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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ProcedureCash priceGross charge× Medicare
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 shoulder (73040) $783.69 $918 2.2×
Arthrogram wrist (73115) $583.92 $684 1.6×
Arthrography knee lt (73580) $476.36 $558 1.3×
Bone &/Joint Imaging Limited Area (78300) $812.33 $1,122 2.0×
Bone &/Joint Imaging Multiple Areas (78305) $964.37 $1,332 2.4×
Bone &/joint imaging whole body (78306) $1,746.29 $2,412 4.3×
Bone age studies (77072) $181.68 $240 1.7×
Bone Imaging 3 Phase (78315) $2,007.65 $2,773 4.9×
Bone survey complete (77075) $373.20 $493 3.5×
Cervical spine 2 or 3 views (72040) $355.79 $470 4.0×
Chest 1 view (71045) $158.40 $220 1.8×
Chest 3 views (71047) $342.72 $476 3.9×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $465.56 $615 2.6×
Clavicle complete (73000) $267.98 $354 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $377.16 $549 3.5×
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 angiography upper extremity lt (73206) $2,449.84 $3,566 13.7×
CT c-spine w/o contrast (72125) $2,034.89 $2,962 19.1×
CT cervical spine w&w/o contrast (72127) $3,052.34 $4,443 17.0×
CT cervical spine with contrast (72126) $2,543.96 $3,703 7.1×
CT chest w/wo contrast (71270) $1,565.67 $2,279 8.7×
CT chest with contrast (71260) $1,304.61 $1,899 7.3×
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 limited/localized follow up study (76380) $640.48 $993 7.2×
CT lower ext w/o (73700) $1,125.99 $1,639 10.5×
CT lower extremity w wo contrast (73702) $1,689.33 $2,459 9.4×
CT lower extremity with contrast (73701) $1,407.66 $2,049 7.9×
CT lumbar spine w & w/o contrast (72133) $3,221.34 $4,689 18.0×
CT lumbar spine w/o contrast (72131) $2,147.56 $3,126 20.1×
CT lumbar spine with contrast (72132) $2,684.80 $3,908 7.5×
CT maxillofacial w contrast (70487) $1,980.15 $3,070 11.0×
CT maxillofacial w/o contrast (70486) $1,584.12 $2,456 14.8×
CT maxillofacial w/wo contrast (70488) $2,376.18 $3,684 13.3×
CT neck soft tissue w contrast (70491) $1,328.06 $2,059 7.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (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 for measuring calcium and other minerals in bone (77078) $446.55 $650 5.0×
CT soft tissue neck w/o & w/contrast material (70492) $1,593.80 $2,471 8.9×
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 contrast (72130) $3,246.08 $4,725 18.1×
CT thorax w/o contrast (71250) $1,043.55 $1,519 9.8×
CT upper extremity w/o & w/contrast material (73202) $2,333.05 $3,396 13.0×
CT upper extremity w/o contrast rt (73200) $1,555.37 $2,264 14.6×
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 abdomen pelvis (74174) $2,298.70 $3,346 6.4×
CTA chest (71275) $1,643.99 $2,393 9.2×
Cta Head (70496) $1,523.49 $2,362 8.5×
CTA lwr ext w&w/o contrast (73706) $1,773.83 $2,582 9.9×
Cta Neck (70498) $1,673.78 $2,595 9.3×
Cta Pelvis (72191) $3,228.21 $4,699 18.0×
Cystography minimum 3 views rs&i (74430) $408.02 $539 1.1×
Doppler Echo Fetal Spectral Display Complete (76827) $439.62 $510 4.1×
Dxa bone density study 1/> sites axial skel (77080) $343.68 $454 3.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $358.06 $473 4.0×
Dxa bone density study axial skeleton (77085) $383.80 $507 3.6×
Echo exam of fetal heart (76825) $930.96 $1,080 1.7×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $428.41 $497 1.8×
Echoencephalography real time imaging (76506) $447.38 $519 4.2×
Esophagus (74220) $330.81 $437 1.8×
Fetal biophysical profile non-stress testing (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×
Gated Heart Planar Single (78472) $1,375.60 $1,900 3.4×
Hand 2 views (73120) $173.35 $229 1.6×
Hand 3 views (73130) $269.49 $356 3.0×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,875.88 $2,591 3.4×
Hepatobiliary syst imaging including gallbladder (78226) $1,369.81 $1,892 3.4×
Ht muscle image spect sing (78451) $2,986.50 $4,125 2.3×
Humerus Min 2 Views Left (73060) $324 $428 3.6×
Hysterosalpingogram (74740) $400.45 $529 1.6×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $146.86 $194 1.4×
Kidney Img Morphology Vascular Flow 1 W/O Rx (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 Ventilation Imaging (78579) $590.78 $816 1.4×
Meckels Diverticulum (78290) $1,228.63 $1,697 3.0×
Mr safety determination physician/other qhp (76016) $100.68 $133 1.1×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $236.94 $313 3.9×
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 med physics xm customization plng&mntr (76017) $368.66 $487 1.5×
MRA head w & w/o contrast (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 & w/contrast material (74183) $3,634.54 $4,776 10.2×
MRI abdomen w/o contrast (74181) $2,423.02 $3,184 9.9×
MRI any jnt lwr ext with con lt (73722) $2,273.87 $2,988 2.8×
MRI any jt upper extremity w/contrast matrl (73222) $1,806.61 $2,374 2.3×
MRI c-spine with contrast (72142) $1,469.09 $2,170 4.1×
MRI cervical spine w/o contrast (72141) $1,175.27 $1,736 4.8×
MRI chest w/o & w/contrast material (71552) $3,294.37 $4,329 9.2×
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 Forearm w/ Contrast Bilateral 73219 (73219) $2,206.90 $2,900 6.2×
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 contr matrl (73718) $1,352.30 $1,777 5.5×
MRI orbit face &/neck w/o contrast (70540) $2,267.71 $2,976 9.3×
MRI orbit/face/neck w&w/o cont (70543) $3,401.57 $4,464 9.5×
MRI orbit/face/neck w/contrast (70542) $2,834.64 $3,720 8.0×
MRI pelvis w contrast (72196) $1,966.42 $2,584 5.5×
MRI pelvis w/o & w/contrast material (72197) $2,359.86 $3,101 6.6×
MRI pelvis w/o contrast (72195) $1,572.99 $2,067 6.5×
MRI scan of arm joint before and after contrast (73223) $2,168.09 $2,849 6.1×
MRI scan of leg joint before and after contrast (73723) $2,728.18 $3,585 7.7×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,762.91 $2,604 4.9×
MRI spinal canal lumbar w/contrast material (72149) $1,469.09 $2,170 4.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,762.91 $2,604 4.9×
MRI spinal canal thoracic w/contrast matrl (72147) $1,469.09 $2,170 4.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,762.91 $2,604 4.9×
MRI thoracic spine w/o contrast (72146) $1,175.27 $1,736 4.8×
MRI tmj (70336) $2,356.82 $3,097 9.7×
MRI upper ext joint w/o contrast (73221) $1,445.14 $1,899 5.9×
MRI upper extrem other than jt w/o & w/contras (73220) $2,648.28 $3,480 7.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,765.52 $2,320 7.2×
Myelogram Cervical (72240) $1,641.93 $2,169 2.1×
Myelogram Lumbar (72265) $1,664.64 $2,199 2.1×
Myelogram thoracic (72255) $1,308.85 $1,729 1.6×
Myocardial Spect Multiple Studies (78452) $3,858.20 $5,329 2.9×
Neck soft tissue (70360) $235.43 $311 2.6×
Nm gastric emptying study (78264) $1,555.15 $2,148 3.8×
Nm gastroesophageal reflux study (78262) $887.62 $1,226 2.2×
Nuclear medicine study of heart muscle at rest with stress (78453) $1,961.32 $2,709 1.5×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $468.07 $543 4.4×
Osseous survey limited (77074) $247.54 $327 2.3×
Parathyroid imaging (78070) $833.32 $1,151 2.0×
Pelvis 1 or 2 views (72170) $186.98 $247 1.8×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,028.83 $2,666 5.7×
Pulmonary Perfusion Imaging Particulate (78580) $833.32 $1,151 2.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,319.13 $1,822 2.4×
Radex abscess/fistula/sinus tract rs&i (76080) $541.26 $715 1.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $262.68 $347 3.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $376.99 $498 3.5×
Radex hips bilateral with pelvis 2 views (73521) $206.66 $273 1.9×
Radex mastoids compl minimum 3 views pr side (70130) $248.30 $328 2.3×
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 1 View - Xr Abdomen 1 View (74018) $170.32 $225 1.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $322.48 $426 3.0×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $332.64 $462 3.7×
Radiologic exam colon single contrast study (74270) $691.14 $913 3.9×
Radiologic exam upr gi trc double contrast study (74246) $669.19 $884 3.7×
Radiologic exam upr gi trc single contrast study (74240) $504.16 $666 2.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $208.93 $276 2.3×
Radiological examination surgical specimen (76098) $195.31 $258 0.3×
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×
Scanogram (77073) $430.73 $569 4.0×
Scapula complete (73010) $202.88 $268 1.9×
Screening digital breast tomosynthesis (77063) $39.15 $49 1.7×
Small bowel series (74250) $456.47 $603 2.5×
Spine thoracic 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×
Tomogram (76100) $373.20 $493 3.5×
Ultrasound, abdomen limited (76705) $768.04 $891 7.2×
Upper Extremity Infant (73092) $266.46 $352 2.5×
Urethrocystography voiding (74455) $609.38 $805 2.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $1,167.29 $1,542 6.5×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $1,054.50 $1,393 5.9×
Us abdl aorta screen aaa (76706) $331.01 $384 3.1×
Us breast unilateral complete (76641) $610.30 $708 5.7×
Us breast unilateral limited (76642) $500.82 $581 5.6×
Us chest (76604) $512.03 $594 4.8×
Us compl joint r-t w/image documentation (76881) $783.56 $909 7.3×
Us infant hips limited static (76886) $248.26 $288 2.8×
Us ob transvaginal (76817) $593.92 $689 5.6×
Us pelvic non ob complete (76856) $900.79 $1,045 8.4×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $660.29 $766 6.2×
Us pregnancy ltd (76815) $460.31 $534 4.3×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $769.77 $893 7.2×
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 soft tissue head/neck (76536) $802.52 $931 7.5×
Us xtr non-vasc lmtd (76882) $505.13 $586 4.7×
Venogram extremity bilateral (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 Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $373.20 $493 3.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $285.39 $377 3.2×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $356.55 $471 4.0×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $766.84 $1,013 4.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $295.23 $390 3.3×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $364.12 $481 4.1×
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 3-4 Views (73522) $336.86 $445 3.2×
X-ray exam of femur 1 (73551) $140.80 $186 1.6×
X-ray eye for foreign body (70030) $127.18 $168 1.4×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $346.71 $458 3.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $296.74 $392 3.3×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $336.11 $444 3.8×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $177.14 $234 2.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $355.79 $470 4.0×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $442.85 $585 4.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $398.18 $526 4.5×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $140.80 $186 1.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $283.88 $375 2.7×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $644.96 $852 6.0×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $555.64 $734 5.2×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $260.41 $344 2.9×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $102.95 $136 1.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $280.09 $370 2.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $297.50 $393 3.3×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $337.62 $446 3.2×
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 Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $336.11 $444 3.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $329.30 $435 3.7×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $209.69 $277 2.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $357.30 $472 3.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $311.13 $411 2.9×
X-Ray Spine One View - Xr Spine (72020) $249.81 $330 2.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $278.58 $368 3.1×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $175.62 $232 2.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $373.20 $493 3.5×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $445.12 $588 4.2×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $194.55 $257 2.2×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $334.59 $442 3.8×
Xr chest 4+ views (71048) $387.36 $538 3.6×
Xr finger(s) 2+ views (73140) $198.33 $262 2.2×
Xr shoulder 1 view (73020) $243.75 $322 2.7×
Xr spine cervical 4 or 5 views (72050) $489.78 $647 4.6×
Xr tibia/fibula 2 views (73590) $201.36 $266 2.3×
Xr tmj bilateral (70330) $295.23 $390 3.3×
Xray knee 1 or 2 views rt (73560) $238.46 $315 2.7×