Imaging prices at Roger Mills Memorial Hospital
Cheyenne, OK · every code in this section with a posted price and a Medicare benchmark.
105 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $181.50 | $242 | 2.2× |
| Abdomen 2 views (74019) | $278.25 | $371 | 2.8× |
| Ankle 2 views (73600) | $181.50 | $242 | 2.2× |
| Chest 1 view (71045) | $186 | $248 | 2.2× |
| Chest 2 views (71046) | $227.25 | $303 | 2.7× |
| Clavicle complete (73000) | $223.50 | $298 | 2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,095.75 | $1,461 | 10.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,636.25 | $3,515 | 7.9× |
| CT abdomen and pelvis without contrast (74176) | $1,797 | $2,396 | 7.8× |
| CT abdomen w contrast (74160) | $1,518.75 | $2,025 | 9.0× |
| CT abdomen w wo contrast (74170) | $1,708.50 | $2,278 | 10.1× |
| CT abdomen w/o contrast (74150) | $1,176.75 | $1,569 | 11.7× |
| CT Angio Chest (71275) | $1,434 | $1,912 | 8.5× |
| CT Angio Head (70496) | $1,264.50 | $1,686 | 7.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,698.75 | $2,265 | 10.1× |
| CT Angio Neck (70498) | $1,400.25 | $1,867 | 8.3× |
| CT bone density (77078) | $256.50 | $342 | 3.1× |
| CT cervical spine w/ contrast (72126) | $804 | $1,072 | 2.4× |
| CT cervical spine w/o contrast (72125) | $1,513.50 | $2,018 | 15.1× |
| CT chest w contrast (71260) | $1,602.75 | $2,137 | 9.5× |
| CT chest w/wo contrast (71270) | $1,611 | $2,148 | 9.5× |
| CT head/brain with contrast (70460) | $804 | $1,072 | 4.8× |
| CT head/brain without and with contrast (70470) | $1,623.75 | $2,165 | 9.6× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$15–$480.75 | $20–$641 | varies |
| CT l-spine w&w/o contrast (72133) | $923.25 | $1,231 | 5.5× |
| CT lower ext w/o (73700) | $1,218.75 | $1,625 | 12.1× |
| CT lower extremity w/contrast material (73701) | $923.25 | $1,231 | 5.5× |
| CT lumbar spine w contrast (72132) | $1,983 | $2,644 | 5.9× |
| CT lumbar spine w/o contrast (72131) | $1,573.50 | $2,098 | 15.6× |
| CT maxillofacial w contrast (70487) | $804 | $1,072 | 4.8× |
| CT maxillofacial wo contrast (70486) | $1,209.75 | $1,613 | 12.0× |
| CT neck tissue combo (70492) | $1,062.75 | $1,417 | 6.3× |
| CT pelvis w&w/o contrast (72194) | $923.25 | $1,231 | 5.5× |
| CT pelvis w/o contrast (72192) | $1,074.75 | $1,433 | 10.7× |
| CT scan of leg combo (73702) | $993 | $1,324 | 5.9× |
| CT scans face/jaw combo (70488) | $919.50 | $1,226 | 5.5× |
| CT soft tissue neck w contrast (70491) | $1,476 | $1,968 | 8.7× |
| CT soft tissue neck w/o contrast (70490) | $1,264.50 | $1,686 | 12.6× |
| CT thoracic spine w contrast (72129) | $804 | $1,072 | 4.8× |
| CT thoracic spine w/o contrast (72128) | $1,158.75 | $1,545 | 11.5× |
| CT thoracic spine w/wo cont (72130) | $923.25 | $1,231 | 5.5× |
| CT thorax w/o contrast (71250) | $1,294.50 | $1,726 | 12.9× |
| CT upper ext wo (73200) range across 12 matching MRF lines |
$1,257–$1,264.50 | $1,676–$1,686 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $923.25 | $1,231 | 5.5× |
| CT upper extremity with contrast (73201) | $804 | $1,072 | 2.4× |
| Cta Abdomen (74175) | $1,446 | $1,928 | 8.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $75.75 | $101 | 0.9× |
| Foot 2 views (73620) | $198 | $264 | 2.4× |
| Forearm 2 views (73090) | $207 | $276 | 2.5× |
| Hand 2 views (73120) | $164.25 | $219 | 1.6× |
| Knee 3 Views (73562) | $244.50 | $326 | 2.9× |
| Neck soft tissue (70360) | $135 | $180 | 1.6× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$181.50–$451.50 | $242–$602 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $215.25 | $287 | 2.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $227.25 | $303 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $223.50 | $298 | 2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $219.75 | $293 | 2.2× |
| Radex fingr minimum 2 views (73140) | $189.75 | $253 | 2.3× |
| Radex foot complete minimum 3 views (73630) | $223.50 | $298 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $211.50 | $282 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $135 | $180 | 1.6× |
| Radex Ribs Unilateral 2 Views (71100) | $223.50 | $298 | 2.7× |
| Radex shoulder complete minimum 2 views (73030) | $227.25 | $303 | 2.7× |
| Radex Spine 1 View Specify Level (72020) | $252.75 | $337 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $104.25 | $139 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $162.75 | $217 | 1.9× |
| Radex Toe Minimum 2 Views (73660) | $168.75 | $225 | 2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $201.75 | $269 | 2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $485.25 | $647 | 4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $130.50 | $174 | 1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $295.50 | $394 | 2.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $111 | $148 | 1.1× |
| Radiologic examination femur 1 view (73551) | $151.50 | $202 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $151.50 | $202 | 1.8× |
| Radiologic examination knee 1/2 views (73560) | $207 | $276 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $219.75 | $293 | 2.6× |
| Ribs bilateral 3 views (71110) | $278.25 | $371 | 2.8× |
| Scapula (73010) | $135 | $180 | 1.3× |
| Skull less than 4 views (70250) | $111 | $148 | 1.1× |
| Thoracic spine 2 views (72070) | $287.25 | $383 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $464.25 | $619 | 4.6× |
| Ultrasound, abdomen limited (76705) | $421.50 | $562 | 4.2× |
| Us chest (76604) | $421.50 | $562 | 4.2× |
| Us complete joint (76881) | $506.25 | $675 | 5.0× |
| Us pelvic non ob complete (76856) | $548.25 | $731 | 5.5× |
| Us retroperitoneal complete (76770) | $548.25 | $731 | 5.5× |
| Us scrotum and contents (76870) | $336.75 | $449 | 3.3× |
| Us thyroid (76536) | $548.25 | $731 | 5.5× |
| Wrist 2 views (73100) | $198 | $264 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $176.25 | $235 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $256.50 | $342 | 2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $485.25 | $647 | 4.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $156.75 | $209 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $156.75 | $209 | 1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $256.50 | $342 | 2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $485.25 | $647 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $249 | $332 | 3.0× |
| X-ray humerus (73060) | $207 | $276 | 2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $127.50 | $170 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $244.50 | $326 | 2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $194.25 | $259 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $130.50 | $174 | 1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $162.75 | $217 | 1.6× |
| Xr c-spine 4 or 5 views (72050) | $405 | $540 | 4.0× |
| Xr orbits complete 4 views (70200) | $136.50 | $182 | 1.4× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.