Imaging prices at Shriners Children’s St. Louis

St. Louis, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $248.70 $248.70 2.9×
Abdomen 2 views (74019) $298.40 $298.40 2.8×
Ankle 2 views (73600)
range across 2 matching MRF lines
$310.80–$621.60 $310.80–$621.60 varies
Arthrogram ankle (73615) $1,469.30 $1,469.30 4.2×
Arthrogram hip (73525) $1,469.30 $1,469.30 4.2×
Arthrogram Wrist (73115) $1,469.30 $1,469.30 4.2×
Bone age studies (77072) $248.70 $248.70 2.4×
Bone Imaging 3 Phase (78315) $805.26 $805.26 2.0×
Bone Imaging Limited Area (78300) $1,305 $1,305 3.3×
Bone Imaging Multiple Areas (78305) $1,474.80 $1,474.80 3.7×
Bone Imaging Whole Body (78306) $1,613.10 $1,613.10 4.0×
Bone survey infant (77076) $416.60 $416.60 4.0×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $2,379.22 $2,379.22 4.4×
Cat Scan Follow-Up Study (76380) $399.30 $399.30 4.6×
Chest 1 view (71045) $248.70 $248.70 2.9×
Chest 2 views (71046) $298.40 $298.40 3.4×
Chest 4 or more views (71048) $429.60 $429.60 4.1×
Clavicle complete (73000) $248.70 $248.70 2.9×
Contrast X-Ray Bladder (74430) $998.70 $998.70 2.9×
Contrast X-Ray Of Elbow (73085) $1,469.30 $1,469.30 4.2×
Contrast X-Ray Of Knee Joint (73580) $1,469.30 $1,469.30 4.2×
Contrast Xray Throat/Cerv Esopha (74210) $472.90 $472.90 2.7×
CT abdomen and pelvis without and with contrast (74178) $3,175.30 $3,175.30 9.1×
CT abdomen and pelvis without contrast (74176) $2,238.30 $2,238.30 9.4×
CT abdomen w contrast (74160) $1,644.80 $1,644.80 9.4×
CT abdomen w wo contrast (74170) $1,847 $1,847 10.5×
CT abdomen w/o contrast (74150) $1,080.30 $1,080.30 10.3×
CT Angio Chest (71275) $1,885.50 $1,885.50 10.7×
CT Angio Head (70496) $1,885.50 $1,885.50 10.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,885.50 $1,885.50 10.7×
CT Angio Neck (70498) $1,885.50 $1,885.50 10.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,885.50 $1,885.50 10.7×
CT cervical spine w/ contrast (72126) $4,934.50 $4,934.50 14.1×
CT cervical spine w/o contrast (72125) $3,240.50 $3,240.50 30.9×
CT cervical spine w/wo cont (72127) $5,540.50 $5,540.50 31.5×
CT chest w contrast (71260) $1,644.80 $1,644.80 9.4×
CT chest w/wo contrast (71270) $1,847 $1,847 10.5×
CT head/brain with contrast (70460) $1,644.80 $1,644.80 9.4×
CT head/brain without and with contrast (70470) $1,847 $1,847 10.5×
CT iac w contrast (70481) $1,644.80 $1,644.80 9.4×
CT l-spine w&w/o contrast (72133) $5,540.50 $5,540.50 31.5×
CT lower ext w/o (73700) $1,080.30 $1,080.30 10.3×
CT lower extremity w/contrast material (73701) $1,644.80 $1,644.80 9.4×
CT lumbar spine w contrast (72132) $4,934.50 $4,934.50 14.1×
CT lumbar spine w/o contrast (72131) $3,240.50 $3,240.50 30.9×
CT maxillofacial w contrast (70487) $1,644.80 $1,644.80 9.4×
CT maxillofacial wo contrast (70486) $1,080.30 $1,080.30 10.3×
CT neck tissue combo (70492) $1,847 $1,847 10.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,847 $1,847 10.5×
CT orbits w/o contrast (70480)
range across 2 matching MRF lines
$1,080.30–$1,338.40 $1,080.30–$1,338.40 varies
CT pelvis w&w/o contrast (72194) $1,847 $1,847 10.5×
CT pelvis w/o contrast (72192) $1,080.30 $1,080.30 10.3×
CT scan of leg combo (73702) $1,847 $1,847 10.5×
CT scans face/jaw combo (70488) $1,847 $1,847 10.5×
CT soft tissue neck w contrast (70491) $1,644.80 $1,644.80 9.4×
CT soft tissue neck w/o contrast (70490) $1,080.30 $1,080.30 10.3×
CT thoracic spine w contrast (72129) $4,934.50 $4,934.50 28.1×
CT thoracic spine w/o contrast (72128) $3,240.50 $3,240.50 30.9×
CT thoracic spine w/wo cont (72130) $5,540.50 $5,540.50 31.5×
CT thorax w/o contrast (71250) $1,080.30 $1,080.30 10.3×
CT upper ext wo (73200) $1,080.30 $1,080.30 10.3×
CT upper extremity w/o & w/contrast material (73202) $1,847 $1,847 10.5×
CT upper extremity with contrast (73201) $1,644.80 $1,644.80 4.7×
Cta Abdomen (74175) $1,885.50 $1,885.50 10.7×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,680.92 $1,680.92 4.8×
CTA pelvis (72191) $1,885.50 $1,885.50 10.7×
Dxa Bone Density Axial (77080) $401.50 $401.50 3.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $161.30 $161.30 1.9×
Esophagram (74220) $484.70 $484.70 2.8×
Fluoroscopy up to 1 hr (76000) $131.50 $131.50 0.6×
Foot 2 views (73620) $310.80 $310.80 3.6×
Forearm 2 views (73090) $310.80 $310.80 3.6×
Hand 2 views (73120) $310.80 $310.80 3.0×
Infant hip ultrasound with hip movement (dynamic) (76885) $415.10 $415.10 4.8×
Infant hip ultrasound, limited static exam (76886) $345.80 $345.80 4.0×
Knee 3 Views (73562) $310.80 $310.80 3.6×
Magnetic Image Jaw Joint (70336) $1,935.50 $1,935.50 8.1×
Mra Head W/O & W/Contrast Material (70546) $2,964.90 $2,964.90 8.5×
MRA head w/o contrast (70544) $1,935.50 $1,935.50 8.1×
MRA head with contrast (70545) $2,348 $2,348 6.7×
MRA neck w contrast (70548) $2,348 $2,348 6.7×
Mra Neck W/O &W/Contrast Material (70549) $2,964.90 $2,964.90 8.5×
MRA neck w/o contrast (70547) $1,935.50 $1,935.50 8.1×
MRI abdomen w contrast (74182) $2,348 $2,348 6.7×
MRI abdomen w/o contrast (74181) $1,935.50 $1,935.50 8.1×
MRI any jt lower extrem w/contrast material (73722) $2,348 $2,348 3.0×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,964.90 $2,964.90 8.5×
MRI any jt upper extremity w/contrast matrl (73222) $2,348 $2,348 3.0×
MRI cervical spine w contrast (72142) $6,708 $6,708 19.2×
MRI cervical spine w/o cont (72141) $5,530.10 $5,530.10 23.1×
MRI chest w/o contrast (71550) $1,935.50 $1,935.50 8.1×
MRI chest with contrast (71551) $2,348 $2,348 3.0×
MRI chest wo w contrast (71552) $2,964.90 $2,964.90 8.5×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,348 $2,348 6.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,964.90 $2,964.90 8.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,935.50 $1,935.50 8.1×
MRI lumbar spine w contrast (72149) $6,544.40 $6,544.40 18.7×
Mri Neck Spine W/O & W/Dye (72156) $8,471.20 $8,471.20 24.2×
MRI orbit face &/neck w/o contrast (70540) $1,935.50 $1,935.50 8.1×
MRI orbit face neck w contrast (70542) $2,348 $2,348 6.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,964.90 $2,964.90 8.5×
MRI pelvis w contrast (72196) $2,348 $2,348 6.7×
MRI pelvis w/o & w contrast (72197) $2,964.90 $2,964.90 8.5×
MRI pelvis w/o contrast (72195) $1,935.50 $1,935.50 8.1×
MRI thoracic spine w/o contrast (72146) $5,395.20 $5,395.20 22.6×
MRI upper extremity oth than jt w/contr matrl (73219) $2,348 $2,348 6.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,935.50 $1,935.50 8.1×
Mri Uppr Extremity W/O&W/Dye (73220) $2,964.90 $2,964.90 8.5×
MRI, abdomen, combo (74183) $2,964.90 $2,964.90 8.5×
MRI, dorsal spine combo (72157) $8,264.60 $8,264.60 23.7×
MRI, dorsal spine contrast (72147) $6,544.40 $6,544.40 18.7×
MRI, joint upper extrem (73221) $1,935.50 $1,935.50 8.1×
MRI, joint upper extrem combo (73223) $2,964.90 $2,964.90 8.5×
MRI, lumbar spine combo (72158) $8,264.60 $8,264.60 23.7×
Myelograpy 2/more regions rs&i (72270) $3,236.50 $3,236.50 4.1×
Neck soft tissue (70360) $248.70 $248.70 2.9×
Nonvascular Shunt X-Ray (75809) $419.60 $419.60 4.0×
Panoramic X-ray of jaws (70355) $248.70 $248.70 2.9×
Pelvis 1 or 2 views (72170) $248.70 $248.70 2.4×
PET whole body (78813) $6,564.90 $6,564.90 4.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $416.60 $416.60 4.0×
Radex Ankle Complete Minimum 3 Views (73610) $388.50 $388.50 4.5×
Radex Calcaneus Minimum 2 Views (73650) $310.80 $310.80 3.6×
Radex elbow complete minimum 3 views (73080) $388.50 $388.50 4.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $298.40 $298.40 2.8×
Radex fingr minimum 2 views (73140) $310.80 $310.80 3.6×
Radex foot complete minimum 3 views (73630) $388.50 $388.50 4.5×
Radex Hand Minimum 3 Views (73130) $388.50 $388.50 4.5×
Radex lower extremity infant minimum 2 views (73592) $249.10 $249.10 2.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $358 $358 4.1×
Radex Ribs Unilateral 2 Views (71100) $310.80 $310.80 3.6×
Radex shoulder complete minimum 2 views (73030) $310.80 $310.80 3.6×
Radex Sinuses Paransl < 3 Views (70210) $248.70 $248.70 2.9×
Radex Spine 1 View Specify Level (72020) $248.70 $248.70 2.9×
Radex Sternum Minimum 2 Views (71120) $298.40 $298.40 3.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $298.40 $298.40 3.4×
Radex Toe Minimum 2 Views (73660) $372.90 $372.90 4.3×
Radex upper extremity infant minimum 2 views (73092) $249.10 $249.10 2.4×
Radex Wrist Complete Minimum 3 Views (73110) $388.50 $388.50 4.5×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $537.50 $537.50 5.1×
Radiolog exam mandible compl minimum 4 views (70110) $298.40 $298.40 2.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $358 $358 3.4×
Radiologic exam colon single contrast study (74270) $484.70 $484.70 2.8×
Radiologic exam knee complete 4/more views (73564) $388.50 $388.50 3.7×
Radiologic exam pelvis compl minimum 3 views (72190) $298.40 $298.40 2.8×
Radiologic Exam Small Int Single Contrast Study (74250) $484.70 $484.70 2.8×
Radiologic exam swallow function contrast study (74230) $484.70 $484.70 2.8×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $200.20 $200.20 0.8×
Radiologic examination femur 1 view (73551)
range across 2 matching MRF lines
$112.30–$224.60 $112.30–$224.60 varies
Radiologic examination femur minimum 2 views (73552) $133.10 $133.10 1.5×
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines
$248.70–$497.40 $248.70–$497.40 varies
Radiologic Examination Osseous Survey Limited (77074) $416.60 $416.60 4.0×
Radiologic examination tibia & fibula 2 views (73590) $310.80 $310.80 3.6×
Radiologic examination, teeth; single view Non-Facility (70300) $166.90 $166.90 1.9×
Ribs bilateral 3 views (71110) $466.30 $466.30 4.5×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,289.90 $2,289.90 4.2×
Scapula (73010) $248.70 $248.70 2.4×
Shoulder 1 view (73020) $248.70 $248.70 2.9×
Shoulder Arthrography (73040) $1,469.30 $1,469.30 4.2×
Skull less than 4 views (70250) $248.70 $248.70 2.4×
Speech evaluation, complex (70371) $326.30 $326.30 1.4×
Sternoclavicular joints (71130) $358 $358 4.1×
Thoracic spine 2 views (72070) $242.60 $242.60 2.3×
Thoracic spine 3 views (72072) $298.40 $298.40 2.8×
Thoracolumbar 2 views (72080) $298.40 $298.40 3.4×
Ultrasound, abdomen limited (76705) $538.70 $538.70 5.1×
Unlisted Dx Radiographic Procedure (76499) $248.70 $248.70 2.9×
Unlisted fluoroscopic procedure (76496) $473.90 $473.90 5.4×
Unlisted us procedure (76999) $345.80 $345.80 4.0×
Upper gi w/o kub (74240) $783.90 $783.90 4.5×
Urethrocystogram voiding (74455) $998.70 $998.70 4.2×
Us chest (76604) $345.80 $345.80 3.3×
Us complete joint (76881) $538.70 $538.70 5.1×
Us exam, pelvic, limited (76857) $541.70 $541.70 5.2×
Us head (76506) $345.80 $345.80 3.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $538.70 $538.70 5.1×
Us pelvic non ob complete (76856) $541.70 $541.70 5.2×
Us retroperitoneal complete (76770) $646.50 $646.50 6.2×
Us retroperitoneal limited (76775) $538.70 $538.70 5.1×
Us scrotum and contents (76870) $528.80 $528.80 5.1×
Us spinal canal and contents (76800) $538.70 $538.70 5.1×
Us thyroid (76536) $538.70 $538.70 5.1×
Vertebral fracture assessment via dxa (77086) $248.70 $248.70 2.9×
Wrist 2 views (73100) $310.80 $310.80 3.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $248.70 $248.70 2.9×
X-Ray Bend Only L-S Spine (72120) $537.50 $537.50 5.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $310.80 $310.80 3.6×
X-Ray Exam Entire Spi 1 Vw (72081) $248.70 $248.70 2.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $267.50 $267.50 2.6×
X-Ray Exam Entire Spi 4/5 Vw (72083) $290.20 $290.20 2.8×
X-Ray Exam Hip Uni 1 View (73501) $118.60 $118.60 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $174.70 $174.70 2.0×
X-Ray Exam Hip Uni 4/> Views (73503) $215.80 $215.80 2.1×
X-Ray Exam Hips Bi 2 Views (73521) $164 $164 1.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $195 $195 1.9×
X-Ray Exam Hips Bi 5/> Views (73523) $234.30 $234.30 2.2×
X-Ray Exam L-S Spine Bending (72114) $458.20 $458.20 4.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $248.70 $248.70 2.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $458.20 $458.20 4.4×
X-Ray Exam Unilat Ribs/Chest (71101) $388.50 $388.50 3.7×
X-ray eye for foreign body (70030) $399.30 $399.30 4.6×
X-ray head for orthodontia (70350) $248.70 $248.70 2.9×
X-ray humerus (73060) $310.80 $310.80 3.6×
X-ray IV pyelogram (ivp) (74400) $950.40 $950.40 5.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $248.70 $248.70 2.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $485.70 $485.70 5.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $248.70 $248.70 2.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $485.70 $485.70 4.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $298.40 $298.40 2.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $248.70 $248.70 2.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $298.40 $298.40 3.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $298.40 $298.40 3.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $416.60 $416.60 4.0×
X-Ray Stress View (77071) $298.40 $298.40 3.4×
X-ray thoracic spine 4 vw (72074) $358 $358 3.4×
X-Ray Tmj Unilat (70328) $248.70 $248.70 2.9×
X-Rays Bone Length Studies (77073) $249.10 $249.10 2.4×
X-Rays Bone Survey Complete (77075) $500 $500 4.8×
Xr c-spine 4 or 5 views (72050) $416.60 $416.60 4.0×
Xr facial bones less than 3 views (70140) $248.70 $248.70 2.9×
Xr orbits complete 4 views (70200) $537.50 $537.50 5.1×

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.