Imaging prices at CHI St. Gabriel's Hospital
Little Falls, MN · every code in this section with a posted price and a Medicare benchmark.
219 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) | $104.98 | $181 | 1.2× |
| Abdomen 2 views (74019) | $201.84 | $348 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $652.50 | $1,125 | 1.6× |
| Arthrogram ankle (73615) | $527.22 | $909 | 1.5× |
| Arthrogram hip (73525) | $527.22 | $909 | 1.5× |
| Arthrogram Wrist (73115) | $495.90 | $855 | 1.4× |
| Bone age studies (77072) | $234.90 | $405 | 2.2× |
| Bone Imaging 3 Phase (78315) | $895.52 | $1,544 | 2.2× |
| Bone Imaging Limited Area (78300) | $895.52 | $1,544 | 2.2× |
| Bone Imaging Multiple Areas (78305) | $895.52 | $1,544 | 2.2× |
| Bone Imaging Whole Body (78306) | $1,030.08 | $1,776 | 2.5× |
| Bone survey infant (77076) | $381.06 | $657 | 3.5× |
| Chest 1 view (71045) | $100.34 | $173 | 1.1× |
| Chest 2 views (71046) | $193.14 | $333 | 2.2× |
| Chest 3 views (71047) | $285.36 | $492 | 3.2× |
| Chest 4 or more views (71048) | $380.48 | $656 | 3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $481.40 | $830 | 4.5× |
| Contrast X-Ray Bladder (74430) | $636.26 | $1,097 | 1.8× |
| Contrast X-Ray Of Elbow (73085) | $527.22 | $909 | 1.5× |
| Contrast X-Ray Of Knee Joint (73580) | $527.22 | $909 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $3,504.36 | $6,042 | 9.7× |
| CT abdomen and pelvis without contrast (74176) | $2,336.24 | $4,028 | 9.5× |
| CT abdomen w contrast (74160) | $1,354.30 | $2,335 | 7.5× |
| CT abdomen w wo contrast (74170) | $2,020.72 | $3,484 | 11.2× |
| CT abdomen w/o contrast (74150) | $1,354.30 | $2,335 | 12.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,902.90 | $5,005 | 8.1× |
| CT Angio Chest (71275) | $1,634.44 | $2,818 | 9.0× |
| CT Angio Head (70496) | $1,639.66 | $2,827 | 9.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,577.02 | $2,719 | 8.7× |
| CT Angio Neck (70498) | $1,484.22 | $2,559 | 8.2× |
| CT cervical spine w/ contrast (72126) | $1,445.94 | $2,493 | 4.0× |
| CT cervical spine w/o contrast (72125) | $1,445.94 | $2,493 | 13.4× |
| CT cervical spine w/wo cont (72127) | $2,169.20 | $3,740 | 12.0× |
| CT chest w contrast (71260) | $1,301.52 | $2,244 | 7.2× |
| CT chest w/wo contrast (71270) | $1,952.28 | $3,366 | 10.8× |
| CT head/brain with contrast (70460) | $1,219.16 | $2,102 | 6.7× |
| CT head/brain without and with contrast (70470) | $1,828.74 | $3,153 | 10.1× |
| CT iac w contrast (70481) | $1,139.12 | $1,964 | 6.3× |
| CT l-spine w&w/o contrast (72133) | $2,154.70 | $3,715 | 11.9× |
| CT lower ext w/o (73700) | $1,333.42 | $2,299 | 12.4× |
| CT lower extremity w/contrast material (73701) | $1,333.42 | $2,299 | 7.4× |
| CT lumbar spine w contrast (72132) | $1,436.66 | $2,477 | 4.0× |
| CT lumbar spine w/o contrast (72131) | $1,436.66 | $2,477 | 13.3× |
| CT maxillofacial w contrast (70487) | $1,210.46 | $2,087 | 6.7× |
| CT maxillofacial wo contrast (70486) | $1,210.46 | $2,087 | 11.2× |
| CT neck tissue combo (70492) | $1,866.44 | $3,218 | 10.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,708.68 | $2,946 | 9.4× |
| CT orbits w/o contrast (70480) | $1,139.12 | $1,964 | 10.6× |
| CT pelvis w&w/o contrast (72194) | $1,976.64 | $3,408 | 10.9× |
| CT pelvis w/o contrast (72192) | $1,317.76 | $2,272 | 12.2× |
| CT scan of leg combo (73702) | $1,999.84 | $3,448 | 11.0× |
| CT scans face/jaw combo (70488) | $1,815.98 | $3,131 | 10.0× |
| CT soft tissue neck w contrast (70491) | $1,244.10 | $2,145 | 6.9× |
| CT soft tissue neck w/o contrast (70490) | $1,244.10 | $2,145 | 11.5× |
| CT thoracic spine w contrast (72129) | $1,405.92 | $2,424 | 7.8× |
| CT thoracic spine w/o contrast (72128) | $1,405.92 | $2,424 | 13.0× |
| CT thoracic spine w/wo cont (72130) | $2,108.88 | $3,636 | 11.6× |
| CT thorax w/o contrast (71250) | $1,301.52 | $2,244 | 12.1× |
| CT upper ext wo (73200) | $1,218 | $2,100 | 11.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,827 | $3,150 | 10.1× |
| CT upper extremity with contrast (73201) | $1,218 | $2,100 | 3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,930.82 | $3,329 | 10.7× |
| Cta Abdomen (74175) | $1,800.32 | $3,104 | 9.9× |
| CTA pelvis (72191) | $1,829.90 | $3,155 | 10.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $205.32 | $354 | 1.9× |
| Dxa Bone Density Axial (77080) | $230.26 | $397 | 2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $149.64 | $258 | 1.7× |
| Echo exam uterus (76831) | $328.28 | $566 | 1.3× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$154.86–$706.44 | $267–$1,218 | varies |
| Esophagram (74220) | $352.06 | $607 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $429.20 | $740 | 4.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $211.70 | $365 | 2.0× |
| Fluoroscopy up to 1 hr (76000) | $440.22 | $759 | 1.8× |
| Gastric emptying imaging study (78264) | $1,048.64 | $1,808 | 2.5× |
| Gastroesophageal Reflux Exam (78262) | $1,059.66 | $1,827 | 2.6× |
| Gated Heart Planar Single (78472) | $1,679.10 | $2,895 | 4.1× |
| Hepatobil Syst Image W/Drug (78227) | $972.08 | $1,676 | 1.7× |
| Hepatobiliary System Imaging (78226) | $826.50 | $1,425 | 2.0× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$713.98–$1,998.68 | $1,231–$3,446 | varies |
| Hysterosalpingogram (74740) | $502.28 | $866 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$60.90–$469.22 | $105–$809 | varies |
| Infusion Ivp (74410) | $822.44 | $1,418 | 4.5× |
| Joint Survey Single View (77077) | $211.70 | $365 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $900.16 | $1,552 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $900.16 | $1,552 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $754 | $1,300 | 1.3× |
| Kidney Imaging Morphol (78700) | $899.58 | $1,551 | 2.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,017.32 | $1,754 | 2.5× |
| Liver & Spleen Imaging Static Only (78215) | $766.76 | $1,322 | 1.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $969.18 | $1,671 | 2.3× |
| Liver imaging w/vascular flow (78202) | $1,024.28 | $1,766 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,269.04 | $2,188 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,505.10 | $2,595 | 2.7× |
| Lung Ventilation Imaging (78579) | $827.66 | $1,427 | 2.0× |
| Lymph System Imaging (78195) | $1,161.74 | $2,003 | 2.1× |
| Magnetic Image Jaw Joint (70336) | $2,173.84 | $3,748 | 8.8× |
| Meckels Divert Exam (78290) | $652.50 | $1,125 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,351.90 | $4,055 | 6.5× |
| MRA head w/o contrast (70544) | $1,912.26 | $3,297 | 7.8× |
| MRA neck w contrast (70548) | $2,134.40 | $3,680 | 5.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,185.94 | $5,493 | 8.8× |
| MRA neck w/o contrast (70547) | $2,134.40 | $3,680 | 8.7× |
| MRI abdomen w contrast (74182) | $2,134.40 | $3,680 | 5.9× |
| MRI abdomen w/o contrast (74181) | $2,134.40 | $3,680 | 8.7× |
| MRI cervical spine w contrast (72142) | $1,926.18 | $3,321 | 5.3× |
| MRI cervical spine w/o cont (72141) | $1,926.18 | $3,321 | 7.8× |
| MRI chest w/o contrast (71550) | $2,173.84 | $3,748 | 8.8× |
| MRI chest with contrast (71551) | $2,173.84 | $3,748 | 2.7× |
| MRI chest wo w contrast (71552) | $3,260.76 | $5,622 | 9.1× |
| MRI lumbar spine w contrast (72149) | $2,123.38 | $3,661 | 5.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,888.98 | $4,981 | 8.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,383.80 | $4,110 | 9.7× |
| MRI orbit face neck w contrast (70542) | $2,383.80 | $4,110 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,575.70 | $6,165 | 9.9× |
| MRI pelvis w contrast (72196) | $1,921.54 | $3,313 | 5.3× |
| MRI pelvis w/o & w contrast (72197) | $2,863.46 | $4,937 | 8.0× |
| MRI pelvis w/o contrast (72195) | $1,921.54 | $3,313 | 7.8× |
| MRI thoracic spine w/o contrast (72146) | $2,123.38 | $3,661 | 8.6× |
| MRI, abdomen, combo (74183) | $3,185.94 | $5,493 | 8.8× |
| MRI, dorsal spine combo (72157) | $3,185.36 | $5,492 | 8.8× |
| MRI, dorsal spine contrast (72147) | $2,123.38 | $3,661 | 5.9× |
| MRI, lumbar spine combo (72158) | $3,185.36 | $5,492 | 8.8× |
| Myelogram Lumbar (72265) | $839.84 | $1,448 | 1.0× |
| Myelography thoracic (72255) | $907.12 | $1,564 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $2,855.34 | $4,923 | 2.1× |
| Neck soft tissue (70360) | $84.10 | $145 | 0.9× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) range across 2 matching MRF lines |
$55.10–$124.12 | $95–$214 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $82.94 | $143 | 0.8× |
| Parathyroid Planar Imaging (78070) | $1,141.44 | $1,968 | 2.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,095.62 | $1,889 | 2.7× |
| Pelvis 1 or 2 views (72170) | $144.42 | $249 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $734.86 | $1,267 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $106.72 | $184 | 1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $381.06 | $657 | 0.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $209.38 | $361 | 1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $362.50 | $625 | 3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $142.68 | $246 | 1.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $140.94 | $243 | 1.6× |
| Radex Spine 1 View Specify Level (72020) | $188.50 | $325 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $176.90 | $305 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $116 | $200 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $95.12 | $164 | 0.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $298.12 | $514 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $735.44 | $1,268 | 4.1× |
| Radiologic exam colon single contrast study (74270) | $502.28 | $866 | 2.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $206.48 | $356 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $577.10 | $995 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $424.56 | $732 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $699.48 | $1,206 | 3.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $423.40 | $730 | 3.9× |
| Ribs bilateral 3 views (71110) | $128.18 | $221 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,535.84 | $2,648 | 2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $81.20 | $140 | 3.5× |
| Shoulder Arthrography (73040) | $527.22 | $909 | 1.5× |
| Skull less than 4 views (70250) | $223.88 | $386 | 2.1× |
| Spleen Imaging (78185) | $538.24 | $928 | 1.3× |
| Sternoclavicular joints (71130) | $94.54 | $163 | 1.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $580 | $1,000 | 3.2× |
| Thoracic spine 2 views (72070) | $135.14 | $233 | 1.3× |
| Thoracic spine 3 views (72072) | $135.14 | $233 | 1.3× |
| Thoracolumbar 2 views (72080) | $64.96 | $112 | 0.7× |
| Thyroid Imaging With Vascular Flow (78013) | $475.60 | $820 | 1.2× |
| Ultrasound Breast Limited (76642) | $262.74 | $453 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $407.16 | $702 | 3.8× |
| Ultrasound, abdomen limited (76705) | $413.54 | $713 | 3.8× |
| Umbilical-artery Doppler (OB) (76820) | $205.32 | $354 | 1.9× |
| Upper gi w/o kub (74240) | $513.88 | $886 | 2.8× |
| Ureteral Reflux Study (78740) | $845.64 | $1,458 | 2.0× |
| Urethrocystogram voiding (74455) | $729.64 | $1,258 | 3.0× |
| Urethrocystography retrograde (74450) | $729.64 | $1,258 | 3.0× |
| Us breast unilateral complete (76641) | $396.72 | $684 | 3.7× |
| Us chest (76604) | $313.20 | $540 | 2.9× |
| Us exam, pelvic, limited (76857) | $305.08 | $526 | 2.8× |
| Us head (76506) range across 2 matching MRF lines |
$51.62–$346.84 | $89–$598 | varies |
| Us kidney transplant (76776) | $413.54 | $713 | 3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$53.36–$60.32 | $92–$104 | varies |
| Us ob limited 1 or more fetuses (76815) | $320.74 | $553 | 3.0× |
| Us ob transvaginal (76817) | $302.76 | $522 | 2.8× |
| Us pelvic non ob complete (76856) | $391.50 | $675 | 3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $295.22 | $509 | 2.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $218.08 | $376 | 2.0× |
| Us retroperitoneal complete (76770) | $551 | $950 | 5.1× |
| Us retroperitoneal limited (76775) | $402.52 | $694 | 3.7× |
| Us scrotum and contents (76870) | $508.08 | $876 | 4.7× |
| Us spinal canal and contents (76800) | $241.86 | $417 | 2.2× |
| Us thyroid (76536) | $605.52 | $1,044 | 5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $147.32 | $254 | 1.6× |
| X-ray antegrade pyelogram tube (74425) | $754 | $1,300 | 2.1× |
| X-Ray Bend Only L-S Spine (72120) | $254.62 | $439 | 2.4× |
| X-Ray Exam Breast Specimen (76098) | $343.36 | $592 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $238.38 | $411 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $366.56 | $632 | 3.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $22.62 | $39 | 0.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $93.96 | $162 | 0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$229.68–$310.30 | $396–$535 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $303.34 | $523 | 2.8× |
| X-Ray Exam L-S Spine Bending (72114) | $510.98 | $881 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $165.30 | $285 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $165.30 | $285 | 1.5× |
| X-ray eye for foreign body (70030) | $151.96 | $262 | 1.7× |
| X-ray IV pyelogram (ivp) (74400) | $792.28 | $1,366 | 4.4× |
| X-ray IV pyelogram+tomography (74415) | $853.76 | $1,472 | 4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $218.66 | $377 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $169.36 | $292 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $133.98 | $231 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $173.42 | $299 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $597.98 | $1,031 | 5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $107.30 | $185 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $249.40 | $430 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $107.30 | $185 | 1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $101.50 | $175 | 1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $316.68 | $546 | 2.9× |
| X-Ray Stress View (77071) | $110.78 | $191 | 1.2× |
| X-ray thoracic spine 4 vw (72074) | $579.42 | $999 | 5.4× |
| X-Ray Tmj Unilat (70328) | $316.68 | $546 | 3.5× |
| X-Rays Bone Survey Complete (77075) | $237.80 | $410 | 2.2× |
| Xr c-spine 4 or 5 views (72050) | $122.38 | $211 | 1.1× |
| Xr facial bones less than 3 views (70140) | $80.62 | $139 | 0.9× |
| Xr orbits complete 4 views (70200) | $184.44 | $318 | 1.7× |
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.