Imaging prices at Powell Valley Healthcare

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $190.02 $223.55 1.8×
Acute gastrointestinal blood loss imaging (78278) $780.09 $917.75 1.9×
Ankle 2 views (73600) $150.58 $177.15 1.7×
Arthrogram elbow (73085) $468.82 $551.55 1.3×
Arthrogram hip (73525) $547.23 $643.80 1.5×
Arthrogram shoulder (73040) $629.04 $740.05 1.8×
Arthrogram wrist (73115) $440.82 $518.60 1.2×
Arthrography knee lt (73580) $699.08 $822.45 2.0×
Bone &/Joint Imaging Limited Area (78300) $553.74 $651.45 1.4×
Bone &/joint imaging whole body (78306) $762.12 $896.60 1.9×
Bone age studies (77072) $402.74 $473.80 3.8×
Bone Imaging 3 Phase (78315) $838.32 $986.25 2.1×
Bone survey complete (77075) $396.61 $466.60 3.7×
Cervical spine 2 or 3 views (72040) $204.90 $241.05 2.3×
Chest 1 view (71045) $69.19 $81.40 0.8×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $202.22 $237.90 1.1×
Clavicle complete (73000) $143.56 $168.90 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $541.92 $637.55 5.1×
CT abdomen and pelvis without and with contrast (74178) $3,643.87 $4,286.90 10.2×
CT abdomen and pelvis without contrast (74176) $2,497.81 $2,938.60 10.2×
CT abdomen w contrast (74160) $1,779.90 $2,094 9.9×
CT abdomen w wo contrast (74170) $2,179.15 $2,563.70 12.2×
CT abdomen w/o contrast (74150) $1,481.38 $1,742.80 13.9×
CT angiography upper extremity lt (73206) $1,234.03 $1,451.80 6.9×
CT c-spine w/o contrast (72125) $231.12 $271.90 2.2×
CT cervical spine w&w/o contrast (72127) $1,193.32 $1,403.90 6.7×
CT cervical spine with contrast (72126) $1,065.94 $1,254.05 3.0×
CT chest w/wo contrast (71270) $1,144.28 $1,346.20 6.4×
CT chest with contrast (71260) $1,031.82 $1,213.90 5.8×
CT head/brain with contrast (70460) $977.08 $1,149.50 5.5×
CT head/brain without and with contrast (70470) $1,060.21 $1,247.30 5.9×
CT iac w contrast (70481) $856.25 $1,007.35 4.8×
CT limited/localized follow up study (76380) $527.94 $621.10 5.9×
CT lower ext w/o (73700) $676.78 $796.20 6.3×
CT lower extremity w wo contrast (73702) $899.56 $1,058.30 5.0×
CT lower extremity with contrast (73701) $806.78 $949.15 4.5×
CT lumbar spine w & w/o contrast (72133) $2,255.31 $2,653.30 12.6×
CT lumbar spine w/o contrast (72131) $850.98 $1,001.15 8.0×
CT lumbar spine with contrast (72132) $1,147.80 $1,350.35 3.2×
CT maxillofacial w contrast (70487) $863.26 $1,015.60 4.8×
CT maxillofacial w/o contrast (70486) $743.76 $875 7.0×
CT maxillofacial w/wo contrast (70488) $976.61 $1,148.95 5.4×
CT neck soft tissue w contrast (70491) $930.67 $1,094.90 5.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $999.39 $1,175.75 5.6×
CT orbits w/o contrast (70480) $787.95 $927 7.4×
CT pelvis w & w/o contrast (72194) $1,038.79 $1,222.10 5.8×
CT pelvis w/o contrast (72192) $762.12 $896.60 7.1×
CT soft tissue neck w/o & w/contrast material (70492) $1,019.54 $1,199.45 5.7×
CT soft tissue neck w/o contrast (70490) $878.60 $1,033.65 8.2×
CT thoracic spine w/contrast (72129) $1,014.74 $1,193.80 5.7×
CT thoracic spine w/o contrast (72128) $853.62 $1,004.25 8.0×
CT thoracic spine w/wo contrast (72130) $1,149.54 $1,352.40 6.4×
CT thorax w/o contrast (71250) $1,503.23 $1,768.50 14.1×
CT upper extremity w/o & w/contrast material (73202) $883.84 $1,039.80 4.9×
CT upper extremity w/o contrast rt (73200) $700.40 $824 6.6×
CT upper extremity with contrast (73201) $808.56 $951.25 2.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,546.39 $2,995.75 14.2×
Cta Abdomen (74175) $391.34 $460.40 2.2×
CTA abdomen pelvis (74174) $1,179.72 $1,387.90 3.3×
CTA chest (71275) $1,461.20 $1,719.05 8.2×
Cta Head (70496) $1,316.74 $1,549.10 7.3×
CTA lwr ext w&w/o contrast (73706) $1,188.04 $1,397.70 6.6×
Cta Neck (70498) $1,314.57 $1,546.55 7.3×
Cta Pelvis (72191) $1,339.09 $1,575.40 7.5×
Cystography minimum 3 views rs&i (74430) $511.74 $602.05 1.4×
Dxa bone density study 1/> sites axial skel (77080) $234.64 $276.05 2.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $121.72 $143.20 1.4×
Dxa bone density study axial skeleton (77085) $160.22 $188.50 1.5×
Echoencephalography real time imaging (76506) $281.95 $331.70 2.6×
Esophagus (74220) $353.69 $416.10 2.0×
Fetal biophysical profile non-stress testing (76818) $457.48 $538.20 4.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $457.48 $538.20 4.3×
Fluoroscopy up to 1 hr (76000) $567.29 $667.40 2.3×
Foot 2 views (73620) $117.30 $138 1.3×
Forearm 2 views (73090) $148.84 $175.10 1.7×
Gated Heart Planar Single (78472) $988.90 $1,163.40 2.4×
Hand 2 views (73120) $154.96 $182.30 1.5×
Hand 3 views (73130) $169.88 $199.85 1.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $940.74 $1,106.75 1.7×
Hepatobiliary syst imaging including gallbladder (78226) $542.86 $638.65 1.3×
Humerus Min 2 Views Left (73060) $165.50 $194.70 1.9×
Hysterosalpingogram (74740) $598.87 $704.55 2.5×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $239.02 $281.20 2.2×
Knee 3 views (73562) $200.05 $235.35 2.3×
Liver & spleen imaging static only (78215) $434.27 $510.90 1.1×
Lung perf&ventilat diferentl (78598) $233.75 $275 0.4×
Lymphoscintigraphy (78195) $828.24 $974.40 1.5×
Meckels Diverticulum (78290) $425.04 $500.05 1.0×
MRA head w & w/o contrast (70546) $1,486.61 $1,748.95 4.2×
MRA head w/o contrast (70544) $1,267.74 $1,491.45 5.2×
MRA head with contrast (70545) $1,705.48 $2,006.45 4.8×
MRA neck w contrast (70548) $1,705.48 $2,006.45 4.8×
Mra Neck W/O &W/Contrast Material (70549) $1,486.61 $1,748.95 4.2×
MRA neck w/o contrast (70547) $1,399.06 $1,645.95 5.7×
MRI abdomen w contrast (74182) $1,574.16 $1,851.95 4.4×
MRI abdomen w/o & w/contrast material (74183) $1,749.26 $2,057.95 4.9×
MRI abdomen w/o contrast (74181) $1,442.84 $1,697.45 5.9×
MRI any jnt lwr ext with con lt (73722) $1,486.61 $1,748.95 1.9×
MRI any jt upper extremity w/contrast matrl (73222) $1,486.61 $1,748.95 1.9×
MRI breast w/o contrast bilateral (77047) $1,399.06 $1,645.95 5.7×
MRI breast w/o contrast unilat (77046) $1,136.41 $1,336.95 4.7×
MRI c-spine with contrast (72142) $434.27 $510.90 1.2×
MRI cervical spine w/o contrast (72141) $434.27 $510.90 1.8×
MRI chest w/o & w/contrast material (71552) $1,880.58 $2,212.45 5.3×
MRI chest w/o contrast (71550) $1,442.84 $1,697.45 5.9×
MRI chest with contrast (71551) $1,705.48 $2,006.45 2.1×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $434.27 $510.90 1.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $434.27 $510.90 1.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,180.18 $1,388.45 4.8×
MRI orbit face &/neck w/o contrast (70540) $1,267.74 $1,491.45 5.2×
MRI orbit/face/neck w&w/o cont (70543) $1,880.58 $2,212.45 5.3×
MRI orbit/face/neck w/contrast (70542) $1,749.26 $2,057.95 4.9×
MRI pelvis w contrast (72196) $1,880.58 $2,212.45 5.3×
MRI pelvis w/o & w/contrast material (72197) $434.27 $510.90 1.2×
MRI pelvis w/o contrast (72195) $434.27 $510.90 1.8×
MRI scan of arm joint before and after contrast (73223) $1,486.61 $1,748.95 4.2×
MRI scan of leg joint before and after contrast (73723) $1,486.61 $1,748.95 4.2×
MRI spinal canal cervical w/o & w/contr matrl (72156) $434.27 $510.90 1.2×
MRI spinal canal lumbar w/contrast material (72149) $434.27 $510.90 1.2×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $434.27 $510.90 1.2×
MRI spinal canal thoracic w/contrast matrl (72147) $434.27 $510.90 1.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $434.27 $510.90 1.2×
MRI thoracic spine w/o contrast (72146) $434.27 $510.90 1.8×
MRI tmj (70336) $1,223.96 $1,439.95 5.0×
MRI upper ext joint w/o contrast (73221) $1,180.18 $1,388.45 4.8×
MRI upper extrem other than jt w/o & w/contras (73220) $1,486.61 $1,748.95 4.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,180.18 $1,388.45 4.8×
Myocardial Spect Multiple Studies (78452) $1,427.11 $1,678.95 1.1×
Neck soft tissue (70360) $136.17 $160.20 1.5×
Nm gastric emptying study (78264) $553.74 $651.45 1.4×
Nuclear medicine study of kidney and blood flow (78701) $332.27 $390.90 0.8×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $321.30 $378 3.0×
Osseous survey infant (77076) $180.80 $212.70 1.7×
Osseous survey limited (77074) $503.42 $592.25 4.7×
Parathyrd planar w/wo subtrj (78071) $968.32 $1,139.20 2.4×
Parathyroid imaging (78070) $819.91 $964.60 2.0×
Pelvis 1 or 2 views (72170) $158.91 $186.95 1.5×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,486.61 $1,748.95 4.2×
Pulmonary Perfusion Imaging Particulate (78580) $553.74 $651.45 1.4×
Pulmonary Ventilation & Perfusion Imaging (78582) $777.88 $915.15 1.4×
Radex abscess/fistula/sinus tract rs&i (76080) $556.84 $655.10 1.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $91.50 $107.65 1.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $138.76 $163.25 1.3×
Radex hips bilateral with pelvis 2 views (73521) $104.21 $122.60 1.0×
Radex mastoids compl minimum 3 views pr side (70130) $205.32 $241.55 1.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $268.77 $316.20 2.5×
Radiolog exam mandible compl minimum 4 views (70110) $130.90 $154 1.2×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $182.12 $214.25 2.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $242.98 $285.85 2.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $154.53 $181.80 1.7×
Radiologic exam colon single contrast study (74270) $563.85 $663.35 3.1×
Radiologic exam upr gi trc double contrast study (74246) $692.96 $815.25 3.9×
Radiologic exam upr gi trc single contrast study (74240) $692.96 $815.25 3.9×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $166.34 $195.70 1.9×
Radiological examination surgical specimen (76098) $167.66 $197.25 0.3×
Ribs bilateral 3 views (71110) $255.68 $300.80 2.4×
Rp loclzj tum spect 1 area single day imaging (78803) $1,557.97 $1,832.90 2.8×
Sacroiliac Joints < 3 Views (72200) $172.94 $203.45 1.6×
Saline Infus Sonohysterography W/Color Doppler (76831) $448.25 $527.35 1.8×
Scanogram (77073) $298.99 $351.75 2.8×
Scapula complete (73010) $170.30 $200.35 1.6×
Screening digital breast tomosynthesis (77063) $125.68 $147.85 5.4×
Sella turcica (70240) $238.17 $280.20 2.7×
Small bowel series (74250) $580.04 $682.40 3.2×
Spine thoracic 3 views (72072) $177.74 $209.10 1.7×
Therapeutic Enema (74283) $969.64 $1,140.75 5.4×
Thoracolumbar 2 views (72080) $101.15 $119 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $671.08 $789.50 1.6×
Tmj unilateral (70328) $133.11 $156.60 1.5×
Ultrasound, abdomen limited (76705) $305.15 $359 2.9×
Umbilical-artery Doppler (OB) (76820) $179.48 $211.15 1.7×
Upper Extremity Infant (73092) $124.36 $146.30 1.2×
Urethrocystography retrograde rs&i (74450) $605.84 $712.75 2.5×
Urethrocystography voiding (74455) $474.09 $557.75 1.9×
Us abdl aorta screen aaa (76706) $291.08 $342.45 2.7×
Us breast unilateral complete (76641) $427.68 $503.15 4.0×
Us breast unilateral limited (76642) $517.40 $608.70 5.8×
Us chest (76604) $553.74 $651.45 5.2×
Us compl joint r-t w/image documentation (76881) $528.36 $621.60 4.9×
Us elastography parenchyma (76981) $305.15 $359 2.9×
Us fetal nuchal translucency 1st gestation (76813) $470.99 $554.10 4.4×
Us infant hips dynamic (76885) $283.64 $333.70 3.2×
Us infant hips limited static (76886) $211.86 $249.25 2.4×
Us kidney transplant (76776) $274.04 $322.40 2.6×
Us ob transvaginal (76817) $221.51 $260.60 2.1×
Us pelvic non ob complete (76856) $372.56 $438.30 3.5×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $441.24 $519.10 4.1×
Us pregnancy ltd (76815) $92.82 $109.20 0.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $175.95 $207 1.6×
Us retroperitoneal complete (76770) $413.66 $486.65 3.9×
Us retroperitoneal limited (76775) $144.50 $170 1.4×
Us scrotum and contents (76870) $274.04 $322.40 2.6×
Us soft tissue head/neck (76536) $353.30 $415.65 3.3×
Us spinal canal and contents (76800) $464.06 $545.95 4.3×
Us xtr non-vasc lmtd (76882) $528.36 $621.60 4.9×
Venogram extremity bilateral (75822) $405.37 $476.90 0.3×
Venography caval inferior serialography rs&i (75825) $2,524.08 $2,969.50 0.8×
Venography extremity unilateral rs&i (75820) $746.82 $878.60 0.5×
Vertebral fracture assessment via dxa (77086) $160.22 $188.50 1.8×
Wrist 2 views (73100) $138.76 $163.25 1.6×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $218.45 $257 2.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $183.43 $215.80 2.1×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $172.89 $203.40 1.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $634.74 $746.75 3.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $151.90 $178.70 1.7×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $170.72 $200.85 1.9×
X-ray exam entire spi 4/5 vw (72083) $225.85 $265.70 2.1×
X-ray exam hip uni 1 view (73501) $141.82 $166.85 1.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $184.32 $216.85 2.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $112.08 $131.85 1.0×
X-Ray Exam Hips Bi 5/> Views (73523) $126.95 $149.35 1.2×
X-ray exam of femur 1 (73551) $135.70 $159.65 1.5×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $1,034.41 $1,216.95 5.8×
X-ray eye for foreign body (70030) $133.11 $156.60 1.5×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $98.09 $115.40 0.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $120.40 $141.65 1.4×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $169.40 $199.30 1.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $117.77 $138.55 1.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $124.36 $146.30 1.4×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $221.51 $260.60 2.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $163.71 $192.60 1.8×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $137.02 $161.20 1.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $191.30 $225.05 1.8×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $368.18 $433.15 3.4×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $187.81 $220.95 1.8×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $161.12 $189.55 1.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $152.79 $179.75 1.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $220.20 $259.05 2.1×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $155.85 $183.35 1.5×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $764.32 $899.20 2.1×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $188.70 $222 2.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $208.80 $245.65 2.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $279.31 $328.60 2.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $174.68 $205.50 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $170.30 $200.35 1.9×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $167.66 $197.25 1.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $161.12 $189.55 1.8×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $158.06 $185.95 1.8×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $246.46 $289.95 2.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $192.18 $226.10 1.8×
X-Ray Spine One View - Xr Spine (72020) $143.14 $168.40 1.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $181.69 $213.75 2.0×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $177.74 $209.10 2.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $170.30 $200.35 1.6×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $315.18 $370.80 3.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $138.30 $162.70 1.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $164.18 $193.15 1.8×
Xr arthrogram ankle (73615) $440.82 $518.60 1.2×
Xr c-spine 6 or more views (72052) $301.62 $354.85 2.8×
Xr finger(s) 2+ views (73140) $130.01 $152.95 1.5×
XR Mastoids < 3 Views Bilateral (70120) $171.62 $201.90 1.6×
Xr shoulder 1 view (73020) $147.10 $173.05 1.7×
Xr spine cervical 4 or 5 views (72050) $241.66 $284.30 2.3×
Xr tibia/fibula 2 views (73590) $160.22 $188.50 1.8×
Xr tmj bilateral (70330) $276.25 $325 3.1×
Xray knee 1 or 2 views rt (73560) $174.68 $205.50 2.0×