Imaging prices at Rio Grande Hospital

Del Norte, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $191.59 $255.45 1.7×
Ankle 2 views (73600) $170.06 $226.74 1.9×
Cervical spine 2 or 3 views (72040) $186.32 $248.42 2.0×
Chest 1 view (71045) $103.18 $137.58 1.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $892.90 $1,190.53 4.8×
Clavicle complete (73000) $254.42 $339.23 2.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $844.62 $1,126.16 7.7×
CT abdomen and pelvis without and with contrast (74178) $2,849.94 $3,799.92 7.7×
CT abdomen and pelvis without contrast (74176) $1,920.25 $2,560.33 7.6×
CT abdomen w contrast (74160) $1,275.19 $1,700.25 6.9×
CT abdomen w wo contrast (74170) $2,313.08 $3,084.10 12.5×
CT abdomen w/o contrast (74150) $1,107.34 $1,476.45 10.0×
CT angiography upper extremity lt (73206) $1,167.08 $1,556.11 6.3×
CT c-spine w/o contrast (72125) $1,038.79 $1,385.05 9.4×
CT chest w/wo contrast (71270) $1,982.65 $2,643.53 10.7×
CT chest with contrast (71260) $1,924.64 $2,566.18 10.4×
CT head/brain with contrast (70460) $1,116.13 $1,488.17 6.0×
CT head/brain without and with contrast (70470) $1,340.22 $1,786.96 7.2×
CT heart no contrast quant eval coronry calcium (75571) $81.18 $108.24 0.9×
CT iac w contrast (70481) $1,214.54 $1,619.39 6.6×
CT lower ext w/o (73700) $529.94 $706.58 4.8×
CT lower extremity with contrast (73701) $853.34 $1,137.79 4.6×
CT lumbar spine w/o contrast (72131) $1,038.79 $1,385.05 9.4×
CT maxillofacial w contrast (70487) $1,180.28 $1,573.70 6.4×
CT maxillofacial w/o contrast (70486) $1,045.81 $1,394.41 9.5×
CT maxillofacial w/wo contrast (70488) $1,415.81 $1,887.74 7.7×
CT neck soft tissue w contrast (70491) $1,214.54 $1,619.39 6.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,137.22 $1,516.29 6.1×
CT orbits w/o contrast (70480) $959.69 $1,279.58 8.7×
CT pelvis w/o contrast (72192) $871.81 $1,162.41 7.9×
CT soft tissue neck w/o & w/contrast material (70492) $1,454.48 $1,939.30 7.9×
CT soft tissue neck w/o contrast (70490) $1,057.24 $1,409.65 9.6×
CT thoracic spine w/o contrast (72128) $1,038.79 $1,385.05 9.4×
CT thorax w/o contrast (71250) $1,513.91 $2,018.54 13.7×
CT upper extremity w/o contrast rt (73200) $744.38 $992.50 6.7×
CT upper extremity with contrast (73201) $855.98 $1,141.31 2.3×
Cta Abdomen (74175) $1,543.23 $2,057.64 8.3×
CTA abdomen pelvis (74174) $803.25 $1,071 2.2×
CTA chest (71275) $2,024.80 $2,699.74 10.9×
Cta Head (70496) $1,385.91 $1,847.88 7.5×
CTA lwr ext w&w/o contrast (73706) $928.05 $1,237.40 5.0×
Cta Neck (70498) $1,481.72 $1,975.62 8.0×
Cta Pelvis (72191) $1,148.63 $1,531.51 6.2×
Foot 2 views (73620) $217.50 $290 2.4×
Forearm 2 views (73090) $233.33 $311.10 2.5×
Hand 2 views (73120) $187.19 $249.59 1.7×
Hand 3 views (73130) $230.69 $307.58 2.5×
Humerus Min 2 Views Left (73060) $259.70 $346.26 2.8×
MRA head w/o contrast (70544) $2,263.88 $3,018.51 9.0×
MRA head with contrast (70545) $2,638.25 $3,517.67 7.2×
MRA neck w contrast (70548) $2,460.72 $3,280.96 6.7×
Mra Neck W/O &W/Contrast Material (70549) $3,084.68 $4,112.91 8.4×
MRA neck w/o contrast (70547) $2,016.92 $2,689.22 8.0×
MRI abdomen w contrast (74182) $2,596.07 $3,461.43 7.1×
MRI abdomen w/o & w/contrast material (74183) $3,224.45 $4,299.26 8.8×
MRI abdomen w/o contrast (74181) $2,418.54 $3,224.72 9.6×
MRI any jnt lwr ext with con lt (73722) $2,326.09 $3,101.45 2.8×
MRI any jt upper extremity w/contrast matrl (73222) $1,449.92 $1,933.23 1.8×
MRI c-spine with contrast (72142) $2,346.47 $3,128.63 6.4×
MRI cervical spine w/o contrast (72141) $2,019.55 $2,692.73 8.0×
MRI chest w/o & w/contrast material (71552) $3,428.32 $4,571.09 9.3×
MRI chest w/o contrast (71550) $1,911.45 $2,548.60 7.6×
MRI chest with contrast (71551) $2,132.93 $2,843.91 2.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,973.96 $3,965.28 11.8×
MRI orbit face &/neck w/o contrast (70540) $1,994.07 $2,658.76 7.9×
MRI orbit/face/neck w&w/o cont (70543) $3,443.25 $4,591 9.4×
MRI orbit/face/neck w/contrast (70542) $2,218.16 $2,957.54 6.0×
MRI pelvis w contrast (72196) $2,310.44 $3,080.59 6.3×
MRI pelvis w/o & w/contrast material (72197) $3,452.05 $4,602.73 9.4×
MRI pelvis w/o contrast (72195) $2,001.98 $2,669.31 8.0×
MRI scan of arm joint before and after contrast (73223) $1,550.72 $2,067.63 4.2×
MRI scan of leg joint before and after contrast (73723) $2,412.25 $3,216.33 6.6×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,495.12 $4,660.16 9.5×
MRI spinal canal lumbar w/contrast material (72149) $2,400.96 $3,201.28 6.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,391.96 $5,855.94 11.9×
MRI spinal canal thoracic w/contrast matrl (72147) $2,417.67 $3,223.56 6.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,495.12 $4,660.16 9.5×
MRI thoracic spine w/o contrast (72146) $2,011.64 $2,682.19 8.0×
MRI tmj (70336) $1,573.12 $2,097.49 6.2×
MRI upper ext joint w/o contrast (73221) $2,175.11 $2,900.14 8.6×
MRI upper extrem other than jt w/o & w/contras (73220) $2,518.73 $3,358.30 6.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,175.11 $2,900.14 8.6×
Neck soft tissue (70360) $124.79 $166.39 1.4×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $318.14 $424.18 2.9×
Osseous survey limited (77074) $278.59 $371.45 2.5×
Pelvis 1 or 2 views (72170) $169.62 $226.16 1.5×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $3,218.29 $4,291.05 8.7×
Pr sono bone density measure,peripheral (76977) $108.97 $145.29 1.0×
Pulmonary Perfusion Imaging Particulate (78580) $3,724.49 $4,965.99 8.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,182.83 $1,577.10 2.1×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $168.81 $225.08 1.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $174.02 $232.03 1.6×
Radex hips bilateral with pelvis 2 views (73521) $255.76 $341.01 2.3×
Radex mastoids compl minimum 3 views pr side (70130) $241.67 $322.23 2.2×
Radiolog exam mandible compl minimum 4 views (70110) $241.67 $322.23 2.2×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $149.41 $199.21 1.6×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $109.80 $146.40 1.2×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $253.21 $337.61 2.8×
Ribs bilateral 3 views (71110) $238.16 $317.55 2.2×
Scapula complete (73010) $239.93 $319.90 2.2×
Spine thoracic 3 views (72072) $255.76 $341.01 2.3×
Thoracolumbar 2 views (72080) $203 $270.67 2.2×
Ultrasound, abdomen limited (76705) $181.91 $242.55 1.6×
Upper Extremity Infant (73092) $118.65 $158.20 1.1×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $312 $416 1.7×
Us abdl aorta screen aaa (76706) $350.37 $467.16 3.2×
Us breast unilateral complete (76641) $354.17 $472.23 3.2×
Us chest (76604) $209.96 $279.95 1.9×
Us ob detailed single fetus (76811) $402.50 $536.67 1.6×
Us ob transvaginal (76817) $335.72 $447.62 3.0×
Us pelvic non ob complete (76856) $406.03 $541.37 3.7×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $257.49 $343.32 2.3×
Us pregnancy ltd (76815) $285.62 $380.83 2.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $394.59 $526.12 3.6×
Us retroperitoneal complete (76770) $428.88 $571.84 3.9×
Us retroperitoneal limited (76775) $181.04 $241.38 1.6×
Us scrotum and contents (76870) $299.24 $398.99 2.7×
Us soft tissue head/neck (76536) $298.82 $398.42 2.7×
Us transrectal prostate volume (76873) $443.81 $591.74 4.0×
Us xtr non-vasc lmtd (76882) $340.11 $453.48 3.1×
Wrist 2 views (73100) $214.88 $286.50 2.3×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $258.38 $344.51 2.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $174.88 $233.17 1.9×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $255.74 $340.99 2.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $212.24 $282.98 2.3×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $230.69 $307.58 2.5×
X-ray exam hip uni 1 view (73501) $147.92 $197.22 1.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $189.84 $253.12 2.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $304.55 $406.06 2.8×
X-ray exam of femur 1 (73551) $182.72 $243.62 2.0×
X-ray eye for foreign body (70030) $51.86 $69.14 0.6×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $247.84 $330.45 2.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $184.56 $246.08 2.0×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $253.10 $337.48 2.8×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $89.64 $119.51 1.0×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $297.92 $397.23 2.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $149.41 $199.21 1.6×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $121.27 $161.70 1.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $207.40 $276.53 1.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $326.05 $434.73 3.0×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $175.78 $234.37 1.9×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $241.67 $322.23 2.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $202.13 $269.50 1.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $198.61 $264.81 2.2×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $241.67 $322.23 2.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $321.65 $428.87 2.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $203 $270.67 1.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $195.10 $260.13 2.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $199.50 $265.99 2.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $215.31 $287.08 2.3×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $146.33 $195.10 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $275.95 $367.93 2.5×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $212.68 $283.57 1.9×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $161.70 $215.60 1.8×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $173.14 $230.85 1.9×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $203 $270.67 1.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $137.10 $182.80 1.5×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $242.56 $323.42 2.6×
Xr c-spine 6 or more views (72052) $275.95 $367.93 2.5×
Xr finger(s) 2+ views (73140) $230.69 $307.58 2.5×
Xr shoulder 1 view (73020) $187.19 $249.59 2.0×
Xr spine cervical 4 or 5 views (72050) $244.32 $325.76 2.2×
Xr tibia/fibula 2 views (73590) $254.42 $339.23 2.8×
Xr tmj bilateral (70330) $227.62 $303.49 2.5×
Xray knee 1 or 2 views rt (73560) $230.69 $307.58 2.5×