Imaging prices at Ranken Jordan Pediatric Bridge Hospital

Maryland Heights, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $424.78 $530.97 4.1×
Ankle 2 views (73600) $481.36 $601.70 5.5×
Bone age studies (77072) $184.80 $231 1.8×
Bone Imaging 3 Phase (78315) $1,980 $2,475 4.9×
Bone survey complete (77075) $579.04 $723.80 5.5×
Cervical spine 2 or 3 views (72040) $526.26 $657.83 6.0×
Chest 1 view (71045) $262.24 $327.80 3.0×
Chest 3 views (71047) $310.64 $388.30 3.6×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $480.48 $600.60 2.7×
Clavicle complete (73000) $250.80 $313.50 2.9×
CT abdomen w contrast (74160) $1,112.32 $1,390.40 6.3×
CT abdomen w wo contrast (74170) $1,297.12 $1,621.40 7.4×
CT abdomen w/o contrast (74150) $848.94 $1,061.17 8.1×
CT c-spine w/o contrast (72125) $1,845.98 $2,307.47 17.6×
CT cervical spine w&w/o contrast (72127) $2,197.98 $2,747.47 12.5×
CT cervical spine with contrast (72126) $2,021.98 $2,527.47 5.8×
CT chest w/wo contrast (71270) $1,664.08 $2,080.10 9.5×
CT chest with contrast (71260) $1,488.08 $1,860.10 8.5×
CT head/brain with contrast (70460) $1,772.32 $2,215.40 10.1×
CT head/brain without and with contrast (70470) $2,036.32 $2,545.40 11.6×
CT lumbar spine w & w/o contrast (72133) $1,886.90 $2,358.62 10.7×
CT lumbar spine w/o contrast (72131) $1,534.90 $1,918.62 14.7×
CT lumbar spine with contrast (72132) $1,710.90 $2,138.62 4.9×
CT maxillofacial w contrast (70487) $1,936.80 $2,420.99 11.0×
CT maxillofacial w/o contrast (70486) $1,760.80 $2,200.99 16.8×
CT maxillofacial w/wo contrast (70488) $2,112.80 $2,640.99 12.0×
CT pelvis w & w/o contrast (72194) $2,065.36 $2,581.70 11.8×
CT pelvis w/o contrast (72192) $1,713.36 $2,141.70 16.4×
CT thoracic spine w/contrast (72129) $2,021.98 $2,527.47 11.5×
CT thoracic spine w/o contrast (72128) $1,845.98 $2,307.47 17.6×
CT thoracic spine w/wo contrast (72130) $2,197.98 $2,747.47 12.5×
CT thorax w/o contrast (71250) $1,312.08 $1,640.10 12.5×
Echoencephalography real time imaging (76506) $586.08 $732.60 5.6×
Fluoroscopy up to 1 hr (76000) $852.72 $1,065.90 3.6×
Foot 2 views (73620) $368.81 $461.01 4.2×
Forearm 2 views (73090) $216.48 $270.60 2.5×
Hand 3 views (73130) $251.68 $314.60 2.9×
Humerus Min 2 Views Left (73060) $331.76 $414.70 3.8×
Knee 3 views (73562) $258.37 $322.96 3.0×
MRI any jnt lwr ext with con lt (73722) $579.52 $724.39 0.7×
MRI any jt upper extremity w/contrast matrl (73222) $2,022.24 $2,527.80 2.6×
MRI c-spine with contrast (72142) $2,461.36 $3,076.70 7.0×
MRI cervical spine w/o contrast (72141) $2,285.36 $2,856.70 9.6×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,711.60 $2,139.50 4.9×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $519.45 $649.31 1.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $466.11 $582.63 2.0×
MRI scan of arm joint before and after contrast (73223) $2,022.24 $2,527.80 5.8×
MRI scan of leg joint before and after contrast (73723) $713.27 $891.58 2.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,637.36 $3,296.70 7.5×
MRI spinal canal lumbar w/contrast material (72149) $2,150.72 $2,688.40 6.2×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,326.72 $2,908.40 6.7×
MRI spinal canal thoracic w/contrast matrl (72147) $2,461.36 $3,076.70 7.0×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,104.08 $2,630.10 6.0×
MRI thoracic spine w/o contrast (72146) $2,285.36 $2,856.70 9.6×
MRI upper ext joint w/o contrast (73221) $2,022.24 $2,527.80 8.5×
MRI upper extrem other than jt w/o & w/contras (73220) $1,711.60 $2,139.50 4.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,711.60 $2,139.50 7.2×
Osseous survey infant (77076) $557.04 $696.30 5.3×
Osseous survey limited (77074) $403.04 $503.80 3.8×
Pelvis 1 or 2 views (72170) $249.92 $312.40 2.4×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $646.28 $807.85 1.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $1,175.68 $1,469.60 11.2×
Radex hips bilateral with pelvis 2 views (73521) $403.92 $504.90 3.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $248.78 $310.97 2.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $451.18 $563.97 4.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $310.64 $388.30 3.6×
Radiologic exam upr gi trc single contrast study (74240) $564.08 $705.10 3.2×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $542.92 $678.65 6.2×
Ribs bilateral 3 views (71110) $344.96 $431.20 3.3×
Spine thoracic 3 views (72072) $351.12 $438.90 3.4×
Ultrasound, abdomen limited (76705) $698.72 $873.40 6.7×
Urethrocystography retrograde rs&i (74450) $999.68 $1,249.60 4.2×
Urethrocystography voiding (74455) $662.64 $828.30 2.8×
Us chest (76604) $557.04 $696.30 5.3×
Us infant hips dynamic (76885) $624.80 $781 7.2×
Us infant hips limited static (76886) $448.80 $561 5.1×
Us pelvic non ob complete (76856) $836 $1,045 8.0×
Us retroperitoneal complete (76770) $720.72 $900.90 6.9×
Us retroperitoneal limited (76775) $544.72 $680.90 5.2×
Us soft tissue head/neck (76536) $550 $687.50 5.3×
Wrist 2 views (73100) $278.79 $348.48 3.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $240.07 $300.08 2.8×
X-ray exam hip uni 1 view (73501) $273.20 $341.50 3.1×
X-ray exam of femur 1 (73551) $406.56 $508.20 4.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $335.28 $419.10 3.8×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $210.32 $262.90 2.4×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $244.91 $306.13 2.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $412.72 $515.90 3.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $462 $577.50 4.4×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $337.40 $421.74 3.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $212.96 $266.20 2.4×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $428.56 $535.70 4.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $667.04 $833.80 6.4×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $287.76 $359.70 2.7×
X-Ray Spine One View - Xr Spine (72020) $384.56 $480.70 4.4×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $316.01 $395.01 3.0×
Xr shoulder 1 view (73020) $363.44 $454.30 4.2×
Xr tibia/fibula 2 views (73590) $307.12 $383.90 3.5×
Xray knee 1 or 2 views rt (73560) $232.06 $290.07 2.7×