Imaging prices at Perkins County Health Services
Grant, NE · every code in this section with a posted price and a Medicare benchmark.
214 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $50 | $50 | 0.6× |
| Abdomen 2 views (74019) | $74 | $74 | 0.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,250 | $3,250 | 7.8× |
| Ankle 2 views (73600) | $72 | $72 | 0.8× |
| Arthrogram hip (73525) | $956 | $956 | 2.6× |
| Bone age studies (77072) | $66 | $66 | 0.6× |
| Bone Imaging 3 Phase (78315) | $2,690 | $2,690 | 6.5× |
| Bone Imaging Multiple Areas (78305) | $1,479 | $1,479 | 3.6× |
| Bone Imaging Whole Body (78306) | $2,224 | $2,224 | 5.4× |
| Chest 1 view (71045) | $60 | $60 | 0.7× |
| Chest 2 views (71046) | $58 | $58 | 0.6× |
| Chest 3 views (71047) | $426 | $426 | 4.7× |
| Chest 4 or more views (71048) | $566 | $566 | 5.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$82–$113 | $82–$113 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,573 | $1,573 | 14.5× |
| Contrast X-Ray Bladder (74430) | $837 | $837 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) | $6,506 | $6,506 | 18.0× |
| CT abdomen and pelvis without contrast (74176) | $4,127 | $4,127 | 16.7× |
| CT abdomen w contrast (74160) | $3,409 | $3,409 | 18.7× |
| CT abdomen w wo contrast (74170) | $3,968 | $3,968 | 21.8× |
| CT abdomen w/o contrast (74150) | $2,558 | $2,558 | 23.6× |
| CT Angio Abdomen and Pelvis (74174) | $6,310 | $6,310 | 17.4× |
| CT Angio Chest (71275) | $4,008 | $4,008 | 22.0× |
| CT Angio Head (70496) | $3,374 | $3,374 | 18.5× |
| CT Angio Neck (70498) | $3,661 | $3,661 | 20.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,979 | $2,979 | 16.4× |
| CT cervical spine w/ contrast (72126) | $3,469 | $3,469 | 9.6× |
| CT cervical spine w/o contrast (72125) | $2,663 | $2,663 | 24.5× |
| CT chest w contrast (71260) | $3,300 | $3,300 | 18.1× |
| CT chest w/wo contrast (71270) | $3,673 | $3,673 | 20.2× |
| CT head/brain with contrast (70460) | $2,789 | $2,789 | 15.3× |
| CT head/brain without and with contrast (70470) | $3,161 | $3,161 | 17.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $178 | $178 | 2.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$3,105–$3,136 | $3,105–$3,136 | varies |
| CT l-spine w&w/o contrast (72133) | $3,504 | $3,504 | 19.2× |
| CT lower ext w/o (73700) | $2,286 | $2,286 | 21.1× |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,773–$3,123 | $2,773–$3,123 | varies |
| CT lumbar spine w contrast (72132) | $3,483 | $3,483 | 9.6× |
| CT lumbar spine w/o contrast (72131) | $2,609 | $2,609 | 24.0× |
| CT maxillofacial w contrast (70487) | $2,830 | $2,830 | 15.5× |
| CT maxillofacial wo contrast (70486) | $2,085 | $2,085 | 19.2× |
| CT neck tissue combo (70492) | $3,587 | $3,587 | 19.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$3,202–$3,231 | $3,202–$3,231 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$2,552–$2,776 | $2,552–$2,776 | varies |
| CT pelvis w&w/o contrast (72194) | $3,704 | $3,704 | 20.3× |
| CT pelvis w/o contrast (72192) | $2,432 | $2,432 | 22.4× |
| CT scan of leg combo (73702) | $3,464 | $3,464 | 19.0× |
| CT scans face/jaw combo (70488) | $3,121 | $3,121 | 17.1× |
| CT soft tissue neck w contrast (70491) | $3,198 | $3,198 | 17.6× |
| CT soft tissue neck w/o contrast (70490) | $2,426 | $2,426 | 22.3× |
| CT thoracic spine w contrast (72129) | $3,706 | $3,706 | 20.3× |
| CT thoracic spine w/o contrast (72128) | $2,587 | $2,587 | 23.8× |
| CT thoracic spine w/wo cont (72130) | $3,634 | $3,634 | 20.0× |
| CT thorax w/o contrast (71250) | $2,515 | $2,515 | 23.2× |
| CT upper ext wo (73200) | $2,178 | $2,178 | 20.1× |
| CT upper extremity w/o & w/contrast material (73202) | $3,639 | $3,639 | 20.0× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,635–$3,235 | $2,635–$3,235 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,075 | $4,075 | 22.4× |
| Cta Abdomen (74175) | $3,600 | $3,600 | 19.8× |
| CTA pelvis (72191) | $2,696 | $2,696 | 14.8× |
| Dxa Bone Density Axial (77080) | $562 | $562 | 5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $314 | $314 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,359 | $1,359 | 12.5× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$234–$777 | $234–$777 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$71–$104 | $71–$104 | varies |
| Forearm 2 views (73090) | $64 | $64 | 0.7× |
| Gastric emptying imaging study (78264) | $2,373 | $2,373 | 5.7× |
| Gated Heart Planar Single (78472) | $2,294 | $2,294 | 5.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$63–$94 | $63–$94 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,916 | $2,916 | 5.2× |
| Hepatobiliary System Imaging (78226) | $2,099 | $2,099 | 5.1× |
| Ht Muscle Image Spect Sing (78451) | $4,999 | $4,999 | 3.7× |
| Infant hip ultrasound, limited static exam (76886) | $931 | $931 | 10.3× |
| K Flow/Funct Image Multiple (78709) | $2,962 | $2,962 | 5.3× |
| K Flow/Funct Image W/Drug (78708) | $2,222 | $2,222 | 3.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,757 | $1,757 | 3.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$94–$188 | $94–$188 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,565 | $1,565 | 3.8× |
| Lung Perf&Ventilat Diferentl (78598) | $2,888 | $2,888 | 5.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,725 | $2,725 | 4.8× |
| Lymph System Imaging (78195) | $2,478 | $2,478 | 4.4× |
| Magnetic Image Jaw Joint (70336) | $2,764 | $2,764 | 11.2× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$394–$5,394 | $394–$5,394 | varies |
| MRA head w/o contrast (70544) | $3,821 | $3,821 | 15.4× |
| MRA head with contrast (70545) | $4,476 | $4,476 | 12.4× |
| MRA neck w contrast (70548) | $4,658 | $4,658 | 12.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,086 | $5,086 | 14.0× |
| MRA neck w/o contrast (70547) | $3,948 | $3,948 | 15.9× |
| MRI abdomen w contrast (74182) | $4,403 | $4,403 | 12.2× |
| MRI abdomen w/o contrast (74181) | $3,887 | $3,887 | 15.7× |
| MRI any jt lower extrem w/contrast material (73722) | $4,259 | $4,259 | 5.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,442 | $4,442 | 12.3× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$3,314–$3,368 | $3,314–$3,368 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,366 | $3,366 | 13.6× |
| MRI cervical spine w contrast (72142) | $4,124 | $4,124 | 11.4× |
| MRI cervical spine w/o cont (72141) | $3,804 | $3,804 | 15.4× |
| MRI chest w/o contrast (71550) | $4,590 | $4,590 | 18.5× |
| MRI chest wo w contrast (71552) | $4,762 | $4,762 | 13.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,403 | $4,403 | 12.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,998 | $2,998 | 12.1× |
| MRI lumbar spine w contrast (72149) | $3,868 | $3,868 | 10.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,061 | $5,061 | 14.0× |
| MRI orbit face &/neck w/o contrast (70540) | $3,020 | $3,020 | 12.2× |
| MRI orbit face neck w contrast (70542) | $3,803 | $3,803 | 10.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,268 | $5,268 | 14.5× |
| MRI pelvis w contrast (72196) | $4,286 | $4,286 | 11.8× |
| MRI pelvis w/o & w contrast (72197) | $4,653 | $4,653 | 12.8× |
| MRI pelvis w/o contrast (72195) | $3,648 | $3,648 | 14.7× |
| MRI thoracic spine w/o contrast (72146) | $3,999 | $3,999 | 16.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,077 | $3,077 | 12.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,286 | $4,286 | 11.8× |
| MRI, abdomen, combo (74183) | $5,351 | $5,351 | 14.8× |
| MRI, dorsal spine combo (72157) | $5,125 | $5,125 | 14.1× |
| MRI, dorsal spine contrast (72147) | $4,830 | $4,830 | 13.3× |
| MRI, joint upper extrem (73221) | $2,735 | $2,735 | 11.0× |
| MRI, joint upper extrem combo (73223) | $4,766 | $4,766 | 13.2× |
| MRI, lumbar spine combo (72158) | $4,825 | $4,825 | 13.3× |
| Myocardial Spect Multiple Studies (78452) | $5,069 | $5,069 | 3.8× |
| Neck soft tissue (70360) | $358 | $358 | 4.0× |
| Parathyroid Planar Imaging (78070) | $1,597 | $1,597 | 3.8× |
| Pelvis 1 or 2 views (72170) | $72 | $72 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $662 | $662 | 6.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $75 | $75 | 0.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $63 | $63 | 0.7× |
| Radex elbow complete minimum 3 views (73080) | $77 | $77 | 0.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $525 | $525 | 4.8× |
| Radex fingr minimum 2 views (73140) | $87 | $87 | 1.0× |
| Radex foot complete minimum 3 views (73630) | $82 | $82 | 0.9× |
| Radex Hand Minimum 3 Views (73130) | $75 | $75 | 0.8× |
| Radex lower extremity infant minimum 2 views (73592) | $415 | $415 | 4.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $485 | $485 | 4.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $74 | $74 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) | $69 | $69 | 0.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$65–$90 | $65–$90 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $368 | $368 | 4.1× |
| Radex Spine 1 View Specify Level (72020) | $424 | $424 | 4.7× |
| Radex Sternum Minimum 2 Views (71120) | $67 | $67 | 0.7× |
| Radex Toe Minimum 2 Views (73660) | $64 | $64 | 0.7× |
| Radex upper extremity infant minimum 2 views (73092) | $407 | $407 | 3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $83 | $83 | 0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,127 | $1,127 | 10.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $106 | $106 | 1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $490 | $490 | 4.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$438–$658 | $438–$658 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $481 | $481 | 4.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $934 | $934 | 5.1× |
| Radiologic examination femur 1 view (73551) | $328 | $328 | 3.6× |
| Radiologic examination femur minimum 2 views (73552) | $73 | $73 | 0.8× |
| Radiologic examination knee 1/2 views (73560) | $71 | $71 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $65 | $65 | 0.7× |
| Ribs bilateral 3 views (71110) | $82 | $82 | 0.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,323 | $2,323 | 4.1× |
| Scapula (73010) range across 3 matching MRF lines |
$60–$90 | $60–$90 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines |
$55–$82 | $55–$82 | varies |
| Shoulder 1 view (73020) | $50 | $50 | 0.6× |
| Shoulder Arthrography (73040) | $1,048 | $1,048 | 2.9× |
| Skull less than 4 views (70250) | $460 | $460 | 4.2× |
| Sternoclavicular joints (71130) | $329 | $329 | 3.6× |
| Thoracic spine 2 views (72070) | $54 | $54 | 0.5× |
| Thoracic spine 3 views (72072) | $65 | $65 | 0.6× |
| Thoracolumbar 2 views (72080) | $84 | $84 | 0.9× |
| Thyroid Imaging With Vascular Flow (78013) | $851 | $851 | 2.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$453–$649 | $453–$649 | varies |
| Ultrasound Exam Aaa Screen (76706) | $664 | $664 | 6.1× |
| Ultrasound, abdomen limited (76705) | $806 | $806 | 7.4× |
| Umbilical-artery Doppler (OB) (76820) | $336 | $336 | 3.1× |
| Urethrocystogram voiding (74455) | $972 | $972 | 3.9× |
| Urethrocystography retrograde (74450) | $1,021 | $1,021 | 4.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$691–$938 | $691–$938 | varies |
| Us chest (76604) | $754 | $754 | 6.9× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$603–$760 | $603–$760 | varies |
| Us head (76506) | $862 | $862 | 7.9× |
| Us kidney transplant (76776) | $1,024 | $1,024 | 9.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $722 | $722 | 6.7× |
| Us ob limited 1 or more fetuses (76815) | $578 | $578 | 5.3× |
| Us ob transvaginal (76817) | $702 | $702 | 6.5× |
| Us pelvic non ob complete (76856) | $887 | $887 | 8.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $897 | $897 | 8.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $525 | $525 | 4.8× |
| Us retroperitoneal complete (76770) | $948 | $948 | 8.7× |
| Us retroperitoneal limited (76775) | $782 | $782 | 7.2× |
| Us scrotum and contents (76870) | $838 | $838 | 7.7× |
| Us thyroid (76536) | $799 | $799 | 7.4× |
| Wrist 2 views (73100) | $60 | $60 | 0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $260 | $260 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $70 | $70 | 0.8× |
| X-Ray Exam Breast Specimen (76098) | $210 | $210 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $347 | $347 | 3.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $902 | $902 | 8.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,127 | $1,127 | 10.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $64 | $64 | 0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $97 | $97 | 1.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $726 | $726 | 6.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $92 | $92 | 0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $656 | $656 | 6.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,001 | $1,001 | 9.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $56 | $56 | 0.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $723 | $723 | 6.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $75 | $75 | 0.7× |
| X-ray eye for foreign body (70030) | $291 | $291 | 3.2× |
| X-ray humerus (73060) | $66 | $66 | 0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $65 | $65 | 0.6× |
| X-ray nose-rectum child f.b. (76010) | $693 | $693 | 7.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $98 | $98 | 0.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $68 | $68 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $75 | $75 | 0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $514 | $514 | 5.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $99 | $99 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,032 | $1,032 | 2.8× |
| X-Rays Bone Length Studies (77073) | $345 | $345 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $1,151 | $1,151 | 10.6× |
| Xr c-spine 4 or 5 views (72050) | $171 | $171 | 1.6× |
| Xr facial bones less than 3 views (70140) | $320 | $320 | 3.5× |
| Xr orbits complete 4 views (70200) | $540 | $540 | 5.0× |
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.