Imaging prices at Platte County Hospital

Wheatland, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $170.32 $225 1.9×
Abdomen 2 views (74019) $308.10 $407 2.9×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,293.06 $1,786 3.2×
Ankle 2 views (73600) $200.60 $265 2.3×
Arthrogram hip (73525) $825.52 $967 2.3×
Arthrogram Wrist (73115) $583.92 $684 1.6×
Bone age studies (77072) $181.68 $240 1.7×
Bone Imaging 3 Phase (78315) $2,007.65 $2,773 4.9×
Bone Imaging Limited Area (78300) $812.33 $1,122 2.0×
Bone Imaging Multiple Areas (78305) $964.37 $1,332 2.4×
Bone Imaging Whole Body (78306) $1,746.29 $2,412 4.3×
Cat Scan Follow-Up Study (76380) $640.48 $993 7.2×
Chest 1 view (71045) $158.40 $220 1.8×
Chest 2 views (71046) $332.64 $462 3.7×
Chest 3 views (71047) $342.72 $476 3.9×
Chest 4 or more views (71048) $387.36 $538 3.6×
Clavicle complete (73000) $267.98 $354 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $377.16 $549 3.5×
Contrast X-Ray Bladder (74430) $408.02 $539 1.1×
Contrast X-Ray Of Knee Joint (73580) $476.36 $558 1.3×
CT abdomen and pelvis without and with contrast (74178) $2,188.78 $3,186 6.1×
CT abdomen and pelvis without contrast (74176) $1,459.19 $2,124 6.0×
CT abdomen w contrast (74160) $1,170.65 $1,704 6.5×
CT abdomen w wo contrast (74170) $1,404.92 $2,045 7.8×
CT abdomen w/o contrast (74150) $936.38 $1,363 8.8×
CT Angio Abdomen and Pelvis (74174) $2,298.70 $3,346 6.4×
CT Angio Chest (71275) $1,643.99 $2,393 9.2×
CT Angio Head (70496) $1,523.49 $2,362 8.5×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,773.83 $2,582 9.9×
CT Angio Neck (70498) $1,673.78 $2,595 9.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,449.84 $3,566 13.7×
CT bone density (77078) $446.55 $650 5.0×
CT cervical spine w/ contrast (72126) $2,543.96 $3,703 7.1×
CT cervical spine w/o contrast (72125) $2,034.89 $2,962 19.1×
CT cervical spine w/wo cont (72127) $3,052.34 $4,443 17.0×
CT chest w contrast (71260) $1,304.61 $1,899 7.3×
CT chest w/wo contrast (71270) $1,565.67 $2,279 8.7×
CT head/brain with contrast (70460) $1,208.73 $1,874 6.7×
CT head/brain without and with contrast (70470) $1,450.61 $2,249 8.1×
CT iac w contrast (70481) $1,971.77 $3,057 11.0×
CT l-spine w&w/o contrast (72133) $3,221.34 $4,689 18.0×
CT lower ext w/o (73700) $1,125.99 $1,639 10.5×
CT lower extremity w/contrast material (73701) $1,407.66 $2,049 7.9×
CT lumbar spine w contrast (72132) $2,684.80 $3,908 7.5×
CT lumbar spine w/o contrast (72131) $2,147.56 $3,126 20.1×
CT maxillofacial w contrast (70487) $1,980.15 $3,070 11.0×
CT maxillofacial wo contrast (70486) $1,584.12 $2,456 14.8×
CT neck tissue combo (70492) $1,593.80 $2,471 8.9×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,365.86 $3,668 13.2×
CT orbits w/o contrast (70480) $1,577.03 $2,445 14.8×
CT pelvis w&w/o contrast (72194) $3,074.33 $4,475 17.2×
CT pelvis w/o contrast (72192) $2,049.32 $2,983 19.2×
CT scan of leg combo (73702) $1,689.33 $2,459 9.4×
CT scans face/jaw combo (70488) $2,376.18 $3,684 13.3×
CT soft tissue neck w contrast (70491) $1,328.06 $2,059 7.4×
CT soft tissue neck w/o contrast (70490) $1,062.32 $1,647 9.9×
CT thoracic spine w contrast (72129) $2,705.41 $3,938 15.1×
CT thoracic spine w/o contrast (72128) $2,164.05 $3,150 20.3×
CT thoracic spine w/wo cont (72130) $3,246.08 $4,725 18.1×
CT thorax w/o contrast (71250) $1,043.55 $1,519 9.8×
CT upper ext wo (73200) $1,555.37 $2,264 14.6×
CT upper extremity w/o & w/contrast material (73202) $2,333.05 $3,396 13.0×
CT upper extremity with contrast (73201) $1,944.21 $2,830 5.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,926.62 $2,987 10.8×
Cta Abdomen (74175) $1,475.68 $2,148 8.2×
CTA pelvis (72191) $3,228.21 $4,699 18.0×
Doppler Echo Fetal Spectral Display Complete (76827) $439.62 $510 4.1×
Dxa Bone Density Axial (77080) $343.68 $454 3.2×
Dxa bone density study (77085) $383.80 $507 3.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $358.06 $473 4.0×
Echo exam of fetal heart (76825) $930.96 $1,080 1.7×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $428.41 $497 1.8×
Esophagram (74220) $330.81 $437 1.8×
Fetal Biophys Profile W/Nst (76818) $730.98 $848 6.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $673.22 $781 6.3×
Fluoroscopy up to 1 hr (76000) $567.75 $750 2.3×
Foot 2 views (73620) $234.67 $310 2.6×
Forearm 2 views (73090) $243.75 $322 2.7×
Gastric emptying imaging study (78264) $1,555.15 $2,148 3.8×
Gastroesophageal Reflux Exam (78262) $887.62 $1,226 2.2×
Gated Heart Planar Single (78472) $1,375.60 $1,900 3.4×
Hand 2 views (73120) $173.35 $229 1.6×
Hepatobil Syst Image W/Drug (78227) $1,875.88 $2,591 3.4×
Hepatobiliary System Imaging (78226) $1,369.81 $1,892 3.4×
Ht Muscle Image Spect Sing (78451) $2,986.50 $4,125 2.3×
Hysterosalpingogram (74740) $400.45 $529 1.6×
Infant hip ultrasound, limited static exam (76886) $248.26 $288 2.8×
Joint Survey Single View (77077) $146.86 $194 1.4×
K Flow/Funct Image W/O Drug (78707) $758.03 $1,047 1.4×
Knee 3 Views (73562) $290.69 $384 3.3×
Liver & Spleen Imaging Static Only (78215) $1,045.46 $1,444 2.6×
Lung Perf&Ventilat Diferentl (78598) $1,125.10 $1,554 2.0×
Lung perfusion differential (78597) $687.80 $950 1.7×
Lung Ventilat&Perfus Imaging (78582) $1,319.13 $1,822 2.4×
Lung Ventilation Imaging (78579) $590.78 $816 1.4×
Magnetic Image Jaw Joint (70336)
range across 3 matching MRF lines
$2,356.82–$3,535.61 $3,097–$4,646 varies
Meckels Divert Exam (78290) $1,228.63 $1,697 3.0×
Mr safety determination physician/other qhp (76016) $100.68 $133 1.1×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $28.77 $38 1.0×
Mr safety implt electronics prepj supvj phys/qhp (76018) $155.18 $205 1.6×
Mr safety implt pos&/immoblj (76019) $236.94 $313 3.9×
Mr safety med physics xm customization plng&mntr (76017) $368.66 $487 1.5×
Mra Head W/O & W/Contrast Material (70546) $2,040.92 $3,179 5.7×
MRA head w/o contrast (70544) $1,360.40 $2,119 5.6×
MRA head with contrast (70545) $1,700.66 $2,649 4.8×
MRA neck w contrast (70548) $2,948.71 $4,593 8.3×
Mra Neck W/O &W/Contrast Material (70549) $3,538.06 $5,511 9.9×
MRA neck w/o contrast (70547) $2,358.71 $3,674 9.7×
MRI abdomen w contrast (74182) $3,028.78 $3,980 8.5×
MRI abdomen w/o contrast (74181) $2,423.02 $3,184 9.9×
MRI any jt lower extrem w/contrast material (73722) $2,273.87 $2,988 2.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,728.18 $3,585 7.7×
MRI any jt upper extremity w/contrast matrl (73222) $1,806.61 $2,374 2.3×
MRI cervical spine w contrast (72142) $1,469.09 $2,170 4.1×
MRI cervical spine w/o cont (72141) $1,175.27 $1,736 4.8×
MRI chest w/o contrast (71550) $2,196.25 $2,886 9.0×
MRI chest with contrast (71551) $2,745.69 $3,608 3.4×
MRI chest wo w contrast (71552) $3,294.37 $4,329 9.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,690.94 $2,222 4.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,028.83 $2,666 5.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,352.30 $1,777 5.5×
MRI lumbar spine w contrast (72149) $1,469.09 $2,170 4.1×
Mri Neck Spine W/O & W/Dye (72156) $1,762.91 $2,604 4.9×
MRI orbit face &/neck w/o contrast (70540) $2,267.71 $2,976 9.3×
MRI orbit face neck w contrast (70542) $2,834.64 $3,720 8.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,401.57 $4,464 9.5×
MRI pelvis w contrast (72196) $1,966.42 $2,584 5.5×
MRI pelvis w/o & w contrast (72197) $2,359.86 $3,101 6.6×
MRI pelvis w/o contrast (72195) $1,572.99 $2,067 6.5×
MRI thoracic spine w/o contrast (72146) $1,175.27 $1,736 4.8×
MRI upper extremity oth than jt w/contr matrl (73219) $2,206.90 $2,900 6.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,765.52 $2,320 7.2×
Mri Uppr Extremity W/O&W/Dye (73220) $2,648.28 $3,480 7.4×
MRI, abdomen, combo (74183) $3,634.54 $4,776 10.2×
MRI, dorsal spine combo (72157) $1,762.91 $2,604 4.9×
MRI, dorsal spine contrast (72147) $1,469.09 $2,170 4.1×
MRI, joint upper extrem (73221) $1,445.14 $1,899 5.9×
MRI, joint upper extrem combo (73223) $2,168.09 $2,849 6.1×
MRI, lumbar spine combo (72158) $1,762.91 $2,604 4.9×
Myelogram cervical (72240) $1,641.93 $2,169 2.1×
Myelogram Lumbar (72265) $1,664.64 $2,199 2.1×
Myelography thoracic (72255) $1,308.85 $1,729 1.6×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,961.32 $2,709 1.5×
Myocardial Spect Multiple Studies (78452) $3,858.20 $5,329 2.9×
Neck soft tissue (70360) $235.43 $311 2.6×
Parathyroid Planar Imaging (78070) $833.32 $1,151 2.0×
Pelvis 1 or 2 views (72170) $186.98 $247 1.8×
Pulmonary Perfusion Imaging Particulate (78580) $833.32 $1,151 2.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $373.20 $493 3.5×
Radex abscess/fistula/sinus tract rs&i (76080) $541.26 $715 1.0×
Radex Ankle Complete Minimum 3 Views (73610) $356.55 $471 4.0×
Radex Calcaneus Minimum 2 Views (73650) $177.14 $234 2.0×
Radex elbow complete minimum 3 views (73080) $364.12 $481 4.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $346.71 $458 3.2×
Radex fingr minimum 2 views (73140) $198.33 $262 2.2×
Radex foot complete minimum 3 views (73630) $336.11 $444 3.8×
Radex Hand Minimum 3 Views (73130) $269.49 $356 3.0×
Radex lower extremity infant minimum 2 views (73592) $140.80 $186 1.6×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $248.30 $328 2.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $260.41 $344 2.9×
Radex Ribs Unilateral 2 Views (71100) $297.50 $393 3.3×
Radex shoulder complete minimum 2 views (73030) $336.11 $444 3.8×
Radex Sinuses Paransl < 3 Views (70210) $209.69 $277 2.4×
Radex Spine 1 View Specify Level (72020) $249.81 $330 2.8×
Radex Sternum Minimum 2 Views (71120) $175.62 $232 2.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $295.23 $390 3.3×
Radex Toe Minimum 2 Views (73660) $194.55 $257 2.2×
Radex upper extremity infant minimum 2 views (73092) $266.46 $352 2.5×
Radex Wrist Complete Minimum 3 Views (73110) $334.59 $442 3.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $444.36 $587 4.2×
Radiolog exam mandible compl minimum 4 views (70110) $376.23 $497 3.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $322.48 $426 3.0×
Radiologic exam colon double contrast study (74280) $766.84 $1,013 4.3×
Radiologic exam colon single contrast study (74270) $691.14 $913 3.9×
Radiologic exam knee complete 4/more views (73564) $442.85 $585 4.1×
Radiologic exam pelvis compl minimum 3 views (72190) $280.09 $370 2.6×
Radiologic Exam Small Int Single Contrast Study (74250) $456.47 $603 2.5×
Radiologic exam swallow function contrast study (74230) $465.56 $615 2.6×
Radiologic exam upr gi trc double contrast study (74246) $669.19 $884 3.7×
Radiologic examination femur 1 view (73551) $140.80 $186 1.6×
Radiologic examination femur minimum 2 views (73552) $208.93 $276 2.3×
Radiologic examination knee 1/2 views (73560) $238.46 $315 2.7×
Radiologic Examination Osseous Survey Limited (77074) $247.54 $327 2.3×
Radiologic examination tibia & fibula 2 views (73590) $201.36 $266 2.3×
Ribs bilateral 3 views (71110) $345.95 $457 3.2×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,188.08 $1,641 2.1×
Scapula (73010) $202.88 $268 1.9×
Screening Digital Breast Tomosynthesis Bi (77063) $39.15 $49 1.7×
Shoulder 1 view (73020) $243.75 $322 2.7×
Shoulder Arthrography (73040) $783.69 $918 2.2×
Skull less than 4 views (70250) $311.13 $411 2.9×
Sternoclavicular joints (71130) $278.58 $368 3.1×
Thoracic spine 2 views (72070) $373.20 $493 3.5×
Thoracic spine 3 views (72072) $386.83 $511 3.6×
Thoracolumbar 2 views (72080) $198.33 $262 2.2×
Thyroid Imaging With Vascular Flow (78013) $703.73 $972 1.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $957.85 $1,323 2.3×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines
$500.82–$751.66 $581–$872 varies
Ultrasound Exam Aaa Screen (76706) $331.01 $384 3.1×
Ultrasound, abdomen limited (76705) $768.04 $891 7.2×
Upper gi w/o kub (74240) $504.16 $666 2.8×
Urethrocystogram voiding (74455) $609.38 $805 2.5×
Us breast unilateral complete (76641)
range across 3 matching MRF lines
$610.30–$915.44 $708–$1,062 varies
Us chest (76604) $512.03 $594 4.8×
Us complete joint (76881) $783.56 $909 7.3×
Us exam, pelvic, limited (76857) $660.29 $766 6.2×
Us head (76506) $447.38 $519 4.2×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $505.13 $586 4.7×
Us ob limited 1 or more fetuses (76815) $460.31 $534 4.3×
Us ob transvaginal (76817) $593.92 $689 5.6×
Us pelvic non ob complete (76856) $900.79 $1,045 8.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $769.77 $893 7.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $468.07 $543 4.4×
Us retroperitoneal complete (76770) $885.27 $1,027 8.3×
Us retroperitoneal limited (76775) $290.49 $337 2.7×
Us scrotum and contents (76870) $829.24 $962 7.8×
Us thyroid (76536) $802.52 $931 7.5×
Venography extremity bilateral rs&i (75822) $597.27 $789 0.4×
Venography extremity unilateral rs&i (75820) $510.98 $675 0.3×
Wrist 2 views (73100) $234.67 $310 2.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $285.39 $377 3.2×
X-Ray Bend Only L-S Spine (72120) $555.64 $734 5.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $295.23 $390 3.3×
X-Ray Exam Breast Specimen (76098) $195.31 $258 0.3×
X-Ray Exam Entire Spi 1 Vw (72081) $262.68 $347 3.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $376.99 $498 3.5×
X-Ray Exam Entire Spi 4/5 Vw (72083) $428.46 $566 4.0×
X-Ray Exam Hip Uni 1 View (73501) $167.30 $221 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $314.16 $415 3.5×
X-Ray Exam Hip Uni 4/> Views (73503) $392.88 $519 3.7×
X-Ray Exam Hips Bi 2 Views (73521) $206.66 $273 1.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $336.86 $445 3.2×
X-Ray Exam L-S Spine Bending (72114) $644.96 $852 6.0×
X-Ray Exam Neck Spine 2-3 Vw (72040) $355.79 $470 4.0×
X-Ray Exam Unilat Ribs/Chest (71101) $337.62 $446 3.2×
X-ray eye for foreign body (70030) $127.18 $168 1.4×
X-ray humerus (73060) $324 $428 3.6×
X-ray IV pyelogram (ivp) (74400) $1,167.29 $1,542 6.5×
X-ray IV pyelogram+tomography (74415) $1,054.50 $1,393 5.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $355.79 $470 4.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $398.18 $526 4.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $283.88 $375 2.7×
X-ray nose-rectum child f.b. (76010) $102.95 $136 1.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $424.68 $561 4.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $398.18 $526 3.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $240.73 $318 2.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $329.30 $435 3.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $357.30 $472 3.3×
X-ray thoracic spine 4 vw (72074) $445.12 $588 4.2×
X-Rays Bone Length Studies (77073) $430.73 $569 4.0×
X-Rays Bone Survey Complete (77075) $373.20 $493 3.5×
Xr c-spine 4 or 5 views (72050) $489.78 $647 4.6×
Xr facial bones less than 3 views (70140) $296.74 $392 3.3×
Xr Tomogram Single Plane (76100) $373.20 $493 3.5×

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.