Imaging prices at Saint Alphonsus Medical Center - Baker City

Baker City, OR · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $200.20 — 2.1×
Abdomen 2 views (74019) $268.45 $413 2.3×
Ankle 2 views (73600)
range across 3 matching MRF lines
$206.05–$309.40 $317–$476 varies
Arthrogram hip (73525)
range across 3 matching MRF lines
$538.85–$808.60 $829–$1,244 varies
Bone age studies (77072) $217.10 $334 1.9×
Bone survey infant (77076) $237.90 $366 2.0×
Chest 1 view (71045) $23,446.29 — 242.4×
Chest 2 views (71046) $192.40 — 2.0×
Chest 3 views (71047) $209.95 $323 2.2×
Chest 4 or more views (71048) $219.70 $338 1.9×
Clavicle complete (73000)
range across 3 matching MRF lines
$206.70–$299.65 $318–$461 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,298.05 $1,997 11.2×
CT abdomen and pelvis without and with contrast (74178) $3,078.40 $4,736 7.9×
CT abdomen and pelvis without contrast (74176) $2,087.80 $3,212 7.9×
CT abdomen w contrast (74160) $1,409.20 $2,168 7.2×
CT abdomen w wo contrast (74170) $1,571.70 $2,418 8.1×
CT abdomen w/o contrast (74150) $998.40 $1,536 8.6×
CT Angio Abdomen and Pelvis (74174) $2,910.05 $4,477 7.5×
CT Angio Chest (71275) $1,617.85 $2,489 8.3×
CT Angio Head (70496) $1,784.90 $2,746 9.2×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines
$1,196–$1,794 $1,840–$2,760 varies
CT Angio Neck (70498) $1,820.65 $2,801 9.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,318.85 $2,029 6.8×
CT cervical spine w/ contrast (72126) $1,684.80 $2,592 4.3×
CT cervical spine w/o contrast (72125) $1,299.35 $1,999 11.2×
CT chest w contrast (71260) $1,413.10 $2,174 7.2×
CT chest w/wo contrast (71270) $1,552.85 $2,389 8.0×
CT head/brain with contrast (70460) $1,375.40 $2,116 7.1×
CT head/brain without and with contrast (70470) $1,571.70 $2,418 8.1×
CT heart contrast eval cardiac structure&morph (75572) $518.05 $797 1.3×
CT heart no contrast quant eval coronry calcium (75571) $51.35 $79 0.5×
CT iac w contrast (70481) $1,333.15 $2,051 6.8×
CT l-spine w&w/o contrast (72133) $1,742 $2,680 8.9×
CT lower ext w/o (73700)
range across 3 matching MRF lines
$1,001–$1,501.50 $1,540–$2,310 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines
$1,342.90–$2,014.35 $2,066–$3,099 varies
CT lumbar spine w contrast (72132) $1,482.65 $2,281 3.8×
CT lumbar spine w/o contrast (72131) $1,298.70 $1,998 11.2×
CT maxillofacial w contrast (70487) $1,227.85 $1,889 6.3×
CT maxillofacial wo contrast (70486) $893.10 $1,374 7.7×
CT neck tissue combo (70492) $1,488.50 $2,290 7.6×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,539.20 $2,368 7.9×
CT orbits w/o contrast (70480) $1,068.60 $1,644 9.2×
CT pelvis w&w/o contrast (72194) $1,483.95 $2,283 7.6×
CT pelvis w/o contrast (72192) $993.20 $1,528 8.5×
CT scan of leg combo (73702) $1,875.90 $2,886 9.6×
CT scans face/jaw combo (70488) $1,420.90 $2,186 7.3×
CT soft tissue neck w contrast (70491) $1,414.40 $2,176 7.3×
CT soft tissue neck w/o contrast (70490) $856.05 $1,317 7.4×
CT thoracic spine w contrast (72129) $1,422.20 $2,188 7.3×
CT thoracic spine w/o contrast (72128) $1,173.90 $1,806 10.1×
CT thorax w/o contrast (71250) $1,134.25 $1,745 9.8×
CT upper ext wo (73200)
range across 3 matching MRF lines
$1,017.25–$1,526.20 $1,565–$2,348 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines
$1,288.30–$1,932.45 $1,982–$2,973 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,787.50 $2,750 9.2×
Cta Abdomen (74175) $1,718.60 $2,644 8.8×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,571.70 $2,418 4.1×
CTA pelvis (72191) $1,430 $2,200 7.3×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $284.70 $438 2.4×
Doppler Echo Fetal Spectral Display Complete (76827) $485.55 $747 4.2×
Dxa Bone Density Axial (77080) $277.55 $427 2.4×
Dxa bone density study 1/>sites appendiclr skel (77081) $117 $180 1.2×
Echo exam of fetal heart (76825) $971.10 $1,494 1.6×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $625.30 $962 2.4×
Esophagram (74220) $419.90 $646 2.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $213.20 $328 1.8×
Fluoroscopy up to 1 hr (76000) $518.70 $798 2.0×
Foot 2 views (73620)
range across 3 matching MRF lines
$206.05–$309.40 $317–$476 varies
Forearm 2 views (73090) $211.25 — 2.2×
Hand 2 views (73120)
range across 3 matching MRF lines
$197.60–$296.40 $304–$456 varies
Knee 3 Views (73562)
range across 3 matching MRF lines
$247.65–$371.80 $381–$572 varies
Meckels Divert Exam (78290) $846.30 $1,302 1.9×
Mr safety determination physician/other qhp (76016) $118.30 $182 1.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $33.15 $51 1.0×
Mra Head W/O & W/Contrast Material (70546) $2,520.70 $3,878 6.5×
MRA head w/o contrast (70544) $1,573.65 $2,421 5.9×
MRA neck w contrast (70548) $1,663.35 $2,559 4.3×
Mra Neck W/O &W/Contrast Material (70549) $2,564.90 $3,946 6.6×
MRA neck w/o contrast (70547) $1,433.90 $2,206 5.4×
MRI abdomen w contrast (74182) $1,767.35 $2,719 4.6×
MRI abdomen w/o contrast (74181) $1,600.95 $2,463 6.0×
MRI any jt lower extrem w/contrast material (73722)
range across 3 matching MRF lines
$1,923.35–$2,885.35 $2,959–$4,439 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 3 matching MRF lines
$2,361.45–$3,542.50 $3,633–$5,450 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 3 matching MRF lines
$1,870.70–$2,806.05 $2,878–$4,317 varies
MRI cardiac w/o contrast (75557) $1,610.05 $2,477 6.1×
MRI cervical spine w contrast (72142) $1,875.90 $2,886 4.8×
MRI cervical spine w/o cont (72141) $1,593.15 $2,451 6.0×
MRI chest w/o contrast (71550) $1,233.70 $1,898 4.7×
MRI chest wo w contrast (71552) $2,122.25 $3,265 5.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines
$2,469.35–$3,704.35 $3,799–$5,699 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 3 matching MRF lines
$1,422.20–$2,133.30 $2,188–$3,282 varies
MRI lumbar spine w contrast (72149) $1,716 $2,640 4.4×
Mri Neck Spine W/O & W/Dye (72156) $2,661.75 $4,095 6.9×
MRI orbit face &/neck w/o contrast (70540) $1,446.90 $2,226 5.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,468.05 $3,797 6.4×
MRI pelvis w/o & w contrast (72197) $2,471.30 $3,802 6.4×
MRI pelvis w/o contrast (72195) $1,509.30 $2,322 5.7×
MRI thoracic spine w/o contrast (72146) $1,534.65 $2,361 5.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,474.85 $2,269 5.6×
Mri Uppr Extremity W/O&W/Dye (73220)
range across 3 matching MRF lines
$2,379.65–$3,569.80 $3,661–$5,492 varies
MRI, abdomen, combo (74183) $2,419.95 $3,723 6.2×
MRI, dorsal spine combo (72157) $2,531.75 $3,895 6.5×
MRI, dorsal spine contrast (72147) $1,716 $2,640 4.4×
MRI, joint upper extrem (73221)
range across 3 matching MRF lines
$1,498.25–$2,247.70 $2,305–$3,458 varies
MRI, joint upper extrem combo (73223) $2,141.10 $3,294 5.5×
MRI, lumbar spine combo (72158) $2,648.10 $4,074 6.8×
Myelography thoracic (72255) $1,364.35 $2,099 1.6×
Neck soft tissue (70360) $204.75 $315 2.1×
Nonvascular Shunt X-Ray (75809) $256.75 $395 2.2×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 3 matching MRF lines
$212.55–$319.15 $327–$491 varies
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $13.65 $21 0.4×
Pelvis 1 or 2 views (72170) $224.25 $345 1.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $373.10 $574 3.2×
Radex abscess/fistula/sinus tract rs&i (76080) $884 $1,360 1.5×
Radex Ankle Complete Minimum 3 Views (73610) $228.80 — 2.4×
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines
$206.05–$309.40 $317–$476 varies
Radex elbow complete minimum 3 views (73080) $228.80 — 2.4×
Radex Facial Bones Complete Minimum 3 Views (70150) $156 $240 1.3×
Radex fingr minimum 2 views (73140) $165.75 — 1.7×
Radex foot complete minimum 3 views (73630)
range across 6 matching MRF lines
$237.90–$356.85 $366–$549 varies
Radex Hand Minimum 3 Views (73130)
range across 2 matching MRF lines
$224.90–$309.40 — varies
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines
$210.60–$315.90 $324–$486 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130)
range across 3 matching MRF lines
$248.95–$373.75 $383–$575 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $143 $220 1.5×
Radex Ribs Unilateral 2 Views (71100) $169.65 $261 1.8×
Radex shoulder complete minimum 2 views (73030)
range across 2 matching MRF lines
$228.80–$415.35 — varies
Radex Sinuses Paransl < 3 Views (70210) $130.65 $201 1.4×
Radex Spine 1 View Specify Level (72020) $225.55 $347 2.3×
Radex Sternum Minimum 2 Views (71120) $233.35 $359 2.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $139.10 $214 1.4×
Radex Toe Minimum 2 Views (73660) $182 — 1.9×
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines
$556.40–$834.60 $856–$1,284 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 2 matching MRF lines
$228.80–$474.50 — varies
Radiolog exam mandible compl minimum 4 views (70110) $176.15 $271 1.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $309.40 $476 2.7×
Radiologic exam colon double contrast study (74280) $511.55 $787 2.6×
Radiologic exam colon single contrast study (74270) $549.25 $845 2.8×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines
$299.65–$449.80 $461–$692 varies
Radiologic exam pelvis compl minimum 3 views (72190) $275.60 $424 2.4×
Radiologic Exam Small Int Single Contrast Study (74250) $400.40 $616 2.1×
Radiologic exam swallow function contrast study (74230) $359.45 $553 1.8×
Radiologic exam upr gi trc double contrast study (74246) $488.80 $752 2.5×
Radiologic examination femur 1 view (73551)
range across 3 matching MRF lines
$142.35–$213.85 $219–$329 varies
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines
$250.90–$376.35 $386–$579 varies
Radiologic examination knee 1/2 views (73560)
range across 9 matching MRF lines
$37.70–$300.30 $58–$462 varies
Radiologic examination tibia & fibula 2 views (73590) $471.90 — 4.9×
Ribs bilateral 3 views (71110) $373.75 $575 3.2×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,590.55 $2,447 1.1×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,710.80 $2,632 1.2×
Scapula (73010)
range across 3 matching MRF lines
$252.85–$366.60 $389–$564 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 3 matching MRF lines
$37.05–$39 $57–$60 varies
Shoulder 1 view (73020)
range across 6 matching MRF lines
$193.70–$280.80 $298–$432 varies
Shoulder Arthrography (73040)
range across 3 matching MRF lines
$734.50–$1,101.75 $1,130–$1,695 varies
Skull less than 4 views (70250) $258.05 $397 2.2×
Sternoclavicular joints (71130) $125.45 $193 1.3×
Thoracic spine 2 views (72070) $284.70 $438 2.4×
Thoracic spine 3 views (72072) $340.60 $524 2.9×
Thoracolumbar 2 views (72080) $308.75 $475 3.2×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines
$204.10–$306.15 $314–$471 varies
Ultrasound Exam Aaa Screen (76706) $229.45 $353 2.0×
Ultrasound, abdomen limited (76705)
range across 4 matching MRF lines
$72.15–$367.90 $111–$566 varies
Umbilical-artery Doppler (OB) (76820) $193.05 $297 1.7×
Upper gi w/o kub (74240) $410.80 $632 2.1×
Us breast unilateral complete (76641) $250.90 $386 2.2×
Us chest (76604) $287.30 $442 2.5×
Us complete joint (76881) $176.15 $271 1.5×
Us exam, pelvic, limited (76857) $270.40 $416 2.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $217.10 $334 1.9×
Us ob detailed single fetus (76811) $590.85 $909 2.2×
Us ob limited 1 or more fetuses (76815) $286.65 $441 2.5×
Us ob transvaginal (76817) $254.80 $392 2.2×
Us pelvic non ob complete (76856) $458.90 $706 3.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $299.65 $461 2.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $283.40 $436 2.4×
Us retroperitoneal complete (76770) $439.40 $676 3.8×
Us retroperitoneal limited (76775) $292.50 $450 2.5×
Us scrotum and contents (76870) $428.35 $659 3.7×
Us spinal canal and contents (76800) $385.45 $593 3.3×
Us thyroid (76536) $345.80 $532 3.0×
Wrist 2 views (73100)
range across 6 matching MRF lines
$225.55–$338.65 $347–$521 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $181.35 $279 1.9×
X-ray antegrade pyelogram tube (74425) $834.60 $1,284 2.2×
X-Ray Bend Only L-S Spine (72120) $261.30 $402 2.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines
$206.05–$309.40 $317–$476 varies
X-Ray Exam Entire Spi 1 Vw (72081) $143 $220 1.5×
X-Ray Exam Entire Spi 2/3 Vw (72082) $215.80 $332 1.9×
X-Ray Exam Entire Spi 4/5 Vw (72083) $269.75 $415 2.3×
X-Ray Exam Hip Uni 1 View (73501) $174.20 $268 1.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $215.15 — 2.2×
X-Ray Exam Hip Uni 4/> Views (73503) $202.15 $311 1.7×
X-Ray Exam Hips Bi 2 Views (73521) $325.65 $501 2.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $354.90 $546 3.1×
X-Ray Exam Hips Bi 5/> Views (73523) $349.05 $537 3.0×
X-Ray Exam L-S Spine Bending (72114) $401.70 $618 3.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $261.30 $402 2.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $319.15 $491 2.7×
X-Ray Exam Unilat Ribs/Chest (71101) $257.40 $396 2.2×
X-ray eye for foreign body (70030)
range across 3 matching MRF lines
$132.60–$198.90 $204–$306 varies
X-ray humerus (73060) $228.80 $352 2.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $130.65 $201 1.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $449.80 $692 4.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $296.40 $456 2.6×
X-ray nose-rectum child f.b. (76010) $145.60 $224 1.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $340.60 $524 2.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $230.75 $355 2.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $250.25 $385 2.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $144.95 $223 1.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $250.25 $385 2.2×
X-ray thoracic spine 4 vw (72074) $340.60 $524 2.9×
X-Ray Tmj Unilat (70328) $92.95 $143 1.0×
X-Rays Bone Length Studies (77073) $217.10 $334 1.9×
X-Rays Bone Survey Complete (77075) $263.90 $406 2.3×
Xr c-spine 4 or 5 views (72050) $330.20 $508 2.8×
Xr facial bones less than 3 views (70140) $146.25 $225 1.5×

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.