Imaging prices at Sioux Falls Specialty Hospital LLP
Sioux Falls, SD · every code in this section with a posted price and a Medicare benchmark.
177 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) | $198.28 | $264.37 | 2.2× |
| Abdomen 2 views (74019) | $217.94 | $290.59 | 2.0× |
| Ankle 2 views (73600) | $217.94 | $290.59 | 2.5× |
| Arthrogram hip (73525) | $867.65 | $1,156.86 | 2.4× |
| Arthrogram Wrist (73115) | $867.65 | $1,156.86 | 2.4× |
| Cat Scan Follow-Up Study (76380) | $667.74 | $890.32 | 7.5× |
| Chest 1 view (71045) | $198.28 | $264.37 | 2.2× |
| Chest 2 views (71046) | $217.94 | $290.59 | 2.5× |
| Chest 3 views (71047) | $240.06 | $320.08 | 2.7× |
| Chest 4 or more views (71048) | $290.03 | $386.71 | 2.7× |
| Clavicle complete (73000) | $198.28 | $264.37 | 2.2× |
| Contrast X-Ray Bladder (74430) | $867.65 | $1,156.86 | 2.4× |
| Contrast X-Ray Of Elbow (73085) | $867.65 | $1,156.86 | 2.4× |
| Contrast X-Ray Of Knee Joint (73580) | $867.65 | $1,156.86 | 2.4× |
| CT abdomen and pelvis without and with contrast (74178) | $1,458.38 | $1,944.50 | 4.1× |
| CT abdomen and pelvis without contrast (74176) | $1,224.87 | $1,633.16 | 5.0× |
| CT abdomen w contrast (74160) | $1,330.56 | $1,774.08 | 7.4× |
| CT abdomen w wo contrast (74170) | $1,458.38 | $1,944.50 | 8.1× |
| CT abdomen w/o contrast (74150) | $1,202.75 | $1,603.67 | 11.3× |
| CT Angio Abdomen and Pelvis (74174) | $1,202.75 | $1,603.67 | 3.4× |
| CT Angio Chest (71275) | $1,110.01 | $1,480.01 | 6.2× |
| CT Angio Head (70496) | $1,201.12 | $1,601.49 | 6.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,201.12 | $1,601.49 | 6.7× |
| CT Angio Neck (70498) | $1,201.12 | $1,601.49 | 6.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,130.21 | $2,840.28 | 11.9× |
| CT cervical spine w/ contrast (72126) | $1,873.76 | $2,498.35 | 5.3× |
| CT cervical spine w/o contrast (72125) | $1,745.96 | $2,327.94 | 16.3× |
| CT cervical spine w/wo cont (72127) | $2,001.59 | $2,668.78 | 11.2× |
| CT chest w contrast (71260) | $1,303.53 | $1,738.04 | 7.3× |
| CT chest w/wo contrast (71270) | $1,431.34 | $1,908.45 | 8.0× |
| CT head/brain with contrast (70460) | $1,536.21 | $2,048.28 | 8.6× |
| CT head/brain without and with contrast (70470) | $1,706.63 | $2,275.50 | 9.5× |
| CT iac w contrast (70481) | $1,142.12 | $1,522.83 | 6.4× |
| CT l-spine w&w/o contrast (72133) | $2,001.59 | $2,668.78 | 11.2× |
| CT lower ext w/o (73700) | $983.18 | $1,310.90 | 9.2× |
| CT lower extremity w/contrast material (73701) | $1,228.97 | $1,638.62 | 6.9× |
| CT lumbar spine w contrast (72132) | $1,873.76 | $2,498.35 | 5.3× |
| CT lumbar spine w/o contrast (72131) | $1,745.96 | $2,327.94 | 16.3× |
| CT maxillofacial w contrast (70487) | $1,122.08 | $1,496.11 | 6.3× |
| CT maxillofacial wo contrast (70486) | $971.70 | $1,295.60 | 9.1× |
| CT neck tissue combo (70492) | $1,395.29 | $1,860.38 | 7.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,312.54 | $1,750.05 | 7.3× |
| CT orbits w/o contrast (70480) | $971.70 | $1,295.60 | 9.1× |
| CT pelvis w&w/o contrast (72194) | $1,458.38 | $1,944.50 | 8.1× |
| CT pelvis w/o contrast (72192) | $1,202.75 | $1,603.67 | 11.3× |
| CT scan of leg combo (73702) | $1,474.76 | $1,966.35 | 8.2× |
| CT scans face/jaw combo (70488) | $1,312.54 | $1,750.05 | 7.3× |
| CT soft tissue neck w contrast (70491) | $1,224.87 | $1,633.16 | 6.8× |
| CT soft tissue neck w/o contrast (70490) | $1,054.45 | $1,405.93 | 9.9× |
| CT thoracic spine w contrast (72129) | $1,873.76 | $2,498.35 | 10.5× |
| CT thoracic spine w/o contrast (72128) | $1,745.96 | $2,327.94 | 16.3× |
| CT thoracic spine w/wo cont (72130) | $2,001.59 | $2,668.78 | 11.2× |
| CT thorax w/o contrast (71250) | $1,175.71 | $1,567.61 | 11.0× |
| CT unlisted procedure (76497) | $667.74 | $890.32 | 7.5× |
| CT upper ext wo (73200) | $1,344.50 | $1,792.66 | 12.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,600.12 | $2,133.49 | 8.9× |
| CT upper extremity with contrast (73201) | $1,472.30 | $1,963.07 | 4.1× |
| Cta Abdomen (74175) | $1,201.12 | $1,601.49 | 6.7× |
| Discography Cerv/Thor Spine (72285) | $2,121.20 | $2,828.27 | 1.1× |
| Diskography lumbar (72295) | $2,121.20 | $2,828.27 | 1.1× |
| Fluoroscopy up to 1 hr (76000) | $538.09 | $717.45 | 2.2× |
| Foot 2 views (73620) | $217.94 | $290.59 | 2.5× |
| Forearm 2 views (73090) | $217.94 | $290.59 | 2.5× |
| Hand 2 views (73120) | $217.94 | $290.59 | 2.0× |
| Hysterosalpingogram (74740) | $867.65 | $1,156.86 | 3.6× |
| Knee 3 Views (73562) | $312.16 | $416.21 | 3.5× |
| Lymph System Imaging (78195) | $1,882.16 | $2,509.55 | 3.4× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $2,825.81 | $3,767.74 | 1.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,069.20 | $1,425.60 | 1.7× |
| Magnetic Image Jaw Joint (70336) | $1,205.21 | $1,606.95 | 4.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,432.16 | $1,909.54 | 4.0× |
| MRA head w/o contrast (70544) | $1,176.53 | $1,568.70 | 4.8× |
| MRA head with contrast (70545) | $1,304.35 | $1,739.13 | 3.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,432.16 | $1,909.54 | 4.0× |
| MRA neck w/o contrast (70547) | $1,176.53 | $1,568.70 | 4.8× |
| MRI abdomen w contrast (74182) | $1,605.03 | $2,140.04 | 4.5× |
| MRI abdomen w/o contrast (74181) | $1,477.22 | $1,969.62 | 6.1× |
| MRI any jt lower extrem w/contrast material (73722) | $3,470.60 | $4,627.47 | 4.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,800.79 | $5,067.72 | 10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,470.60 | $4,627.47 | 4.3× |
| MRI brain functional w/o physician admnistration (70554) | $527.06 | $702.75 | 2.2× |
| MRI cervical spine w contrast (72142) | $3,460.78 | $4,614.37 | 9.7× |
| MRI cervical spine w/o cont (72141) | $3,332.96 | $4,443.95 | 13.7× |
| MRI chest w/o contrast (71550) | $1,404.31 | $1,872.41 | 5.8× |
| MRI chest with contrast (71551) | $1,532.12 | $2,042.82 | 1.9× |
| MRI chest wo w contrast (71552) | $1,659.92 | $2,213.23 | 4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,470.60 | $4,627.47 | 9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,800.79 | $5,067.72 | 10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,141.24 | $4,188.32 | 12.9× |
| MRI lumbar spine w contrast (72149) | $3,460.78 | $4,614.37 | 9.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,749.18 | $4,998.90 | 10.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,353.50 | $1,804.67 | 5.6× |
| MRI orbit face neck w contrast (70542) | $1,532.12 | $2,042.82 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,609.13 | $2,145.51 | 4.5× |
| MRI pelvis w contrast (72196) | $3,621.36 | $4,828.48 | 10.2× |
| MRI pelvis w/o & w contrast (72197) | $3,749.18 | $4,998.90 | 10.5× |
| MRI pelvis w/o contrast (72195) | $3,493.55 | $4,658.07 | 14.3× |
| MRI thoracic spine w/o contrast (72146) | $3,332.96 | $4,443.95 | 13.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,470.60 | $4,627.47 | 9.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,948.71 | $3,931.61 | 12.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,758.18 | $5,010.91 | 10.5× |
| MRI, abdomen, combo (74183) | $1,732.85 | $2,310.46 | 4.9× |
| MRI, dorsal spine combo (72157) | $3,749.18 | $4,998.90 | 10.5× |
| MRI, dorsal spine contrast (72147) | $3,460.78 | $4,614.37 | 9.7× |
| MRI, joint upper extrem (73221) | $3,120.76 | $4,161.01 | 12.8× |
| MRI, joint upper extrem combo (73223) | $3,758.18 | $5,010.91 | 10.5× |
| MRI, lumbar spine combo (72158) | $3,749.18 | $4,998.90 | 10.5× |
| Neck soft tissue (70360) | $198.28 | $264.37 | 2.2× |
| Pelvis 1 or 2 views (72170) | $217.94 | $290.59 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $317.90 | $423.86 | 3.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $277.75 | $370.33 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $217.94 | $290.59 | 2.5× |
| Radex elbow complete minimum 3 views (73080) | $263.82 | $351.76 | 3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $263.82 | $351.76 | 2.5× |
| Radex fingr minimum 2 views (73140) | $240.06 | $320.08 | 2.7× |
| Radex foot complete minimum 3 views (73630) | $240.06 | $320.08 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $263.82 | $351.76 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $263.82 | $351.76 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $263.82 | $351.76 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $217.94 | $290.59 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) | $240.06 | $320.08 | 2.7× |
| Radex Spine 1 View Specify Level (72020) | $326.90 | $435.87 | 3.7× |
| Radex Sternum Minimum 2 Views (71120) | $240.06 | $320.08 | 2.7× |
| Radex Toe Minimum 2 Views (73660) | $217.94 | $290.59 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $263.82 | $351.76 | 3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $263.82 | $351.76 | 2.5× |
| Radiologic exam knee complete 4/more views (73564) | $362.14 | $482.85 | 3.4× |
| Radiologic exam teeth complete full mouth (70320) | $240.06 | $320.08 | 1.0× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $215.78 | $287.71 | 0.9× |
| Radiologic examination femur 1 view (73551) | $198.28 | $264.37 | 2.2× |
| Radiologic examination femur minimum 2 views (73552) | $240.06 | $320.08 | 2.7× |
| Radiologic examination knee 1/2 views (73560) | $290.86 | $387.81 | 3.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $217.94 | $290.59 | 2.5× |
| Ribs bilateral 3 views (71110) | $268.73 | $358.31 | 2.5× |
| Scapula (73010) | $198.28 | $264.37 | 1.9× |
| Shoulder 1 view (73020) | $198.28 | $264.37 | 2.2× |
| Shoulder Arthrography (73040) | $867.65 | $1,156.86 | 2.4× |
| Skull less than 4 views (70250) | $240.06 | $320.08 | 2.2× |
| Thoracic spine 2 views (72070) | $343.29 | $457.72 | 3.2× |
| Thoracic spine 3 views (72072) | $359.69 | $479.58 | 3.4× |
| Thoracolumbar 2 views (72080) | $359.69 | $479.58 | 4.0× |
| Tx devices design & construction simple (77332) | $479.30 | $639.06 | 3.5× |
| Unlisted magnetic resonance procedure (76498) | $900 | $1,200 | 10.1× |
| Ureteral Reflux Study (78740) | $1,221.60 | $1,628.80 | 3.0× |
| Urethrocystogram voiding (74455) | $867.65 | $1,156.86 | 3.6× |
| Urethrocystography retrograde (74450) | $867.65 | $1,156.86 | 3.6× |
| Us retroperitoneal limited (76775) | $390.81 | $521.08 | 3.7× |
| Us transrectal (76872) | $390.81 | $521.08 | 3.7× |
| Venography caval inferior serialography rs&i (75825) | $2,560.35 | $3,413.80 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,258.46 | $1,677.95 | 0.8× |
| Wrist 2 views (73100) | $217.94 | $290.59 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $867.65 | $1,156.86 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $217.94 | $290.59 | 2.5× |
| X-Ray Exam Breast Specimen (76098) | $582.53 | $776.70 | 1.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $198.28 | $264.37 | 2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $367.88 | $490.50 | 4.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $217.94 | $290.59 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $263.82 | $351.76 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $426.86 | $569.15 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $359.69 | $479.58 | 4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $426.86 | $569.15 | 4.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $263.82 | $351.76 | 2.5× |
| X-ray humerus (73060) | $240.06 | $320.08 | 2.7× |
| X-ray IV pyelogram (ivp) (74400) | $1,109.35 | $1,479.13 | 6.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $298.23 | $397.64 | 3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $359.69 | $479.58 | 3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $290.03 | $386.71 | 2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $240.06 | $320.08 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $290.03 | $386.71 | 2.7× |
| X-Ray Stress View (77071) | $99.96 | $133.28 | 1.1× |
| X-ray thoracic spine 4 vw (72074) | $393.27 | $524.36 | 3.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,109.35 | $1,479.13 | 3.1× |
| X-Rays Bone Length Studies (77073) | $198.28 | $264.37 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $582.53 | $776.70 | 5.5× |
| Xr c-spine 4 or 5 views (72050) | $393.27 | $524.36 | 3.7× |
| Xr facial bones less than 3 views (70140) | $217.94 | $290.59 | 2.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $217.94 | $290.59 | 2.0× |