Imaging prices at Regional West Medical Center

Scottsbluff, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $7,009.80 $11,683 4.9×
Abdomen 2 views (74019) $388.20 $647 3.6×
Acute gastrointestinal blood loss imaging (78278) $1,581 $2,635 3.8×
Angiography extremity bilateral rs&i (75716) $4,651.20 $7,752 1.4×
Angiography extremity unilateral rs&i (75710) $4,256.40 $7,094 1.3×
Angiography pelvic slctv/supraslctv rs&i (75736) $5,563.80 $9,273 1.0×
Angiography pulmonary bilateral slctv rs&i (75743) $3,234.60 $5,391 1.0×
Angiography Spinal Selective Rs&I (75705) $5,307.60 $8,846 0.9×
Angiography visceral slctv/supraslctv rs&i (75726) $6,604.80 $11,008 1.1×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $2,637 $4,395 0.8×
Ankle 2 views (73600) $314.64 $524.40 3.5×
Antegrade urography radiological supvj & interpj (74425) $1,070.28 $1,783.80 3.0×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $3,966 $6,610 1.2×
Aortography abdominal serialography rs&i (75625) $3,718.80 $6,198 1.1×
Basic radiation dosimetry calculation (77300) $624.60 $1,041 4.5×
Bone &/joint imaging whole body (78306) $1,818.60 $3,031 4.4×
Bone age studies (77072) $196.44 $327.40 1.8×
Bone Imaging 3 Phase (78315) $2,030.40 $3,384 4.9×
Bone survey complete (77075) $884.22 $1,473.70 8.1×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,670.76 $2,784.60 3.0×
Cervical spine 2 or 3 views (72040) $347.76 $579.60 3.8×
Chest 1 view (71045) $192 $320 2.1×
Chest 3 views (71047) $400.62 $667.70 4.4×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $610.20 $1,017 3.4×
Clavicle complete (73000) $333.72 $556.20 3.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $618 $1,030 5.7×
Continuing medical physics consltj pr wk (77336) $867.60 $1,446 6.2×
CT abdomen and pelvis without and with contrast (74178) $4,983.60 $8,306 13.8×
CT abdomen and pelvis without contrast (74176) $3,753.60 $6,256 15.2×
CT abdomen w contrast (74160) $2,600.40 $4,334 14.3×
CT abdomen w wo contrast (74170) $3,239.40 $5,399 17.8×
CT abdomen w/o contrast (74150) $2,290.20 $3,817 21.1×
CT angio hrt w/3d image (75574) $2,221.80 $3,703 6.1×
CT angiography upper extremity lt (73206) $2,194.80 $3,658 12.1×
CT c-spine w/o contrast (72125) $2,209.20 $3,682 20.4×
CT cervical spine w&w/o contrast (72127) $1,949.33 $3,248.87 10.7×
CT cervical spine with contrast (72126) $2,479.20 $4,132 6.8×
CT chest w/wo contrast (71270) $2,554.80 $4,258 14.0×
CT chest with contrast (71260) $2,371.80 $3,953 13.0×
CT head/brain with contrast (70460) $2,067.60 $3,446 11.4×
CT head/brain without and with contrast (70470) $2,471.40 $4,119 13.6×
CT heart no contrast quant eval coronry calcium (75571) $382.38 $637.30 4.2×
CT iac w contrast (70481) $2,577 $4,295 14.1×
CT lower ext w/o (73700) $2,899.80 $4,833 26.7×
CT lower extremity w wo contrast (73702) $2,382 $3,970 13.1×
CT lower extremity with contrast (73701) $2,184 $3,640 12.0×
CT lumbar spine w/o contrast (72131) $2,272.20 $3,787 20.9×
CT lumbar spine with contrast (72132) $2,534.40 $4,224 7.0×
CT maxillofacial w contrast (70487) $2,380.80 $3,968 13.1×
CT maxillofacial w/o contrast (70486) $1,857.60 $3,096 17.1×
CT neck soft tissue w contrast (70491) $2,287.20 $3,812 12.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,594.64 $4,324.40 14.2×
CT orbits w/o contrast (70480) $2,164.20 $3,607 19.9×
CT pelvis w & w/o contrast (72194) $2,709.84 $4,516.40 14.9×
CT pelvis w/o contrast (72192) $2,337.66 $3,896.10 21.5×
CT soft tissue neck w/o & w/contrast material (70492) $2,531.40 $4,219 13.9×
CT soft tissue neck w/o contrast (70490) $2,192.40 $3,654 20.2×
CT thoracic spine w/contrast (72129) $2,325.24 $3,875.40 12.8×
CT thoracic spine w/o contrast (72128) $2,290.80 $3,818 21.1×
CT thorax w/o contrast (71250) $2,116.80 $3,528 19.5×
CT upper extremity w/o & w/contrast material (73202) $2,427 $4,045 13.3×
CT upper extremity w/o contrast rt (73200) $1,773.60 $2,956 16.3×
CT upper extremity with contrast (73201) $2,220 $3,700 6.1×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,247.80 $5,413 17.8×
Cta Abdomen (74175) $2,977.20 $4,962 16.3×
CTA abdomen pelvis (74174) $5,671.80 $9,453 15.7×
CTA chest (71275) $2,982 $4,970 16.4×
Cta Head (70496) $2,575.20 $4,292 14.1×
CTA lwr ext w&w/o contrast (73706) $3,005.40 $5,009 16.5×
Cta Neck (70498) $2,570.40 $4,284 14.1×
Cta Pelvis (72191) $2,975.40 $4,959 16.3×
Cystography minimum 3 views rs&i (74430) $920.88 $1,534.80 2.5×
Dxa bone density study 1/> sites axial skel (77080) $510.54 $850.90 4.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $178.76 $297.92 2.0×
Echoencephalography real time imaging (76506) $500.58 $834.30 4.6×
Esophagus (74220) $731.40 $1,219 4.0×
Fetal biophysical profile non-stress testing (76818) $502.80 $838 4.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $550.20 $917 5.1×
Fluoroscopy up to 1 hr (76000) $643.80 $1,073 2.6×
Foot 2 views (73620) $299.34 $498.90 3.3×
Forearm 2 views (73090) $335.64 $559.40 3.7×
Gated Heart Planar Single (78472) $1,822.07 $3,036.77 4.4×
Hand 2 views (73120) $291 $485 2.7×
Hand 3 views (73130) $362.46 $604.10 4.0×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $2,464.56 $4,107.60 3.4×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $3,076.20 $5,127 0.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $2,289.60 $3,816 4.1×
Hepatobiliary syst imaging including gallbladder (78226) $2,028.90 $3,381.50 4.9×
Humerus Min 2 Views Left (73060) $336.84 $561.40 3.7×
Hysterosalpingogram (74740) $696.78 $1,161.30 2.8×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,249.80 $2,083 2.2×
Kidney img morphology vascular flow 1 w/rx (78708) $1,897.20 $3,162 3.4×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,876.68 $3,127.80 3.3×
Knee 3 views (73562) $382.98 $638.30 4.2×
Liver & spleen imaging static only (78215) $1,254.30 $2,090.50 3.0×
Lung perf&ventilat diferentl (78598) $2,847.66 $4,746.10 5.1×
Lymphoscintigraphy (78195) $1,906.14 $3,176.90 3.4×
Mlc imrt design & construction per imrt plan (77338) $2,319.60 $3,866 6.0×
MRA head w & w/o contrast (70546) $4,160.40 $6,934 11.5×
MRA head w/o contrast (70544) $3,361.80 $5,603 13.6×
MRA head with contrast (70545) $3,558 $5,930 9.8×
Mra Neck W/O &W/Contrast Material (70549) $4,942.20 $8,237 13.6×
MRA neck w/o contrast (70547) $2,937 $4,895 11.9×
MRI abdomen w contrast (74182) $2,886 $4,810 8.0×
MRI abdomen w/o & w/contrast material (74183) $3,779.40 $6,299 10.4×
MRI abdomen w/o contrast (74181) $2,610.60 $4,351 10.5×
MRI any jnt lwr ext with con lt (73722) $2,683.80 $4,473 3.3×
MRI any jt upper extremity w/contrast matrl (73222) $2,550.60 $4,251 3.1×
MRI breast w/o contrast bilateral (77047) $2,293.98 $3,823.30 9.3×
MRI c-spine with contrast (72142) $3,396.60 $5,661 9.4×
MRI cervical spine w/o contrast (72141) $2,940 $4,900 11.9×
MRI chest w/o & w/contrast material (71552) $4,395 $7,325 12.1×
MRI chest w/o contrast (71550) $2,400 $4,000 9.7×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $2,565.71 $4,276.17 7.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,038.04 $5,063.40 8.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,344.80 $3,908 9.5×
MRI orbit face &/neck w/o contrast (70540) $2,653.20 $4,422 10.7×
MRI orbit/face/neck w&w/o cont (70543) $4,086.60 $6,811 11.3×
MRI pelvis w contrast (72196) $3,496.26 $5,827.10 9.7×
MRI pelvis w/o & w/contrast material (72197) $4,395 $7,325 12.1×
MRI pelvis w/o contrast (72195) $3,263.40 $5,439 13.2×
MRI scan of arm joint before and after contrast (73223) $2,973.60 $4,956 8.2×
MRI scan of leg joint before and after contrast (73723) $2,866.80 $4,778 7.9×
MRI spectroscopy (76390) $2,689.80 $4,483 29.8×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,828.60 $6,381 10.6×
MRI spinal canal lumbar w/contrast material (72149) $3,566.40 $5,944 9.8×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,009.20 $6,682 11.1×
MRI spinal canal thoracic w/contrast matrl (72147) $3,365.40 $5,609 9.3×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,972 $6,620 11.0×
MRI thoracic spine w/o contrast (72146) $3,143.40 $5,239 12.7×
MRI tmj (70336) $2,978.64 $4,964.40 12.0×
MRI upper extrem other than jt w/o & w/contras (73220) $3,579 $5,965 9.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,344.80 $3,908 9.5×
Myocardial Spect Multiple Studies (78452) $4,763.76 $7,939.60 3.5×
Neck soft tissue (70360) $324.48 $540.80 3.6×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $1,265.77 $2,109.61 3.0×
Nm gastric emptying study (78264) $1,895.28 $3,158.80 4.6×
Ntsty modul radthx pln dose-vol histos (77301) $6,336 $10,560 4.4×
Nuclear Rx Oral Admin (79005) $1,879.74 $3,132.90 7.8×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $431.52 $719.20 4.0×
Osseous survey infant (77076) $279.30 $465.50 2.6×
Parathyrd planar w/wo subtrj (78071) $1,224.66 $2,041.10 3.0×
Parathyroid imaging (78070) $1,405.74 $2,342.90 3.4×
Pelvis 1 or 2 views (72170) $299.28 $498.80 2.8×
PET image w/CT, skull-thigh (78815) $5,989.80 $9,983 4.0×
PET imaging for CT attenuation whole body (78816) $6,912 $11,520 4.7×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $3,579 $5,965 9.9×
Pulmonary Perfusion Imaging Particulate (78580) $1,371.60 $2,286 3.3×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,438.22 $4,063.70 4.3×
Radex abscess/fistula/sinus tract rs&i (76080) $1,553.12 $2,588.53 2.7×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $78.60 $131 0.9×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $571.92 $953.20 5.3×
Radex hips bilateral with pelvis 2 views (73521) $336 $560 3.1×
Radiation treatment delivery 1 mev >= complex (77412) $1,144.20 $1,907 2.0×
Radiation treatment delivery 1 mev >= simple (77402) $649.56 $1,082.60 6.1×
Radiation tx delivery 1 mev >= intermediate (77407) $2,293.98 $3,823.30 5.7×
Radiolog exam mandible compl minimum 4 views (70110) $465.54 $775.90 4.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $307.92 $513.20 3.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $306 $510 3.4×
Radiologic exam colon single contrast study (74270) $807.60 $1,346 4.4×
Radiologic exam upr gi trc double contrast study (74246) $833.64 $1,389.40 4.6×
Radiologic exam upr gi trc single contrast study (74240) $702 $1,170 3.9×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $307.80 $513 3.4×
Radiological examination surgical specimen (76098) $616.20 $1,027 1.1×
Review by radiologist of liver vein image with assessment of blood flow (75889) $5,611.20 $9,352 1.7×
Ribs bilateral 3 views (71110) $453.12 $755.20 4.2×
Rp loclzj tum spect 1 area single day imaging (78803) $2,121.60 $3,536 3.8×
Rp Therapy Intravenous Administration (79101) $706.01 $1,176.68 2.9×
Sacroiliac Joints < 3 Views (72200) $271.20 $452 2.5×
Scanogram (77073) $343.08 $571.80 3.2×
Scapula complete (73010) $336.66 $561.10 3.1×
Screening digital breast tomosynthesis (77063) $176.82 $294.70 7.6×
Small bowel series (74250) $716.46 $1,194.10 3.9×
Spec medical radj physics consltj (77370) $859.80 $1,433 6.2×
Special dosimetry (77331) $832.20 $1,387 6.0×
Spine thoracic 3 views (72072) $403.20 $672 3.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,687.20 $2,812 4.3×
Ther rad simulaj-aided field setting complex (77290) $2,370.60 $3,951 6.1×
Ther rad simulaj-aided field setting simple (77280) $1,311 $2,185 9.4×
Thoracolumbar 2 views (72080) $345 $575 3.8×
Thyroid carcinoma metastases img whole body (78018) $1,908 $3,180 3.4×
Thyroid Imaging With Vascular Flow (78013) $691.56 $1,152.60 1.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,321.50 $2,202.50 3.2×
Tomogram (76100) $549.18 $915.30 5.1×
Treatment devices simple (77332) $660.60 $1,101 4.7×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $3,665.82 $6,109.70 6.5×
Tx devices design & construction complex (77334) $1,416.60 $2,361 3.6×
Ultrasound, abdomen limited (76705) $574.50 $957.50 5.3×
Umbilical-artery Doppler (OB) (76820) $282.90 $471.50 2.6×
Unlisted magnetic resonance procedure (76498) $3,996.84 $6,661.38 44.2×
Upper Extremity Infant (73092) $71.37 $118.95 0.7×
Urethrocystography voiding (74455) $1,083 $1,805 4.4×
Us abdl aorta screen aaa (76706) $550.32 $917.20 5.1×
Us breast unilateral complete (76641) $670.92 $1,118.20 6.2×
Us chest (76604) $630 $1,050 5.8×
Us compl joint r-t w/image documentation (76881) $799.20 $1,332 7.4×
Us infant hips dynamic (76885) $389.88 $649.80 4.3×
Us infant hips limited static (76886) $422.64 $704.40 4.7×
Us kidney transplant (76776) $728.40 $1,214 6.7×
Us ob transvaginal (76817) $519.60 $866 4.8×
Us pelvic non ob complete (76856) $820.68 $1,367.80 7.6×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $488.62 $814.36 4.5×
Us pregnancy ltd (76815) $508.83 $848.05 4.7×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $564.12 $940.20 5.2×
Us retroperitoneal complete (76770) $858.36 $1,430.60 7.9×
Us retroperitoneal limited (76775) $549.96 $916.60 5.1×
Us scrotum and contents (76870) $666 $1,110 6.1×
Us soft tissue head/neck (76536) $667.74 $1,112.90 6.2×
Us spinal canal and contents (76800) $655.44 $1,092.40 6.0×
Us xtr non-vasc lmtd (76882) $381.42 $635.70 3.5×
Us, eye b-scan (76512) $502.80 $838 4.6×
Venogram extremity bilateral (75822) $2,364.36 $3,940.60 1.4×
Venography caval inferior serialography rs&i (75825) $3,945.84 $6,576.40 1.2×
Venography caval superior serialography rs&i (75827) $2,514.60 $4,191 1.5×
Venography extremity unilateral rs&i (75820) $1,879.20 $3,132 1.1×
Venography renal unilateral selective rs&i (75831) $3,945.84 $6,576.40 1.2×
Wrist 2 views (73100) $314.52 $524.20 3.5×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $558.18 $930.30 5.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $336.66 $561.10 3.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $351.18 $585.30 3.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,042.56 $1,737.60 5.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $315.36 $525.60 3.5×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $371.16 $618.60 4.1×
X-ray exam entire spi 4/5 vw (72083) $628.32 $1,047.20 5.8×
X-ray exam hip uni 1 view (73501) $276.60 $461 3.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $315.60 $526 3.5×
X-ray exam hip uni 4/> views (73503) $411.66 $686.10 3.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $466.20 $777 4.3×
X-Ray Exam Hips Bi 5/> Views (73523) $514.80 $858 4.7×
X-ray exam of femur 1 (73551) $255.72 $426.20 2.8×
X-ray eye for foreign body (70030) $255 $425 2.8×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $461.52 $769.20 4.3×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $348.24 $580.40 3.9×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $350.40 $584 3.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $337.86 $563.10 3.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $306.54 $510.90 3.4×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $187.62 $312.70 2.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $416.04 $693.40 3.8×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $654 $1,090 6.0×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $476.34 $793.90 4.4×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $333.72 $556.20 3.7×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $298.80 $498 3.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $455.88 $759.80 4.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $425.58 $709.30 3.9×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $978.50 $1,630.82 2.7×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $432.30 $720.50 4.8×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $510.84 $851.40 4.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $614.46 $1,024.10 5.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $405.78 $676.30 3.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $346.68 $577.80 3.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $412.26 $687.10 4.6×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $287.04 $478.40 3.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $551.40 $919 5.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $343.80 $573 3.2×
X-Ray Spine One View - Xr Spine (72020) $321.36 $535.60 3.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $259.74 $432.90 2.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $369.18 $615.30 4.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $362.40 $604 3.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $314.25 $523.75 2.9×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $302.10 $503.50 3.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $364.62 $607.70 4.0×
Xr c-spine 6 or more views (72052) $612.54 $1,020.90 5.6×
Xr finger(s) 2+ views (73140) $271.62 $452.70 3.0×
Xr shoulder 1 view (73020) $293.76 $489.60 3.3×
Xr spine cervical 4 or 5 views (72050) $441.36 $735.60 4.1×
Xr tibia/fibula 2 views (73590) $347.04 $578.40 3.8×
Xr tmj bilateral (70330) $464.22 $773.70 5.1×
Xray knee 1 or 2 views rt (73560) $320.70 $534.50 3.5×