Imaging prices at Roosevelt Medical Center

Culbertson, MT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $294 $294 3.3×
Abdomen 2 views (74019) $455 $455 4.3×
Ankle 2 views (73600) $291 $291 3.3×
Bone age studies (77072) $218 $218 2.0×
Chest 1 view (71045) $268 $268 3.0×
Chest 2 views (71046) $317 $317 3.6×
Chest 3 views (71047) $272 $272 3.1×
Chest 4 or more views (71048) $340 $340 3.2×
Clavicle complete (73000) $222 $222 2.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,663 $1,663 15.6×
CT abdomen and pelvis without and with contrast (74178) $3,336 $3,336 9.4×
CT abdomen and pelvis without contrast (74176) $2,184 $2,184 9.0×
CT abdomen w contrast (74160) $2,056 $2,056 11.5×
CT abdomen w wo contrast (74170) $2,861 $2,861 16.0×
CT abdomen w/o contrast (74150) $1,779 $1,779 16.7×
CT Angio Abdomen and Pelvis (74174) $5,293 $5,293 14.9×
CT Angio Chest (71275) $2,820 $2,820 15.7×
CT Angio Head (70496) $2,580 $2,580 14.4×
CT Angio Neck (70498) $2,578 $2,578 14.4×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,969 $1,969 11.0×
CT cervical spine w/ contrast (72126) $2,875 $2,875 8.1×
CT cervical spine w/o contrast (72125) $1,768 $1,768 16.6×
CT chest w contrast (71260) $2,313 $2,313 12.9×
CT chest w/wo contrast (71270) $2,769 $2,769 15.5×
CT head/brain with contrast (70460) $1,760 $1,760 9.8×
CT head/brain without and with contrast (70470) $1,859 $1,859 10.4×
CT lower ext w/o (73700) $1,767 $1,767 16.5×
CT lower extremity w/contrast material (73701) $2,077 $2,077 11.6×
CT lumbar spine w contrast (72132) $1,973 $1,973 5.5×
CT lumbar spine w/o contrast (72131) $1,765 $1,765 16.5×
CT maxillofacial w contrast (70487) $1,650 $1,650 9.2×
CT maxillofacial wo contrast (70486) $1,304 $1,304 12.2×
CT neck tissue combo (70492) $2,300 $2,300 12.8×
CT orbits w/o contrast (70480) $1,486 $1,486 13.9×
CT pelvis w/o contrast (72192) $1,625 $1,625 15.2×
CT scans face/jaw combo (70488) $2,261 $2,261 12.6×
CT soft tissue neck w contrast (70491) $2,017 $2,017 11.3×
CT soft tissue neck w/o contrast (70490) $1,841 $1,841 17.2×
CT thoracic spine w contrast (72129) $1,968 $1,968 11.0×
CT thoracic spine w/o contrast (72128) $1,759 $1,759 16.5×
CT thorax w/o contrast (71250)
range across 2 matching MRF lines		 $1,663–$2,443 $1,663–$2,443 varies
CT upper ext wo (73200) $1,775 $1,775 16.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,839 $2,839 15.8×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $3,580 $3,580 10.0×
Foot 2 views (73620) $219 $219 2.5×
Forearm 2 views (73090) $289 $289 3.3×
Hand 2 views (73120) $266 $266 2.5×
Knee 3 Views (73562) $292 $292 3.3×
Magnetic Image Jaw Joint (70336) $1,928 $1,928 7.9×
MRI abdomen w contrast (74182) $2,108 $2,108 5.9×
MRI abdomen w/o contrast (74181) $1,429 $1,429 5.9×
MRI any jt lower extrem w/contrast material (73722) $2,290 $2,290 2.9×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,816 $2,816 7.9×
MRI any jt upper extremity w/contrast matrl (73222) $2,288 $2,288 2.9×
MRI cervical spine w contrast (72142) $1,937 $1,937 5.4×
MRI cervical spine w/o cont (72141) $1,500 $1,500 6.2×
MRI chest w/o contrast (71550) $2,566 $2,566 10.5×
MRI chest wo w contrast (71552) $3,443 $3,443 9.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,461 $2,461 6.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,630 $1,630 6.7×
Mri Neck Spine W/O & W/Dye (72156) $2,416 $2,416 6.8×
MRI orbit face &/neck w/o contrast (70540) $1,652 $1,652 6.8×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,476 $2,476 6.9×
MRI pelvis w/o & w contrast (72197) $2,737 $2,737 7.7×
MRI pelvis w/o contrast (72195) $1,673 $1,673 6.9×
MRI thoracic spine w/o contrast (72146) $1,500 $1,500 6.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,217 $2,217 9.1×
Mri Uppr Extremity W/O&W/Dye (73220) $2,993 $2,993 8.4×
MRI, abdomen, combo (74183) $2,747 $2,747 7.7×
MRI, dorsal spine combo (72157) $2,416 $2,416 6.8×
MRI, joint upper extrem (73221) $1,676 $1,676 6.9×
MRI, joint upper extrem combo (73223) $2,827 $2,827 7.9×
MRI, lumbar spine combo (72158) $2,416 $2,416 6.8×
Neck soft tissue (70360) $178 $178 2.0×
Pelvis 1 or 2 views (72170) $273 $273 2.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $492 $492 4.6×
Radex Ankle Complete Minimum 3 Views (73610) $301 $301 3.4×
Radex Calcaneus Minimum 2 Views (73650) $227 $227 2.6×
Radex elbow complete minimum 3 views (73080) $314 $314 3.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $312 $312 2.9×
Radex fingr minimum 2 views (73140) $225 $225 2.5×
Radex foot complete minimum 3 views (73630) $290 $290 3.3×
Radex Hand Minimum 3 Views (73130) $295 $295 3.3×
Radex lower extremity infant minimum 2 views (73592) $204 $204 2.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $241 $241 2.7×
Radex Ribs Unilateral 2 Views (71100) $304 $304 3.4×
Radex shoulder complete minimum 2 views (73030) $306 $306 3.4×
Radex Sinuses Paransl < 3 Views (70210) $219 $219 2.5×
Radex Spine 1 View Specify Level (72020) $338 $338 3.8×
Radex Sternum Minimum 2 Views (71120) $234 $234 2.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $343 $343 3.9×
Radex Toe Minimum 2 Views (73660) $254 $254 2.9×
Radex upper extremity infant minimum 2 views (73092) $204 $204 1.9×
Radex Wrist Complete Minimum 3 Views (73110) $291 $291 3.3×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $534 $534 5.0×
Radiolog exam mandible compl minimum 4 views (70110) $293 $293 2.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $302 $302 2.8×
Radiologic exam knee complete 4/more views (73564) $305 $305 2.9×
Radiologic exam pelvis compl minimum 3 views (72190) $314 $314 2.9×
Radiologic examination femur 1 view (73551) $139 $139 1.6×
Radiologic examination femur minimum 2 views (73552) $262 $262 2.9×
Radiologic examination knee 1/2 views (73560) $273 $273 3.1×
Radiologic examination tibia & fibula 2 views (73590) $285 $285 3.2×
Ribs bilateral 3 views (71110) $292 $292 2.7×
Scapula (73010) $182 $182 1.7×
Shoulder 1 view (73020) $222 $222 2.5×
Skull less than 4 views (70250) $344 $344 3.2×
Sternoclavicular joints (71130) $273 $273 3.1×
Thoracic spine 2 views (72070) $302 $302 2.8×
Thoracic spine 3 views (72072) $412 $412 3.9×
Thoracolumbar 2 views (72080) $490 $490 5.5×
Ultrasound Exam Aaa Screen (76706) $560 $560 5.2×
Ultrasound, abdomen limited (76705) $756 $756 7.1×
Us chest (76604) $401 $401 3.8×
Us complete joint (76881) $488 $488 4.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $281 $281 2.6×
Us pelvic non ob complete (76856) $671 $671 6.3×
Us retroperitoneal complete (76770) $651 $651 6.1×
Us retroperitoneal limited (76775) $569 $569 5.3×
Us scrotum and contents (76870) $662 $662 6.2×
Us thyroid (76536) $706 $706 6.6×
Wrist 2 views (73100) $195 $195 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $338 $338 3.8×
X-Ray Bend Only L-S Spine (72120) $393 $393 3.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $223 $223 2.5×
X-Ray Exam Entire Spi 1 Vw (72081) $149 $149 1.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $277 $277 2.6×
X-Ray Exam Entire Spi 4/5 Vw (72083) $405 $405 3.8×
X-Ray Exam Hip Uni 1 View (73501) $310 $310 3.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $350 $350 3.9×
X-Ray Exam Hip Uni 4/> Views (73503) $374 $374 3.5×
X-Ray Exam Hips Bi 2 Views (73521) $343 $343 3.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $511 $511 4.8×
X-Ray Exam Hips Bi 5/> Views (73523) $673 $673 6.3×
X-Ray Exam L-S Spine Bending (72114) $441 $441 4.1×
X-Ray Exam Neck Spine 2-3 Vw (72040) $282 $282 3.2×
X-Ray Exam Neck Spine 6/>Vws (72052) $637 $637 6.0×
X-Ray Exam Unilat Ribs/Chest (71101) $320 $320 3.0×
X-ray eye for foreign body (70030) $221 $221 2.5×
X-ray humerus (73060) $246 $246 2.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $221 $221 2.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $323 $323 3.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $284 $284 2.7×
X-ray nose-rectum child f.b. (76010) $202 $202 2.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $294 $294 2.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $281 $281 2.6×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $251 $251 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $331 $331 3.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $276 $276 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $345 $345 3.2×
X-ray thoracic spine 4 vw (72074) $430 $430 4.0×
X-Ray Tmj Unilat (70328) $76 $76 0.9×
Xr c-spine 4 or 5 views (72050) $450 $450 4.2×
Xr facial bones less than 3 views (70140) $209 $209 2.4×

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.