Imaging prices at St. Andrews Health Center - Cah

Bottineau, ND · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $118 $131 1.3×
Abdomen 2 views (74019) $145 $161 1.4×
Ankle 2 views (73600) $138 $153 1.6×
Bone Imaging 3 Phase (78315) $1,868 $2,076 4.6×
Bone Imaging Limited Area (78300) $1,146 $1,273 2.8×
Bone Imaging Multiple Areas (78305) $1,375 $1,528 3.4×
Bone Imaging Whole Body (78306) $1,495 $1,661 3.7×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $1,076 $1,196 1.9×
Cat Scan Follow-Up Study (76380) $1,036 $1,151 11.7×
Chest 1 view (71045) $95 $106 1.1×
Chest 2 views (71046) $131 $145 1.5×
Chest 3 views (71047) $165 $183 1.9×
Chest 4 or more views (71048) $170 $189 1.6×
Clavicle complete (73000) $136 $151 1.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,025 $1,139 9.6×
CT abdomen and pelvis without and with contrast (74178) $2,957 $3,285 8.3×
CT abdomen and pelvis without contrast (74176) $1,205 $1,339 4.9×
CT abdomen w contrast (74160) $2,057 $2,285 11.5×
CT abdomen w wo contrast (74170) $2,330 $2,589 13.0×
CT abdomen w/o contrast (74150) $963 $1,070 9.0×
CT Angio Abdomen and Pelvis (74174) $3,263 $3,626 9.2×
CT Angio Chest (71275) $2,298 $2,553 12.8×
CT cervical spine w/ contrast (72126) $1,722 $1,913 4.8×
CT cervical spine w/o contrast (72125) $1,353 $1,503 12.7×
CT chest w contrast (71260) $1,685 $1,872 9.4×
CT chest w/wo contrast (71270) $2,076 $2,307 11.6×
CT head/brain with contrast (70460) $1,130 $1,256 6.3×
CT head/brain without and with contrast (70470) $1,361 $1,512 7.6×
CT iac w contrast (70481) $2,139 $2,377 11.9×
CT lower ext w/o (73700) $1,342 $1,491 12.6×
CT lower extremity w/contrast material (73701) $1,737 $1,930 9.7×
CT lumbar spine w contrast (72132) $1,725 $1,917 4.8×
CT lumbar spine w/o contrast (72131) $1,342 $1,491 12.6×
CT maxillofacial w contrast (70487) $1,183 $1,314 6.6×
CT maxillofacial wo contrast (70486) $1,036 $1,151 9.7×
CT neck tissue combo (70492) $2,067 $2,297 11.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,361 $2,623 13.2×
CT orbits w/o contrast (70480) $1,747 $1,941 16.4×
CT pelvis w&w/o contrast (72194) $2,338 $2,598 13.0×
CT pelvis w/o contrast (72192) $974 $1,082 9.1×
CT scan of leg combo (73702) $2,206 $2,451 12.3×
CT scans face/jaw combo (70488) $1,504 $1,671 8.4×
CT soft tissue neck w contrast (70491) $1,674 $1,860 9.3×
CT soft tissue neck w/o contrast (70490) $1,297 $1,441 12.1×
CT thoracic spine w/o contrast (72128) $1,349 $1,499 12.6×
CT thorax w/o contrast (71250) $1,305 $1,450 12.2×
CT upper ext wo (73200) $1,387 $1,541 13.0×
CT upper extremity w/o & w/contrast material (73202) $2,335 $2,594 13.0×
CT upper extremity with contrast (73201) $1,771 $1,968 5.0×
Dxa Bone Density Axial (77080) $431 $479 4.0×
Fetal Biophys Profile W/Nst (76818) $393 $437 3.7×
Foot 2 views (73620) $118 $131 1.3×
Forearm 2 views (73090) $120 $133 1.3×
Hand 2 views (73120) $131 $145 1.2×
Hepatobil Syst Image W/Drug (78227) $2,552 $2,835 4.6×
Hepatobiliary System Imaging (78226) $1,858 $2,064 4.5×
Ht Muscle Image Spect Sing (78451) $1,728 $1,920 1.3×
K Flow/Funct Image W/Drug (78708) $693 $770 1.2×
K Flow/Funct Image W/O Drug (78707) $1,115 $1,239 2.0×
Kidney Imaging Morphol (78700) $896 $996 2.2×
Knee 3 Views (73562) $176 $195 2.0×
Liver & Spleen Imaging Static Only (78215) $1,022 $1,136 2.5×
Lung Ventilat&Perfus Imaging (78582) $1,697 $1,886 3.1×
Lung Ventilation Imaging (78579) $978 $1,087 2.4×
Mra Head W/O & W/Contrast Material (70546) $4,887 $5,430 13.7×
MRA head w/o contrast (70544) $3,351 $3,723 13.7×
MRA head with contrast (70545) $3,157 $3,508 8.9×
MRA neck w contrast (70548) $3,563 $3,959 10.0×
Mra Neck W/O &W/Contrast Material (70549) $5,165 $5,739 14.5×
MRA neck w/o contrast (70547) $3,369 $3,743 13.8×
MRI abdomen w contrast (74182) $3,709 $4,121 10.4×
MRI abdomen w/o contrast (74181) $2,620 $2,911 10.7×
MRI any jt lower extrem w/contrast material (73722) $3,043 $3,381 3.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,672 $4,080 10.3×
MRI any jt upper extremity w/contrast matrl (73222) $3,018 $3,353 3.8×
MRI cervical spine w contrast (72142) $2,399 $2,665 6.7×
MRI cervical spine w/o cont (72141) $1,523 $1,692 6.2×
MRI chest w/o contrast (71550) $3,465 $3,850 14.2×
MRI chest with contrast (71551) $3,785 $4,205 4.7×
MRI chest wo w contrast (71552) $4,724 $5,249 13.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,265 $3,628 9.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,982 $4,424 11.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,997 $3,330 12.3×
MRI lumbar spine w contrast (72149) $2,356 $2,618 6.6×
Mri Neck Spine W/O & W/Dye (72156) $2,691 $2,990 7.5×
MRI orbit face &/neck w/o contrast (70540) $2,714 $3,015 11.1×
MRI orbit face neck w contrast (70542) $2,979 $3,310 8.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,571 $3,968 10.0×
MRI pelvis w contrast (72196) $3,265 $3,628 9.2×
MRI pelvis w/o & w contrast (72197) $3,956 $4,395 11.1×
MRI pelvis w/o contrast (72195) $3,047 $3,385 12.5×
MRI thoracic spine w/o contrast (72146) $1,526 $1,695 6.3×
MRI upper extremity oth than jt w/contr matrl (73219) $3,262 $3,624 9.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,025 $3,361 12.4×
Mri Uppr Extremity W/O&W/Dye (73220)
range across 2 matching MRF lines		 $3,974–$3,982 $4,415–$4,424 varies
MRI, abdomen, combo (74183) $3,966 $4,407 11.1×
MRI, dorsal spine combo (72157) $2,699 $2,999 7.6×
MRI, dorsal spine contrast (72147) $2,380 $2,644 6.7×
MRI, joint upper extrem (73221) $1,715 $1,905 7.0×
MRI, joint upper extrem combo (73223) $3,675 $4,083 10.3×
MRI, lumbar spine combo (72158) $2,681 $2,979 7.5×
Myocardial Spect Multiple Studies (78452) $2,481 $2,757 1.9×
Neck soft tissue (70360) $128 $142 1.4×
Pelvis 1 or 2 views (72170) $139 $154 1.3×
Pulmonary Perfusion Imaging Particulate (78580) $1,217 $1,352 3.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $193 $214 1.8×
Radex Ankle Complete Minimum 3 Views (73610) $158 $176 1.8×
Radex Calcaneus Minimum 2 Views (73650) $118 $131 1.3×
Radex elbow complete minimum 3 views (73080) $133 $148 1.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $194 $216 1.8×
Radex fingr minimum 2 views (73140) $172 $191 1.9×
Radex foot complete minimum 3 views (73630) $147 $163 1.7×
Radex Hand Minimum 3 Views (73130) $157 $174 1.8×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $261 $290 2.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $167 $185 1.9×
Radex Ribs Unilateral 2 Views (71100) $145 $161 1.6×
Radex shoulder complete minimum 2 views (73030) $140 $156 1.6×
Radex Sinuses Paransl < 3 Views (70210) $133 $148 1.5×
Radex Spine 1 View Specify Level (72020) $95 $106 1.1×
Radex Sternum Minimum 2 Views (71120) $136 $151 1.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $237 $263 2.7×
Radex Toe Minimum 2 Views (73660) $130 $144 1.5×
Radex Wrist Complete Minimum 3 Views (73110) $180 $200 2.0×
Radiolog exam mandible compl minimum 4 views (70110) $178 $198 1.7×
Radiologic exam knee complete 4/more views (73564) $199 $221 1.9×
Radiologic exam pelvis compl minimum 3 views (72190) $167 $185 1.6×
Radiologic examination femur minimum 2 views (73552) $149 $166 1.7×
Radiologic examination knee 1/2 views (73560) $147 $163 1.7×
Radiologic Examination Osseous Survey Limited (77074) $251 $279 2.3×
Radiologic examination tibia & fibula 2 views (73590) $133 $148 1.5×
Ribs bilateral 3 views (71110) $169 $188 1.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,913 $2,125 3.4×
Scapula (73010) $127 $141 1.2×
Screening Digital Breast Tomosynthesis Bi (77063) $148 $164 6.3×
Shoulder 1 view (73020) $92 $102 1.0×
Skull less than 4 views (70250) $150 $167 1.4×
Sternoclavicular joints (71130) $174 $193 2.0×
Thoracic spine 2 views (72070) $136 $151 1.3×
Thoracic spine 3 views (72072) $158 $176 1.5×
Ultrasound Breast Limited (76642) $329 $366 3.7×
Ultrasound Exam Aaa Screen (76706) $469 $521 4.4×
Ultrasound, abdomen limited (76705) $377 $419 3.5×
Umbilical-artery Doppler (OB) (76820) $125 $139 1.2×
Unlisted us procedure (76999) $286 $318 3.2×
Us breast unilateral complete (76641) $431 $479 4.0×
Us chest (76604) $371 $412 3.5×
Us complete joint (76881)
range across 3 matching MRF lines		 $151–$505 $168–$561 varies
Us exam, pelvic, limited (76857) $139 $154 1.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $187 $208 1.8×
Us ob limited 1 or more fetuses (76815) $315 $350 2.9×
Us ob transvaginal (76817) $359 $399 3.4×
Us pelvic non ob complete (76856) $458 $509 4.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $442 $491 4.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $435 $483 4.1×
Us retroperitoneal complete (76770) $465 $517 4.4×
Us retroperitoneal limited (76775) $176 $195 1.6×
Us scrotum and contents (76870) $419 $465 3.9×
Us thyroid (76536) $536 $596 5.0×
Us transrectal (76872) $838 $931 7.8×
Wrist 2 views (73100) $145 $161 1.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $149 $166 1.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $118 $131 1.3×
X-Ray Exam Entire Spi 1 Vw (72081) $158 $176 1.8×
X-Ray Exam Hip Uni 1 View (73501) $131 $145 1.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $202 $224 2.3×
X-Ray Exam Hips Bi 2 Views (73521) $170 $189 1.6×
X-Ray Exam L-S Spine Bending (72114) $276 $307 2.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $159 $177 1.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $269 $299 2.5×
X-Ray Exam Unilat Ribs/Chest (71101) $165 $183 1.5×
X-ray eye for foreign body (70030) $131 $146 1.5×
X-ray humerus (73060) $136 $151 1.5×
X-ray IV pyelogram (ivp) (74400) $608 $675 3.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $167 $185 1.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $182 $202 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $163 $181 1.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $209 $232 2.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $158 $176 1.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $133 $148 1.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $152 $169 1.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $176 $195 1.6×
X-Ray Stress View (77071) $133 $148 1.5×
X-Ray Tmj Unilat (70328) $145 $161 1.6×
X-Rays Bone Survey Complete (77075) $404 $449 3.8×
Xr c-spine 4 or 5 views (72050) $222 $247 2.1×
Xr orbits complete 4 views (70200) $194 $216 1.8×

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.