Imaging prices at Southeast Colorado Hospital

Springfield, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $238 $297 2.6×
Abdomen 2 views (74019) $334 $417 3.0×
Ankle 2 views (73600) $190 $237 2.1×
Bone age studies (77072) $41 $51 0.4×
Chest 1 view (71045) $287 $359 3.1×
Chest 2 views (71046) $316 $395 3.4×
Clavicle complete (73000) $238 $297 2.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,069 $1,336 9.7×
CT abdomen and pelvis without and with contrast (74178) $1,988 $2,485 5.4×
CT abdomen and pelvis without contrast (74176) $1,503 $1,879 6.0×
CT abdomen w contrast (74160) $1,538 $1,922 8.3×
CT abdomen w wo contrast (74170) $1,922 $2,402 10.4×
CT abdomen w/o contrast (74150) $1,230 $1,537 11.2×
CT Angio Abdomen and Pelvis (74174) $2,106 $2,633 5.7×
CT Angio Chest (71275) $1,699 $2,124 9.2×
CT Angio Head (70496) $1,165 $1,456 6.3×
CT Angio Neck (70498) $1,002 $1,252 5.4×
Ct Angio Upr Extrm W/O&W/Dye (73206) $691 $864 3.7×
CT cervical spine w/ contrast (72126) $1,251 $1,564 3.4×
CT cervical spine w/o contrast (72125) $1,122 $1,403 10.2×
CT chest w contrast (71260) $1,602 $2,002 8.7×
CT chest w/wo contrast (71270) $2,082 $2,603 11.3×
CT head/brain with contrast (70460) $1,002 $1,252 5.4×
CT head/brain without and with contrast (70470) $1,662 $2,078 9.0×
CT iac w contrast (70481)
range across 2 matching MRF lines		 $441–$1,638 $551–$2,048 varies
CT lower ext w/o (73700) $851 $1,064 7.7×
CT lower extremity w/contrast material (73701) $1,078 $1,348 5.8×
CT lumbar spine w contrast (72132) $1,126 $1,407 3.1×
CT lumbar spine w/o contrast (72131) $1,001 $1,251 9.1×
CT maxillofacial w contrast (70487) $1,564 $1,955 8.5×
CT maxillofacial wo contrast (70486) $1,002 $1,252 9.1×
CT neck tissue combo (70492) $1,574 $1,967 8.5×
CT orbits w/o contrast (70480) $751 $939 6.8×
CT pelvis w&w/o contrast (72194) $1,715 $2,144 9.3×
CT pelvis w/o contrast (72192) $930 $1,163 8.4×
CT scan of leg combo (73702) $1,510 $1,888 8.2×
CT scans face/jaw combo (70488) $441 $551 2.4×
CT soft tissue neck w contrast (70491) $1,002 $1,252 5.4×
CT soft tissue neck w/o contrast (70490) $834 $1,042 7.6×
CT thoracic spine w contrast (72129) $1,405 $1,756 7.6×
CT thoracic spine w/o contrast (72128) $1,201 $1,501 10.9×
CT thorax w/o contrast (71250) $1,068 $1,335 9.7×
CT upper ext wo (73200) $794 $993 7.2×
CT upper extremity w/o & w/contrast material (73202)
range across 2 matching MRF lines		 $441–$454 $551–$568 varies
CT upper extremity with contrast (73201) $929 $1,161 2.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,290 $1,613 7.0×
Cta Abdomen (74175) $2,289 $2,861 12.4×
CTA pelvis (72191) $1,732 $2,165 9.4×
Dxa Bone Density Axial (77080) $714 $893 6.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $218 $273 2.4×
Echo exam uterus (76831) $693 $866 2.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $334 $417 3.0×
Fluoroscopy up to 1 hr (76000) $588 $735 2.3×
Foot 2 views (73620) $190 $237 2.1×
Forearm 2 views (73090) $238 $297 2.6×
Hand 2 views (73120) $190 $237 1.7×
Knee 3 Views (73562) $285 $356 3.1×
MRA head w/o contrast (70544) $1,589 $1,986 6.3×
MRA neck w contrast (70548) $3,173 $3,966 8.6×
Mra Neck W/O &W/Contrast Material (70549) $3,806 $4,758 10.3×
MRA neck w/o contrast (70547) $2,434 $3,043 9.7×
MRI abdomen w contrast (74182) $2,715 $3,394 7.4×
MRI abdomen w/o contrast (74181) $1,769 $2,211 7.0×
MRI any jt lower extrem w/contrast material (73722) $1,602 $2,003 1.9×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $923 $1,154 2.5×
MRI any jt upper extremity w/contrast matrl (73222) $1,602 $2,003 1.9×
MRI cervical spine w/o cont (72141) $1,979 $2,474 7.9×
MRI chest w/o contrast (71550) $835 $1,044 3.3×
MRI chest wo w contrast (71552) $4,426 $5,533 12.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 8 matching MRF lines		 $923–$2,359 $1,154–$2,949 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,186 $3,982 8.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,052 $2,565 8.2×
Mri Neck Spine W/O & W/Dye (72156) $4,107 $5,134 11.2×
MRI orbit face &/neck w/o contrast (70540) $3,015 $3,769 12.0×
MRI orbit face neck w contrast (70542) $3,833 $4,791 10.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,410 $5,513 12.0×
MRI pelvis w contrast (72196) $1,557 $1,946 4.2×
MRI pelvis w/o & w contrast (72197) $1,946 $2,432 5.3×
MRI pelvis w/o contrast (72195) $1,246 $1,557 5.0×
MRI thoracic spine w/o contrast (72146) $2,345 $2,931 9.3×
MRI upper extremity oth than jt w/contr matrl (73219)
range across 10 matching MRF lines		 $923–$2,359 $1,154–$2,949 varies
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 4 matching MRF lines		 $1,557–$2,052 $1,946–$2,565 varies
Mri Uppr Extremity W/O&W/Dye (73220) $3,186 $3,982 8.7×
MRI, abdomen, combo (74183) $3,561 $4,451 9.7×
MRI, dorsal spine combo (72157) $4,107 $5,134 11.2×
MRI, joint upper extrem (73221) $1,954 $2,442 7.8×
MRI, joint upper extrem combo (73223)
range across 2 matching MRF lines		 $923–$2,118 $1,154–$2,647 varies
MRI, lumbar spine combo (72158) $4,107 $5,134 11.2×
Neck soft tissue (70360) $238 $297 2.6×
Ob us nuchal meas 1 gest (76813) $334 $417 3.0×
Panoramic X-ray of jaws (70355) $240 $300 2.6×
Pelvis 1 or 2 views (72170) $270 $337 2.4×
Radex Ankle Complete Minimum 3 Views (73610) $238 $297 2.6×
Radex Calcaneus Minimum 2 Views (73650) $238 $297 2.6×
Radex elbow complete minimum 3 views (73080) $238 $297 2.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $334 $417 3.0×
Radex fingr minimum 2 views (73140) $238 $297 2.6×
Radex foot complete minimum 3 views (73630) $238 $297 2.6×
Radex Hand Minimum 3 Views (73130) $238 $297 2.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $238 $297 2.6×
Radex shoulder complete minimum 2 views (73030) $238 $297 2.6×
Radex Sinuses Paransl < 3 Views (70210) $238 $297 2.6×
Radex Spine 1 View Specify Level (72020) $238 $297 2.6×
Radex Sternum Minimum 2 Views (71120) $238 $297 2.6×
Radex Toe Minimum 2 Views (73660) $238 $297 2.6×
Radex Wrist Complete Minimum 3 Views (73110) $238 $297 2.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $400 $500 3.6×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines		 $334–$634 $417–$793 varies
Radiologic exam pelvis compl minimum 3 views (72190) $324 $405 2.9×
Radiologic examination femur minimum 2 views (73552) $238 $297 2.6×
Radiologic examination knee 1/2 views (73560) $238 $297 2.6×
Radiologic examination tibia & fibula 2 views (73590) $238 $297 2.6×
Scapula (73010)
range across 2 matching MRF lines		 $264–$334 $330–$417 varies
Shoulder 1 view (73020) $190 $237 2.1×
Skull less than 4 views (70250) $334 $417 3.0×
Thoracic spine 2 views (72070) $333 $416 3.0×
Thoracic spine 3 views (72072) $399 $499 3.6×
Ultrasound Breast Limited (76642) $271 $339 3.0×
Ultrasound Exam Aaa Screen (76706) $334 $417 3.0×
Ultrasound, abdomen limited (76705) $1,020 $1,275 9.2×
Umbilical-artery Doppler (OB) (76820) $334 $417 3.0×
Us breast unilateral complete (76641) $522 $652 4.7×
Us chest (76604) $500 $625 4.5×
Us complete joint (76881) $499 $624 4.5×
Us exam, pelvic, limited (76857) $334 $417 3.0×
Us kidney transplant (76776) $334 $417 3.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $222 $278 2.0×
Us ob limited 1 or more fetuses (76815) $334 $417 3.0×
Us ob transvaginal (76817) $334 $417 3.0×
Us pelvic non ob complete (76856) $647 $809 5.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $334 $417 3.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $334 $417 3.0×
Us retroperitoneal complete (76770) $947 $1,184 8.6×
Us retroperitoneal limited (76775) $790 $987 7.2×
Us scrotum and contents (76870) $569 $711 5.2×
Us spinal canal and contents (76800) $334 $417 3.0×
Us thyroid (76536) $609 $761 5.5×
Wrist 2 views (73100) $190 $237 2.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $238 $297 2.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $190 $237 2.1×
X-Ray Exam Hip Uni 1 View (73501) $238 $297 2.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $285 $356 3.1×
X-Ray Exam Hips Bi 2 Views (73521) $389 $486 3.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $400 $500 3.6×
X-Ray Exam L-S Spine Bending (72114) $480 $600 4.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $262 $327 2.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $334 $417 3.0×
X-Ray Exam Unilat Ribs/Chest (71101) $334 $417 3.0×
X-ray eye for foreign body (70030) $158 $198 1.7×
X-ray humerus (73060) $238 $297 2.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $238 $297 2.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $238 $297 2.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $334 $417 3.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $400 $500 3.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $334 $417 3.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $238 $297 2.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $285 $356 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $264 $330 2.4×
Xr c-spine 4 or 5 views (72050) $298 $372 2.7×

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.