Imaging prices at Pipestone County Medical Center & Family Clinic Avera

Pipestone, MN · 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) $330 $330 3.7×
Abdomen 2 views (74019) $450 $450 4.2×
Ankle 2 views (73600) $286 $286 3.2×
Bone Imaging 3 Phase (78315) $1,525 $1,525 3.7×
Bone Imaging Whole Body (78306) $1,937 $1,937 4.7×
Chest 1 view (71045) $328 $328 3.7×
Chest 2 views (71046) $407 $407 4.5×
Clavicle complete (73000) $247 $247 2.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $2,158 $2,158 20.0×
CT abdomen and pelvis without and with contrast (74178) $4,348 $4,348 12.1×
CT abdomen and pelvis without contrast (74176) $3,938 $3,938 16.0×
CT abdomen w contrast (74160) $2,494 $2,494 13.8×
CT abdomen w wo contrast (74170) $3,049 $3,049 16.8×
CT abdomen w/o contrast (74150) $2,063 $2,063 19.1×
CT Angio Abdomen and Pelvis (74174) $4,305 $4,305 12.0×
CT Angio Chest (71275) $2,613 $2,613 14.4×
CT Angio Head (70496) $2,921 $2,921 16.1×
CT Angio Neck (70498) $2,533 $2,533 14.0×
CT cervical spine w/o contrast (72125) $2,218 $2,218 20.6×
CT chest w contrast (71260) $2,613 $2,613 14.4×
CT chest w/wo contrast (71270) $3,155 $3,155 17.4×
CT head/brain with contrast (70460) $2,126 $2,126 11.7×
CT head/brain without and with contrast (70470) $2,611 $2,611 14.4×
CT lower ext w/o (73700) $1,834 $1,834 17.0×
CT lower extremity w/contrast material (73701) $3,719 $3,719 20.5×
CT lumbar spine w contrast (72132) $2,836 $2,836 7.9×
CT lumbar spine w/o contrast (72131) $2,218 $2,218 20.6×
CT maxillofacial w contrast (70487) $2,248 $2,248 12.4×
CT maxillofacial wo contrast (70486) $1,773 $1,773 16.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,653 $2,653 14.7×
CT orbits w/o contrast (70480) $1,439 $1,439 13.3×
CT pelvis w/o contrast (72192) $2,155 $2,155 20.0×
CT soft tissue neck w contrast (70491) $2,126 $2,126 11.7×
CT soft tissue neck w/o contrast (70490) $1,773 $1,773 16.4×
CT thoracic spine w contrast (72129) $2,836 $2,836 15.7×
CT thoracic spine w/o contrast (72128) $2,224 $2,224 20.6×
CT thorax w/o contrast (71250) $2,094 $2,094 19.4×
CT upper ext wo (73200) $1,544 $1,544 14.3×
CT upper extremity with contrast (73201) $3,719 $3,719 10.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $6,270 $6,270 34.6×
Doppler Fetal Mid Cerebral Artery (76821) $146 $146 1.4×
Dxa Bone Density Axial (77080) $592 $592 5.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $592 $592 6.6×
Esophagram (74220) $595 $595 3.3×
Fetal Biophys Profile W/Nst (76818) $945 $945 8.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $945 $945 8.8×
Fluoroscopy up to 1 hr (76000) $480 $480 1.9×
Foot 2 views (73620) $286 $286 3.2×
Forearm 2 views (73090) $253 $253 2.8×
Hand 2 views (73120) $205 $205 1.9×
Hepatobil Syst Image W/Drug (78227) $2,556 $2,556 4.6×
Ht Muscle Image Spect Sing (78451) $593 $593 0.4×
Infant hip ultrasound, limited static exam (76886) $1,098 $1,098 12.2×
Knee 3 Views (73562) $325 $325 3.6×
Lung Ventilat&Perfus Imaging (78582) $1,896 $1,896 3.4×
Magnetic Image Jaw Joint (70336) $2,507 $2,507 10.2×
Mra Head W/O & W/Contrast Material (70546) $5,211 $5,211 14.5×
MRA head w/o contrast (70544) $3,097 $3,097 12.6×
Mra Neck W/O &W/Contrast Material (70549) $3,521 $3,521 9.8×
MRI abdomen w/o contrast (74181) $4,413 $4,413 17.9×
MRI any jt lower extrem w/contrast material (73722) $4,220 $4,220 5.2×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,413 $4,413 12.3×
MRI any jt upper extremity w/contrast matrl (73222) $4,220 $4,220 5.2×
MRI cervical spine w/o cont (72141) $2,992 $2,992 12.1×
MRI chest w/o contrast (71550) $4,413 $4,413 17.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,413 $4,413 12.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $4,025 $4,025 16.3×
Mri Neck Spine W/O & W/Dye (72156) $3,806 $3,806 10.6×
MRI orbit face &/neck w/o contrast (70540) $2,507 $2,507 10.2×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,849 $3,849 10.7×
MRI pelvis w/o & w contrast (72197) $3,933 $3,933 10.9×
MRI pelvis w/o contrast (72195) $3,334 $3,334 13.5×
MRI thoracic spine w/o contrast (72146) $2,992 $2,992 12.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $4,025 $4,025 16.3×
Mri Uppr Extremity W/O&W/Dye (73220) $4,413 $4,413 12.3×
MRI, abdomen, combo (74183) $4,932 $4,932 13.7×
MRI, dorsal spine combo (72157) $3,651 $3,651 10.1×
MRI, joint upper extrem (73221) $3,487 $3,487 14.2×
MRI, joint upper extrem combo (73223) $4,413 $4,413 12.3×
MRI, lumbar spine combo (72158) $3,806 $3,806 10.6×
Myocardial Spect Multiple Studies (78452) $3,408 $3,408 2.6×
Neck soft tissue (70360) $289 $289 3.2×
Ob us nuchal meas 1 gest (76813) $213 $213 2.0×
Pelvis 1 or 2 views (72170) $278 $278 2.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $488 $488 4.5×
Radex Ankle Complete Minimum 3 Views (73610) $318 $318 3.5×
Radex Calcaneus Minimum 2 Views (73650) $182 $182 2.0×
Radex elbow complete minimum 3 views (73080) $310 $310 3.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $435 $435 4.0×
Radex fingr minimum 2 views (73140) $261 $261 2.9×
Radex foot complete minimum 3 views (73630) $318 $318 3.5×
Radex Hand Minimum 3 Views (73130) $318 $318 3.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $435 $435 4.8×
Radex Ribs Unilateral 2 Views (71100) $325 $325 3.6×
Radex shoulder complete minimum 2 views (73030) $361 $361 4.0×
Radex Sinuses Paransl < 3 Views (70210) $232 $232 2.6×
Radex Spine 1 View Specify Level (72020) $284 $284 3.2×
Radex Sternum Minimum 2 Views (71120) $305 $305 3.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $487 $487 5.4×
Radex Toe Minimum 2 Views (73660) $253 $253 2.8×
Radex Wrist Complete Minimum 3 Views (73110) $318 $318 3.5×
Radiolog exam mandible compl minimum 4 views (70110) $433 $433 4.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $595 $595 3.3×
Radiologic exam knee complete 4/more views (73564) $419 $419 3.9×
Radiologic exam pelvis compl minimum 3 views (72190) $317 $317 2.9×
Radiologic Exam Small Int Single Contrast Study (74250) $596 $596 3.3×
Radiologic examination femur minimum 2 views (73552) $289 $289 3.2×
Radiologic examination knee 1/2 views (73560) $289 $289 3.2×
Radiologic examination tibia & fibula 2 views (73590) $305 $305 3.4×
Ribs bilateral 3 views (71110) $335 $335 3.1×
Scapula (73010) $269 $269 2.5×
Screening Digital Breast Tomosynthesis Bi (77063) $85 $85 3.6×
Skull less than 4 views (70250) $258 $258 2.4×
Sternoclavicular joints (71130) $412 $412 4.6×
Thoracic spine 2 views (72070) $415 $415 3.8×
Thoracic spine 3 views (72072) $402 $402 3.7×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $220–$576 $220–$576 varies
Ultrasound Exam Aaa Screen (76706) $706 $706 6.5×
Ultrasound, abdomen limited (76705) $706 $706 6.5×
Umbilical-artery Doppler (OB) (76820) $62 $62 0.6×
Us chest (76604) $580 $580 5.4×
Us complete joint (76881) $628 $628 5.8×
Us exam, pelvic, limited (76857) $657 $657 6.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $628 $628 5.8×
Us ob detailed single fetus (76811) $1,942 $1,942 7.9×
Us ob limited 1 or more fetuses (76815) $595 $595 5.5×
Us ob transvaginal (76817) $488 $488 4.5×
Us pelvic non ob complete (76856) $803 $803 7.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $643 $643 6.0×
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $90–$518 $90–$518 varies
Us retroperitoneal complete (76770) $770 $770 7.1×
Us retroperitoneal limited (76775) $706 $706 6.5×
Us scrotum and contents (76870) $619 $619 5.7×
Us thyroid (76536) $643 $643 6.0×
Wrist 2 views (73100) $236 $236 2.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $437 $437 4.9×
X-Ray Bend Only L-S Spine (72120) $415 $415 3.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $226 $226 2.5×
X-Ray Exam Entire Spi 1 Vw (72081) $284 $284 3.2×
X-Ray Exam Entire Spi 2/3 Vw (72082) $488 $488 4.5×
X-Ray Exam Hip Uni 1 View (73501) $228 $228 2.5×
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 4 matching MRF lines		 $298–$571 $298–$571 varies
X-Ray Exam Hip Uni 4/> Views (73503) $406 $406 3.8×
X-Ray Exam Hips Bi 2 Views (73521) $473 $473 4.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $308 $308 2.9×
X-Ray Exam Hips Bi 5/> Views (73523) $564 $564 5.2×
X-Ray Exam L-S Spine Bending (72114) $534 $534 4.9×
X-Ray Exam Neck Spine 2-3 Vw (72040) $361 $361 4.0×
X-Ray Exam Neck Spine 6/>Vws (72052) $623 $623 5.8×
X-Ray Exam Unilat Ribs/Chest (71101) $335 $335 3.1×
X-ray eye for foreign body (70030) $346 $346 3.9×
X-ray humerus (73060) $253 $253 2.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $428 $428 4.0×
X-ray nose-rectum child f.b. (76010) $225 $225 2.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $407 $407 3.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $382 $382 3.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220)
range across 2 matching MRF lines		 $327–$337 $327–$337 varies
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $369 $369 4.1×
X-Ray Stress View (77071) $221 $221 2.5×
X-ray thoracic spine 4 vw (72074) $503 $503 4.7×
Xr c-spine 4 or 5 views (72050) $421 $421 3.9×
Xr orbits complete 4 views (70200) $357 $357 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.