o contrast (72194) $2,336 $2,920 12.8×
CT pelvis w/o contrast (72192) $1,817 $2,271 16.7×
CT scan of leg combo (73702) $2,413 $3,016 13.2×
CT scans face/jaw combo (70488) $1,723 $2,154 9.5×
CT soft tissue neck w contrast (70491) $1,990 $2,488 10.9×
CT soft tissue neck w/o contrast (70490) $1,636 $2,045 15.1×
CT thoracic spine w/o contrast (72128) $1,990 $2,488 18.3×
CT thoracic spine w/wo cont (72130) $2,246 $2,808 12.3×
CT thorax w/o contrast (71250) $1,904 $2,380 17.5×
CT upper ext wo (73200) $1,774 $2,217 16.3×
Dxa Bone Density Axial (77080) $380 $475 3.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $359 $449 3.3×
Foot 2 views (73620) $216 $270 2.4×
Forearm 2 views (73090) $242 $303 2.7×
Hepatobil Syst Image W/Drug (78227) $1,558 $1,947 2.8×
Hepatobiliary System Imaging (78226) $1,260 $1,575 3.0×
Ht Musc Image Planar Mult (78454) $2,431 $3,039 1.8×
Ht Muscle Image Spect Sing (78451) $2,840 $3,550 2.1×
K Flow/Funct Image W/Drug (78708) $1,101 $1,376 2.0×
Kidney Imaging Morphol (78700) $861 $1,076 2.1×
Knee 3 Views (73562) $298 $373 3.3×
Liver & Spleen Imaging Static Only (78215) $887 $1,109 2.1×
Lung Ventilation Imaging (78579) $816 $1,020 2.0×
Magnetic Image Jaw Joint (70336) $1,980 $2,475 8.0×
Meckels Divert Exam (78290) $909 $1,136 2.2×
MRA head w/o contrast (70544) $2,553 $3,191 10.3×
Mra Neck W/O &W/Contrast Material (70549) $2,747 $3,434 7.6×
MRI abdomen w contrast (74182) $3,120 $3,900 8.6×
MRI abdomen w/o contrast (74181) $2,800 $3,500 11.3×
MRI any jt lower extrem w/contrast material (73722) $2,770 $3,463 3.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,985 $3,731 8.2×
MRI any jt upper extremity w/contrast matrl (73222) $2,077 $2,596 2.6×
MRI cervical spine w contrast (72142) $2,942 $3,677 8.1×
MRI cervical spine w/o cont (72141) $2,655 $3,319 10.7×
MRI chest with contrast (71551) $2,314 $2,893 2.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,250 $2,812 6.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,314 $2,893 6.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,206 $2,758 8.9×
MRI lumbar spine w contrast (72149) $2,769 $3,461 7.6×
Mri Neck Spine W/O & W/Dye (72156) $3,461 $4,326 9.6×
MRI orbit face &/neck w/o contrast (70540) $2,002 $2,503 8.1×
MRI orbit face neck w contrast (70542) $2,034 $2,542 5.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,791 $3,489 7.7×
MRI pelvis w contrast (72196) $2,314 $2,893 6.4×
MRI pelvis w/o & w contrast (72197) $2,790 $3,488 7.7×
MRI pelvis w/o contrast (72195) $2,279 $2,849 9.2×
MRI thoracic spine w/o contrast (72146) $2,655 $3,319 10.7×
MRI upper extremity oth than jt w/contr matrl (73219) $2,336 $2,920 6.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,250 $2,812 9.1×
MRI, abdomen, combo (74183) $3,600 $4,500 9.9×
MRI, dorsal spine combo (72157) $3,461 $4,326 9.6×
MRI, dorsal spine contrast (72147) $2,942 $3,677 8.1×
MRI, joint upper extrem (73221) $1,783 $2,229 7.2×
MRI, joint upper extrem combo (73223) $2,790 $3,488 7.7×
MRI, lumbar spine combo (72158) $3,461 $4,326 9.6×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $2,431 $3,039 5.9×
Myocardial Spect Multiple Studies (78452) $3,374 $4,218 2.5×
Neck soft tissue (70360) $259 $324 2.9×
Pelvis 1 or 2 views (72170) $259 $324 2.4×
PET image w/CT, full body (78816) $6,240 $7,800 4.2×
PET imaging CT attenuation skull base mid-thigh (78815) $4,992 $6,240 3.4×
Pulmonary Perfusion Imaging Particulate (78580) $861 $1,076 2.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $442 $553 4.1×
Radex Ankle Complete Minimum 3 Views (73610) $277 $346 3.1×
Radex Calcaneus Minimum 2 Views (73650) $208 $260 2.3×
Radex elbow complete minimum 3 views (73080) $259 $324 2.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $337 $421 3.1×
Radex foot complete minimum 3 views (73630) $277 $346 3.1×
Radex Hand Minimum 3 Views (73130) $275 $344 3.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $290 $362 3.2×
Radex Ribs Unilateral 2 Views (71100) $245 $306 2.7×
Radex shoulder complete minimum 2 views (73030) $295 $369 3.3×
Radex Sinuses Paransl < 3 Views (70210) $238 $297 2.6×
Radex Sternum Minimum 2 Views (71120) $259 $324 2.9×
Radex Wrist Complete Minimum 3 Views (73110) $259 $324 2.9×
Radiolog exam mandible compl minimum 4 views (70110) $278 $348 2.6×
Radiologic exam knee complete 4/more views (73564) $311 $389 2.9×
Radiologic examination femur 1 view (73551) $254 $317 2.8×
Radiologic examination femur minimum 2 views (73552) $294 $368 3.3×
Radiologic examination knee 1/2 views (73560) $259 $324 2.9×
Radiologic examination tibia & fibula 2 views (73590) $259 $324 2.9×
Scapula (73010) $250 $312 2.3×
Screening Digital Breast Tomosynthesis Bi (77063) $69 $86 3.0×
Shoulder 1 view (73020) $210 $262 2.3×
Skull less than 4 views (70250) $212 $265 2.0×
Sternoclavicular joints (71130) $219 $274 2.4×
Testicular Imaging W/Flow (78761) $765 $956 1.8×
Thoracic spine 2 views (72070) $303 $379 2.8×
Thoracic spine 3 views (72072) $415 $519 3.8×
Thoracolumbar 2 views (72080) $261 $326 2.9×
Thyroid Imaging With Vascular Flow (78013) $854 $1,067 2.1×
Thyroid Uptake Measurement (78012) $866 $1,082 2.1×
Ultrasound Breast Limited (76642) $329 $411 3.6×
Ultrasound Exam Aaa Screen (76706) $502 $627 4.6×
Ultrasound, abdomen limited (76705) $562 $703 5.2×
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $433–$498 $541–$622 varies
Us chest (76604) $415 $519 3.8×
Us exam, pelvic, limited (76857) $331 $414 3.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $411 $514 3.8×
Us ob limited 1 or more fetuses (76815) $336 $420 3.1×
Us ob transvaginal (76817) $467 $584 4.3×
Us pelvic non ob complete (76856) $606 $757 5.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $519 $649 4.8×
Us preg uterus real time f/u trnsabdl per fetus (76816) $294 $368 2.7×
Us retroperitoneal complete (76770) $606 $757 5.6×
Us retroperitoneal limited (76775) $519 $649 4.8×
Us scrotum and contents (76870) $588 $735 5.4×
Us thyroid (76536) $519 $649 4.8×
Vertebral fracture assessment via dxa (77086) $417 $521 4.6×
Wrist 2 views (73100) $208 $260 2.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $234 $292 2.6×
X-Ray Bend Only L-S Spine (72120) $252 $315 2.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $225 $281 2.5×
X-Ray Exam Entire Spi 2/3 Vw (72082) $415 $519 3.8×
X-Ray Exam Hip Uni 1 View (73501) $202 $253 2.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $294 $368 3.3×
X-Ray Exam L-S Spine Bending (72114) $567 $709 5.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $294 $368 3.3×
X-Ray Exam Unilat Ribs/Chest (71101) $346 $433 3.2×
X-ray eye for foreign body (70030) $187 $234 2.1×
X-ray humerus (73060) $251 $314 2.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $363 $454 3.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $396 $495 3.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $277 $346 2.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $259 $324 2.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $278 $348 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $330 $412 3.0×
X-Rays Bone Survey Complete (77075) $692 $865 6.4×
Xr c-spine 4 or 5 views (72050) $429 $536 4.0×
Xr facial bones less than 3 views (70140) $259 $324 2.9×
Xr orbits complete 4 views (70200) $359 $449 3.3×

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.