Imaging prices at Sheridan County Hospital

Hoxie, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $250 $250 3.1×
Abdomen 2 views (74019) $320 $320 3.3×
Acute Gastrointestinal Blood Loss Imaging (78278) $702 $702 1.9×
Ankle 2 views (73600) $193 $193 2.4×
Bone age studies (77072) $260 $260 2.7×
Bone Imaging 3 Phase (78315) $708 $708 1.9×
Bone Imaging Limited Area (78300) $639 $639 1.7×
Bone Imaging Whole Body (78306) $878 $878 2.4×
Bone survey infant (77076) $1,038 $1,038 10.8×
Chest 1 view (71045) $230 $230 2.9×
Chest 2 views (71046) $280 $280 3.5×
Chest 3 views (71047) $291 $291 3.6×
Chest 4 or more views (71048) $302 $302 3.1×
Clavicle complete (73000) $213 $213 2.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $886 $886 9.2×
CT abdomen and pelvis without and with contrast (74178) $1,115 $1,115 3.5×
CT abdomen and pelvis without contrast (74176) $981 $981 4.5×
CT abdomen w contrast (74160) $1,046 $1,046 6.5×
CT abdomen w wo contrast (74170) $1,046 $1,046 6.5×
CT abdomen w/o contrast (74150) $914 $914 9.5×
CT Angio Abdomen and Pelvis (74174) $2,762 $2,762 8.6×
CT Angio Chest (71275)
range across 2 matching MRF lines		 $1,856–$1,880 $1,856–$1,880 varies
CT Angio Head (70496) $1,821 $1,821 11.3×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,616 $1,616 10.0×
CT Angio Neck (70498) $1,881 $1,881 11.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,616 $1,616 10.0×
CT cervical spine w/ contrast (72126) $1,046 $1,046 3.3×
CT cervical spine w/o contrast (72125) $914 $914 9.5×
CT cervical spine w/wo cont (72127) $1,046 $1,046 6.5×
CT chest w contrast (71260) $1,046 $1,046 6.5×
CT chest w/wo contrast (71270) $1,046 $1,046 6.5×
CT head/brain with contrast (70460) $1,046 $1,046 6.5×
CT head/brain without and with contrast (70470) $1,046 $1,046 6.5×
CT iac w contrast (70481) $1,046 $1,046 6.5×
CT l-spine w&w/o contrast (72133) $1,046 $1,046 6.5×
CT lower ext w/o (73700) $914 $914 9.5×
CT lower extremity w/contrast material (73701) $1,046 $1,046 6.5×
CT lumbar spine w contrast (72132) $1,046 $1,046 3.3×
CT lumbar spine w/o contrast (72131) $914 $914 9.5×
CT maxillofacial w contrast (70487) $1,046 $1,046 6.5×
CT maxillofacial wo contrast (70486) $914 $914 9.5×
CT neck tissue combo (70492) $1,046 $1,046 6.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,046 $1,046 6.5×
CT orbits w/o contrast (70480) $914 $914 9.5×
CT pelvis w&w/o contrast (72194) $1,046 $1,046 6.5×
CT pelvis w/o contrast (72192) $914 $914 9.5×
CT scan of leg combo (73702) $1,046 $1,046 6.5×
CT scans face/jaw combo (70488) $1,046 $1,046 6.5×
CT soft tissue neck w contrast (70491) $1,046 $1,046 6.5×
CT soft tissue neck w/o contrast (70490) $914 $914 9.5×
CT thoracic spine w contrast (72129) $1,046 $1,046 6.5×
CT thoracic spine w/o contrast (72128) $914 $914 9.5×
CT thoracic spine w/wo cont (72130) $1,046 $1,046 6.5×
CT thorax w/o contrast (71250) $914 $914 9.5×
CT upper ext wo (73200) $914 $914 9.5×
CT upper extremity w/o & w/contrast material (73202) $1,046 $1,046 6.5×
CT upper extremity with contrast (73201) $1,046 $1,046 3.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,028 $2,028 12.6×
Cta Abdomen (74175) $1,592 $1,592 9.9×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,348 $2,348 7.3×
CTA pelvis (72191) $1,534 $1,534 9.5×
Doppler Fetal Mid Cerebral Artery (76821) $459 $459 4.8×
Dxa Bone Density Axial (77080) $525 $525 5.5×
Dxa bone density study (77085) $525 $525 5.5×
Fetal Biophys Profile W/Nst (76818) $309 $309 3.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $309 $309 3.2×
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines		 $435–$571 $435–$571 varies
Foot 2 views (73620)
range across 2 matching MRF lines		 $232–$264 $232–$264 varies
Forearm 2 views (73090) $232 $232 2.9×
Gastric emptying imaging study (78264) $789 $789 2.1×
Gated Heart Planar Single (78472) $975 $975 2.7×
Hand 2 views (73120) $266 $266 2.8×
Hepatobil Syst Image W/Drug (78227) $1,004 $1,004 2.0×
Ht Muscle Image Spect Sing (78451) $1,878 $1,878 1.6×
Infant hip ultrasound, limited static exam (76886) $149 $149 1.9×
K Flow/Funct Image W/Drug (78708) $1,343 $1,343 2.7×
Knee 3 Views (73562) $278 $278 3.5×
Mra Head W/O & W/Contrast Material (70546) $1,265 $1,265 3.9×
MRA head w/o contrast (70544) $1,265 $1,265 5.8×
MRA head with contrast (70545) $1,265 $1,265 3.9×
Mra Neck W/O &W/Contrast Material (70549) $1,265 $1,265 3.9×
MRI abdomen w contrast (74182) $1,153 $1,153 3.6×
MRI abdomen w/o contrast (74181)
range across 2 matching MRF lines		 $854–$1,049 $854–$1,049 varies
MRI any jt lower extrem w/contrast material (73722) $1,153 $1,153 1.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,185 $1,185 3.7×
MRI any jt upper extremity w/contrast matrl (73222) $1,153 $1,153 1.6×
MRI cervical spine w contrast (72142) $1,153 $1,153 3.6×
MRI cervical spine w/o cont (72141) $854 $854 3.9×
MRI chest w/o contrast (71550) $1,049 $1,049 4.8×
MRI chest with contrast (71551) $1,153 $1,153 1.6×
MRI chest wo w contrast (71552) $1,185 $1,185 3.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,153 $1,153 3.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,185 $1,185 3.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,049 $1,049 4.8×
MRI lumbar spine w contrast (72149) $1,153 $1,153 3.6×
Mri Neck Spine W/O & W/Dye (72156) $1,185 $1,185 3.7×
MRI orbit face &/neck w/o contrast (70540) $1,049 $1,049 4.8×
MRI orbit face neck w contrast (70542) $1,153 $1,153 3.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,185 $1,185 3.7×
MRI pelvis w contrast (72196) $1,153 $1,153 3.6×
MRI pelvis w/o & w contrast (72197) $1,185 $1,185 3.7×
MRI pelvis w/o contrast (72195) $1,049 $1,049 4.8×
MRI thoracic spine w/o contrast (72146) $1,049 $1,049 4.8×
MRI upper extremity oth than jt w/contr matrl (73219) $1,153 $1,153 3.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,049 $1,049 4.8×
Mri Uppr Extremity W/O&W/Dye (73220) $1,185 $1,185 3.7×
MRI, abdomen, combo (74183) $1,185 $1,185 3.7×
MRI, dorsal spine combo (72157) $1,185 $1,185 3.7×
MRI, dorsal spine contrast (72147) $1,153 $1,153 3.6×
MRI, joint upper extrem (73221)
range across 6 matching MRF lines		 $854–$1,049 $854–$1,049 varies
MRI, joint upper extrem combo (73223) $1,185 $1,185 3.7×
MRI, lumbar spine combo (72158) $1,185 $1,185 3.7×
Myocardial Spect Multiple Studies (78452) $2,730 $2,730 2.3×
Neck soft tissue (70360) $241 $241 3.0×
Parathyroid Planar Imaging (78070) $606 $606 1.6×
Pelvis 1 or 2 views (72170) $235 $235 2.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $490 $490 5.1×
Radex Ankle Complete Minimum 3 Views (73610) $260 $260 3.2×
Radex Calcaneus Minimum 2 Views (73650) $213 $213 2.7×
Radex elbow complete minimum 3 views (73080) $281 $281 3.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $352 $352 3.7×
Radex fingr minimum 2 views (73140) $196 $196 2.4×
Radex foot complete minimum 3 views (73630) $250 $250 3.1×
Radex Hand Minimum 3 Views (73130) $253 $253 3.2×
Radex lower extremity infant minimum 2 views (73592) $256 $256 3.2×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $266 $266 2.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $275 $275 3.4×
Radex Ribs Unilateral 2 Views (71100) $248 $248 3.1×
Radex shoulder complete minimum 2 views (73030) $261 $261 3.3×
Radex Sinuses Paransl < 3 Views (70210) $199 $199 2.5×
Radex Sternum Minimum 2 Views (71120) $270 $270 3.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $171 $171 2.1×
Radex Toe Minimum 2 Views (73660) $201 $201 2.5×
Radex upper extremity infant minimum 2 views (73092) $266 $266 2.8×
Radex Wrist Complete Minimum 3 Views (73110) $266 $266 3.3×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $507 $507 5.3×
Radiolog exam mandible compl minimum 4 views (70110) $391 $391 4.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $389 $389 4.0×
Radiologic exam knee complete 4/more views (73564) $403 $403 4.2×
Radiologic exam pelvis compl minimum 3 views (72190) $252 $252 2.6×
Radiologic Exam Small Int Single Contrast Study (74250) $578 $578 3.6×
Radiologic examination femur 1 view (73551) $160 $160 2.0×
Radiologic examination femur minimum 2 views (73552) $204 $204 2.5×
Radiologic examination knee 1/2 views (73560) $201 $201 2.5×
Radiologic examination tibia & fibula 2 views (73590) $264 $264 3.3×
Ribs bilateral 3 views (71110) $250 $250 2.6×
Scapula (73010) $217 $217 2.3×
Screening Digital Breast Tomosynthesis Bi (77063) $145 $145 6.2×
Shoulder 1 view (73020) $196 $196 2.4×
Skull less than 4 views (70250) $266 $266 2.8×
Sternoclavicular joints (71130) $160 $160 2.0×
Thoracic spine 2 views (72070) $248 $248 2.6×
Thoracic spine 3 views (72072) $375 $375 3.9×
Thoracolumbar 2 views (72080) $357 $357 4.5×
Thyroid Imaging With Vascular Flow (78013) $712 $712 1.9×
Ultrasound Breast Limited (76642) $185 $185 2.3×
Ultrasound Exam Aaa Screen (76706) $234 $234 2.4×
Ultrasound, abdomen limited (76705) $309 $309 3.2×
Umbilical-artery Doppler (OB) (76820) $459 $459 4.8×
Unlisted us procedure (76999) $185 $185 2.3×
Us breast unilateral complete (76641) $203 $203 2.1×
Us chest (76604) $222 $222 2.3×
Us complete joint (76881) $309 $309 3.2×
Us exam, pelvic, limited (76857) $169 $169 1.8×
Us kidney transplant (76776) $309 $309 3.2×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $309 $309 3.2×
Us ob limited 1 or more fetuses (76815) $309 $309 3.2×
Us ob transvaginal (76817) $309 $309 3.2×
Us pelvic non ob complete (76856) $309 $309 3.2×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $309 $309 3.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $309 $309 3.2×
Us retroperitoneal complete (76770) $309 $309 3.2×
Us retroperitoneal limited (76775) $309 $309 3.2×
Us scrotum and contents (76870) $309 $309 3.2×
Us spinal canal and contents (76800) $192 $192 2.0×
Us thyroid (76536) $782 $782 8.1×
Us transrectal (76872) $165 $165 1.7×
Wrist 2 views (73100) $180 $180 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $390 $390 4.9×
X-Ray Bend Only L-S Spine (72120) $434 $434 4.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $211 $211 2.6×
X-Ray Exam Entire Spi 1 Vw (72081) $184 $184 2.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $266 $266 2.8×
X-Ray Exam Entire Spi 4/5 Vw (72083) $507 $507 5.3×
X-Ray Exam Hip Uni 1 View (73501) $264 $264 3.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $322 $322 4.0×
X-Ray Exam Hip Uni 4/> Views (73503)
range across 4 matching MRF lines		 $397–$3,970 $397–$3,970 varies
X-Ray Exam Hips Bi 2 Views (73521) $302 $302 3.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $406 $406 4.2×
X-Ray Exam Hips Bi 5/> Views (73523) $513 $513 5.3×
X-Ray Exam L-S Spine Bending (72114) $556 $556 5.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $297 $297 3.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $505 $505 5.3×
X-Ray Exam Unilat Ribs/Chest (71101) $372 $372 3.9×
X-ray eye for foreign body (70030) $156 $156 1.9×
X-ray humerus (73060) $255 $255 3.2×
X-ray IV pyelogram (ivp) (74400) $894 $894 5.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $160 $160 2.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565)
range across 3 matching MRF lines		 $204–$307 $204–$307 varies
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $324 $324 3.4×
X-ray nose-rectum child f.b. (76010) $185 $185 2.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $455 $455 4.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $264 $264 2.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $266 $266 3.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $361 $361 4.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $391 $391 4.1×
X-ray thoracic spine 4 vw (72074) $314 $314 3.3×
X-Ray Tmj Unilat (70328) $160 $160 2.0×
X-Rays Bone Survey Complete (77075) $941 $941 9.8×
Xr c-spine 4 or 5 views (72050) $428 $428 4.5×
Xr facial bones less than 3 views (70140) $334 $334 4.2×
Xr orbits complete 4 views (70200) $339 $339 3.5×

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.