Imaging prices at St. Bernards Five Rivers Medical Center

Pocahontas, AR · every code in this section with a posted price and a Medicare benchmark.

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

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $157.50 $175 2.0×
Abdomen 2 views (74019) $189 $210 2.0×
Ankle 2 views (73600) $157.50 $175 2.0×
Arthrogram ankle (73615) $607.50 $675 1.9×
Arthrogram hip (73525) $607.50 $675 1.9×
Arthrogram Wrist (73115) $607.50 $675 1.9×
Bone age studies (77072) $189 $210 2.0×
Bone survey infant (77076)
range across 2 matching MRF lines		 $126–$189 $140–$210 varies
Cat Scan Follow-Up Study (76380) $108 $120 1.4×
Chest 1 view (71045) $157.50 $175 2.0×
Chest 2 views (71046) $157.50 $175 2.0×
Chest 3 views (71047) $157.50 $175 2.0×
Chest 4 or more views (71048) $189 $210 2.0×
Cholecystography Oral Contrast (74290) $315 $350 2.0×
Clavicle complete (73000) $157.50 $175 2.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $189 $210 2.0×
Contrast X-Ray Bladder (74430) $607.50 $675 1.9×
Contrast X-Ray Of Elbow (73085) $607.50 $675 1.9×
Contrast X-Ray Of Knee Joint (73580) $607.50 $675 1.9×
Corpora cavernosography (74445) $189 $210 2.0×
CT abdomen and pelvis without and with contrast (74178) $661.50 $735 2.1×
CT abdomen and pelvis without contrast (74176) $418.50 $465 1.9×
CT abdomen w contrast (74160) $315 $350 2.0×
CT abdomen w wo contrast (74170) $315 $350 2.0×
CT abdomen w/o contrast (74150) $189 $210 2.0×
CT Angio Abdomen and Pelvis (74174) $661.50 $735 2.1×
CT Angio Chest (71275) $315 $350 2.0×
CT Angio Head (70496) $315 $350 2.0×
CT angio hrt w/3d image (75574) $315 $350 1.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $315 $350 2.0×
CT Angio Neck (70498) $315 $350 2.0×
Ct Angio Upr Extrm W/O&W/Dye (73206) $315 $350 2.0×
CT cervical spine w/ contrast (72126) $661.50 $735 2.1×
CT cervical spine w/o contrast (72125) $189 $210 2.0×
CT cervical spine w/wo cont (72127) $315 $350 2.0×
CT chest w contrast (71260) $315 $350 2.0×
CT chest w/wo contrast (71270) $315 $350 2.0×
CT head/brain with contrast (70460) $315 $350 2.0×
CT head/brain without and with contrast (70470) $315 $350 2.0×
CT heart contrast eval cardiac structure&morph (75572) $315 $350 1.0×
CT heart no contrast quant eval coronry calcium (75571) $67.50 $75 0.9×
CT iac w contrast (70481) $315 $350 2.0×
CT l-spine w&w/o contrast (72133) $315 $350 2.0×
CT lower ext w/o (73700) $189 $210 2.0×
CT lower extremity w/contrast material (73701) $315 $350 2.0×
CT lumbar spine w contrast (72132) $661.50 $735 2.1×
CT lumbar spine w/o contrast (72131) $189 $210 2.0×
CT maxillofacial w contrast (70487) $315 $350 2.0×
CT maxillofacial wo contrast (70486) $189 $210 2.0×
CT neck tissue combo (70492) $315 $350 2.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $315 $350 2.0×
CT orbits w/o contrast (70480) $189 $210 2.0×
CT pelvis w&w/o contrast (72194) $315 $350 2.0×
CT pelvis w/o contrast (72192) $189 $210 2.0×
CT scan of leg combo (73702) $315 $350 2.0×
CT scans face/jaw combo (70488) $315 $350 2.0×
CT soft tissue neck w contrast (70491) $315 $350 2.0×
CT soft tissue neck w/o contrast (70490) $189 $210 2.0×
CT thoracic spine w contrast (72129) $315 $350 2.0×
CT thoracic spine w/o contrast (72128) $189 $210 2.0×
CT thoracic spine w/wo cont (72130) $315 $350 2.0×
CT thorax w/o contrast (71250) $189 $210 2.0×
CT upper ext wo (73200) $189 $210 2.0×
CT upper extremity w/o & w/contrast material (73202) $315 $350 2.0×
CT upper extremity with contrast (73201) $661.50 $735 2.1×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $315 $350 2.0×
Cta Abdomen (74175) $315 $350 2.0×
CTA pelvis (72191) $315 $350 2.0×
Echo Guide For Artery Repair (76936) $540 $600 2.7×
Esophagram (74220) $315 $350 2.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines		 $189–$202.50 $210–$225 varies
Fluoroscopy up to 1 hr (76000) $418.50 $465 1.9×
Foot 2 views (73620) $157.50 $175 2.0×
Forearm 2 views (73090) $157.50 $175 2.0×
Hand 2 views (73120) $189 $210 2.0×
Hysterosalpingogram (74740)
range across 2 matching MRF lines		 $400.50–$418.50 $445–$465 varies
Infusion Ivp (74410) $315 $350 2.0×
Knee 3 Views (73562) $157.50 $175 2.0×
Magnetic Image Jaw Joint (70336) $418.50 $465 1.9×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $45 $50 1.7×
Mr safety implt electronics prepj supvj phys/qhp (76018) $166.50 $185 1.9×
MRA head w/o contrast (70544) $418.50 $465 1.9×
MRA head with contrast (70545) $688.50 $765 2.2×
MRA neck w contrast (70548) $661.50 $735 2.1×
Mra Neck W/O &W/Contrast Material (70549) $661.50 $735 2.1×
MRA neck w/o contrast (70547) $418.50 $465 1.9×
MRI abdomen w contrast (74182) $661.50 $735 2.1×
MRI abdomen w/o contrast (74181) $418.50 $465 1.9×
MRI any jt lower extrem w/contrast material (73722) $1,372.50 $1,525 1.9×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $661.50 $735 2.1×
MRI any jt upper extremity w/contrast matrl (73222) $1,372.50 $1,525 1.9×
MRI Breast W/O Contrast Bilateral (77047) $418.50 $465 1.9×
MRI Breast Without Contrast Material Unilateral (77046) $418.50 $465 1.9×
MRI cardiac w/o contrast (75557) $418.50 $465 1.9×
MRI cervical spine w contrast (72142) $661.50 $735 2.1×
MRI cervical spine w/o cont (72141) $418.50 $465 1.9×
MRI chest w/o contrast (71550) $418.50 $465 1.9×
MRI chest with contrast (71551) $1,372.50 $1,525 1.9×
MRI chest wo w contrast (71552) $661.50 $735 2.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $661.50 $735 2.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $661.50 $735 2.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $418.50 $465 1.9×
MRI lumbar spine w contrast (72149) $661.50 $735 2.1×
Mri Neck Spine W/O & W/Dye (72156) $661.50 $735 2.1×
MRI orbit face &/neck w/o contrast (70540) $418.50 $465 1.9×
MRI orbit face neck w contrast (70542) $661.50 $735 2.1×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $661.50 $735 2.1×
MRI pelvis w contrast (72196) $661.50 $735 2.1×
MRI pelvis w/o & w contrast (72197) $675 $750 2.1×
MRI pelvis w/o contrast (72195) $418.50 $465 1.9×
MRI thoracic spine w/o contrast (72146) $418.50 $465 1.9×
MRI upper extremity oth than jt w/contr matrl (73219) $661.50 $735 2.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $418.50 $465 1.9×
Mri Uppr Extremity W/O&W/Dye (73220) $661.50 $735 2.1×
MRI, abdomen, combo (74183) $661.50 $735 2.1×
MRI, dorsal spine combo (72157) $661.50 $735 2.1×
MRI, dorsal spine contrast (72147) $661.50 $735 2.1×
MRI, joint upper extrem (73221) $418.50 $465 1.9×
MRI, joint upper extrem combo (73223) $661.50 $735 2.1×
MRI, lumbar spine combo (72158) $661.50 $735 2.1×
Neck soft tissue (70360) $157.50 $175 2.0×
Pelvis 1 or 2 views (72170) $189 $210 2.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $189 $210 2.0×
Radex abscess/fistula/sinus tract rs&i (76080) $945 $1,050 1.9×
Radex Ankle Complete Minimum 3 Views (73610) $157.50 $175 2.0×
Radex Calcaneus Minimum 2 Views (73650) $157.50 $175 2.0×
Radex elbow complete minimum 3 views (73080) $157.50 $175 2.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $189 $210 2.0×
Radex fingr minimum 2 views (73140) $157.50 $175 2.0×
Radex foot complete minimum 3 views (73630) $157.50 $175 2.0×
Radex Hand Minimum 3 Views (73130) $157.50 $175 2.0×
Radex lower extremity infant minimum 2 views (73592) $72 $80 0.9×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $189 $210 2.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $157.50 $175 2.0×
Radex Ribs Unilateral 2 Views (71100) $157.50 $175 2.0×
Radex shoulder complete minimum 2 views (73030) $157.50 $175 2.0×
Radex Sinuses Paransl < 3 Views (70210) $157.50 $175 2.0×
Radex Spine 1 View Specify Level (72020) $157.50 $175 2.0×
Radex Sternum Minimum 2 Views (71120) $157.50 $175 2.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $157.50 $175 2.0×
Radex Toe Minimum 2 Views (73660) $157.50 $175 2.0×
Radex upper extremity infant minimum 2 views (73092) $189 $210 2.0×
Radex Wrist Complete Minimum 3 Views (73110) $157.50 $175 2.0×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $189 $210 2.0×
Radiolog exam mandible compl minimum 4 views (70110) $189 $210 2.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $189 $210 2.0×
Radiologic exam colon double contrast study (74280) $315 $350 2.0×
Radiologic exam colon single contrast study (74270) $315 $350 2.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $315 $350 2.0×
Radiologic exam knee complete 4/more views (73564) $189 $210 2.0×
Radiologic exam pelvis compl minimum 3 views (72190) $220.50 $245 2.3×
Radiologic Exam Small Int Single Contrast Study (74250) $315 $350 2.0×
Radiologic exam swallow function contrast study (74230) $315 $350 2.0×
Radiologic exam upr gi trc double contrast study (74246) $315 $350 2.0×
Radiologic examination femur 1 view (73551) $157.50 $175 2.0×
Radiologic examination femur minimum 2 views (73552) $157.50 $175 2.0×
Radiologic examination knee 1/2 views (73560) $157.50 $175 2.0×
Radiologic Examination Osseous Survey Limited (77074) $193.50 $215 2.0×
Radiologic examination tibia & fibula 2 views (73590) $157.50 $175 2.0×
Ribs bilateral 3 views (71110) $189 $210 2.0×
Scapula (73010) $189 $210 2.0×
Sella turcica (70240) $157.50 $175 2.0×
Shoulder 1 view (73020) $157.50 $175 2.0×
Shoulder Arthrography (73040) $607.50 $675 1.9×
Sialogram (70390) $418.50 $465 1.9×
Skull less than 4 views (70250) $189 $210 2.0×
Sternoclavicular joints (71130) $157.50 $175 2.0×
Temporomandble Jt Arthrography Rs&I (70332)
range across 3 matching MRF lines		 $306–$418.50 $340–$465 varies
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $315 $350 2.0×
Thoracic spine 2 views (72070) $189 $210 2.0×
Thoracic spine 3 views (72072) $189 $210 2.0×
Thoracolumbar 2 views (72080) $157.50 $175 2.0×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $157.50–$297 $175–$330 varies
Ultrasound Exam Aaa Screen (76706) $189 $210 2.0×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $189–$202.50 $210–$225 varies
Upper gi w/o kub (74240) $315 $350 2.0×
Urethrocystogram voiding (74455) $418.50 $465 1.9×
Urethrocystography retrograde (74450) $418.50 $465 1.9×
Us breast unilateral complete (76641)
range across 3 matching MRF lines		 $189–$405 $210–$450 varies
Us chest (76604) $189 $210 2.0×
Us exam, pelvic, limited (76857) $202.50 $225 2.1×
Us head (76506) $189 $210 2.0×
Us kidney transplant (76776) $189 $210 2.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $189 $210 2.0×
Us ob limited 1 or more fetuses (76815) $189 $210 2.0×
Us ob transvaginal (76817) $189 $210 2.0×
Us pelvic non ob complete (76856) $189 $210 2.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $189 $210 2.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $189 $210 2.0×
Us retroperitoneal complete (76770) $189 $210 2.0×
Us retroperitoneal limited (76775) $189 $210 2.0×
Us scrotum and contents (76870) $189 $210 2.0×
Us spinal canal and contents (76800) $189 $210 2.0×
Us thyroid (76536) $189 $210 2.0×
Venography extremity unilateral rs&i (75820) $783 $870 0.5×
Wrist 2 views (73100) $157.50 $175 2.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $157.50 $175 2.0×
X-ray antegrade pyelogram tube (74425) $607.50 $675 1.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $157.50 $175 2.0×
X-Ray Exam Entire Spi 1 Vw (72081) $157.50 $175 2.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $189 $210 2.0×
X-Ray Exam Entire Spi 4/5 Vw (72083) $189 $210 2.0×
X-Ray Exam Hip Uni 1 View (73501) $157.50 $175 2.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $157.50 $175 2.0×
X-Ray Exam Hip Uni 4/> Views (73503) $189 $210 2.0×
X-Ray Exam Hips Bi 2 Views (73521) $189 $210 2.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $189 $210 2.0×
X-Ray Exam Hips Bi 5/> Views (73523) $189 $210 2.0×
X-Ray Exam L-S Spine Bending (72114) $189 $210 2.0×
X-Ray Exam Neck Spine 2-3 Vw (72040) $157.50 $175 2.0×
X-Ray Exam Neck Spine 6/>Vws (72052) $189 $210 2.0×
X-Ray Exam Unilat Ribs/Chest (71101) $189 $210 2.0×
X-ray humerus (73060) $157.50 $175 2.0×
X-ray IV pyelogram (ivp) (74400) $315 $350 2.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $162 $180 2.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $157.50 $175 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $189 $210 2.0×
X-ray nose-rectum child f.b. (76010) $66.60 $74 0.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $189 $210 2.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $157.50 $175 2.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $157.50 $175 2.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $189 $210 2.0×
X-Ray Stress View (77071) $157.50 $175 2.0×
X-ray thoracic spine 4 vw (72074) $189 $210 2.0×
X-Ray Tmj Unilat (70328) $157.50 $175 2.0×
X-Ray Urinary Tract Exam With Contrast Material (74420) $607.50 $675 1.9×
X-Rays Bone Length Studies (77073) $189 $210 2.0×
X-Rays Bone Survey Complete (77075) $189 $210 2.0×
Xr c-spine 4 or 5 views (72050) $189 $210 2.0×
Xr facial bones less than 3 views (70140) $76.50 $85 1.0×
Xr orbits complete 4 views (70200) $189 $210 2.0×

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.