Imaging prices at Stoughton Hospital
Stoughton, WI · every code in this section with a posted price and a Medicare benchmark.
226 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) | $254.65 | $463 | 3.0× |
| Abdomen 2 views (74019) | $324.50 | $590 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,335.77 | $2,428.68 | 3.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$60.59–$222.05 | $110.16–$403.72 | varies |
| Arthrogram hip (73525) | $487.36 | $886.10 | 1.4× |
| Arthrogram Wrist (73115) | $567.30 | $1,031.45 | 1.7× |
| Bone age studies (77072) | $268.66 | $488.47 | 2.6× |
| Bone Imaging 3 Phase (78315) | $1,647.25 | $2,995 | 4.2× |
| Bone Imaging Limited Area (78300) | $1,345.85 | $2,447 | 3.5× |
| Bone Imaging Multiple Areas (78305) | $753.20 | $1,369.45 | 1.9× |
| Bone Imaging Whole Body (78306) | $1,439.90 | $2,618 | 3.7× |
| Bone survey infant (77076) | $713.29 | $1,296.89 | 7.0× |
| Chest 1 view (71045) | $270.05 | $491 | 3.2× |
| Chest 2 views (71046) | $293.15 | $533 | 3.5× |
| Clavicle complete (73000) | $233.75 | $425 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,406.72 | $2,557.67 | 13.9× |
| Contrast X-Ray Bladder (74430) | $548.35 | $997 | 1.6× |
| Contrast X-Ray Of Elbow (73085) | $402.90 | $732.54 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,900.05 | $7,091 | 11.5× |
| CT abdomen and pelvis without contrast (74176) | $2,661.10 | $4,838.36 | 11.5× |
| CT abdomen w contrast (74160) | $1,989.35 | $3,617 | 11.7× |
| CT abdomen w wo contrast (74170) | $2,237.95 | $4,069 | 13.1× |
| CT abdomen w/o contrast (74150) | $1,639.55 | $2,981 | 16.1× |
| CT Angio Abdomen and Pelvis (74174) | $3,813.70 | $6,934 | 11.3× |
| CT Angio Chest (71275) | $2,913.90 | $5,298 | 17.1× |
| CT Angio Head (70496) | $2,575.10 | $4,682 | 15.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $232.52 | $422.76 | 1.4× |
| CT Angio Neck (70498) | $2,412.85 | $4,387 | 14.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,186.80 | $3,976 | 12.8× |
| CT cervical spine w/o contrast (72125) | $1,834.80 | $3,336 | 18.1× |
| CT chest w contrast (71260) | $1,901.90 | $3,458 | 11.2× |
| CT chest w/wo contrast (71270) | $2,257.16 | $4,103.92 | 13.2× |
| CT head/brain with contrast (70460) | $1,738.55 | $3,161 | 10.2× |
| CT head/brain without and with contrast (70470) | $1,926.65 | $3,503 | 11.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $41.25 | $75 | 0.5× |
| CT iac w contrast (70481) | $1,689.05 | $3,071 | 9.9× |
| CT lower ext w/o (73700) | $1,430 | $2,600 | 14.1× |
| CT lower extremity w/contrast material (73701) | $1,661.55 | $3,021 | 9.8× |
| CT lumbar spine w contrast (72132) | $2,096.05 | $3,811 | 6.2× |
| CT lumbar spine w/o contrast (72131) | $1,832.05 | $3,331 | 18.0× |
| CT maxillofacial w contrast (70487) | $1,656.05 | $3,011 | 9.7× |
| CT maxillofacial wo contrast (70486) | $1,371.15 | $2,493 | 13.5× |
| CT neck tissue combo (70492) | $2,032.25 | $3,695 | 11.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $267.28 | $485.96 | 1.6× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,256.48–$1,388.20 | $2,284.51–$2,524 | varies |
| CT pelvis w&w/o contrast (72194) | $1,881.16 | $3,420.29 | 11.0× |
| CT pelvis w/o contrast (72192) | $1,635.70 | $2,974 | 16.1× |
| CT scan of leg combo (73702) | $1,574.24 | $2,862.26 | 9.2× |
| CT scans face/jaw combo (70488) | $1,739.17 | $3,162.13 | 10.2× |
| CT soft tissue neck w contrast (70491) | $1,670.90 | $3,038 | 9.8× |
| CT soft tissue neck w/o contrast (70490) | $1,436.05 | $2,611 | 14.1× |
| CT thoracic spine w contrast (72129) | $1,834.80 | $3,336 | 10.8× |
| CT thoracic spine w/o contrast (72128) | $1,830.40 | $3,328 | 18.0× |
| CT thorax w/o contrast (71250) | $1,629.65 | $2,963 | 16.0× |
| CT upper ext wo (73200) | $1,430.55 | $2,601 | 14.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,592.88 | $2,896.14 | 9.3× |
| CT upper extremity with contrast (73201) | $1,620.85 | $2,947 | 4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,312.10 | $6,022 | 19.4× |
| Cta Abdomen (74175) | $267.28 | $485.96 | 1.6× |
| CTA pelvis (72191) | $2,725.25 | $4,955 | 16.0× |
| Dxa Bone Density Axial (77080) | $468.60 | $852 | 4.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $200.20 | $364 | 2.4× |
| Echo exam uterus (76831) | $393.97 | $716.31 | 1.7× |
| Esophagram (74220) | $492.80 | $896 | 2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $793.10 | $1,442 | 7.8× |
| Fluoroscopy up to 1 hr (76000) | $440 | $800 | 1.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$229.35–$232.43 | $417–$422.60 | varies |
| Forearm 2 views (73090) | $284.90 | $518 | 3.4× |
| Gastric emptying imaging study (78264) | $1,328.80 | $2,416 | 3.4× |
| Gated Heart Planar Single (78472) | $1,259.21 | $2,289.47 | 3.2× |
| Hand 2 views (73120) | $230.45 | $419 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,695.10 | $3,082 | 3.2× |
| Hepatobiliary System Imaging (78226) | $1,114.30 | $2,026 | 2.9× |
| Ht Muscle Image Spect Sing (78451) | $2,409.70 | $4,381.28 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $484.22 | $880.40 | 5.7× |
| Joint Survey Single View (77077) | $178.33 | $324.24 | 1.8× |
| K Flow/Funct Image W/Drug (78708) | $1,230.35 | $2,237 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,172.56 | $2,131.92 | 2.2× |
| Knee 3 Views (73562) | $263.45 | $479 | 3.1× |
| Liver & Spleen Imaging Static Only (78215) | $640.18 | $1,163.97 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,784.20 | $3,244 | 3.4× |
| Lung Ventilation Imaging (78579) | $531.93 | $967.15 | 1.4× |
| Lymph System Imaging (78195) | $1,340.90 | $2,438 | 2.5× |
| Magnetic Image Jaw Joint (70336) | $2,084.50 | $3,790 | 9.0× |
| Meckels Divert Exam (78290) | $603.17 | $1,096.67 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,463.45 | $4,479 | 7.3× |
| MRA head w/o contrast (70544) | $2,476.10 | $4,502 | 10.7× |
| MRA head with contrast (70545) | $2,587.52 | $4,704.59 | 7.6× |
| MRA neck w contrast (70548) | $2,644.43 | $4,808.05 | 7.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,229.60 | $5,872 | 9.5× |
| MRI abdomen w contrast (74182) | $2,888.31 | $5,251.47 | 8.5× |
| MRI abdomen w/o contrast (74181) | $2,521.75 | $4,585 | 10.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,982.65 | $5,423 | 3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,002.45 | $5,459 | 8.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,157.44 | $5,740.80 | 4.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,147.55 | $7,541 | 17.9× |
| MRI cervical spine w contrast (72142) | $2,983.53 | $5,424.60 | 8.8× |
| MRI cervical spine w/o cont (72141) | $2,506.35 | $4,557 | 10.8× |
| MRI chest w/o contrast (71550) | $2,486 | $4,520 | 10.7× |
| MRI chest with contrast (71551) | $2,259.30 | $4,107.82 | 3.0× |
| MRI chest wo w contrast (71552) | $3,326.95 | $6,049 | 9.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,440.04 | $4,436.44 | 7.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,227.95 | $5,869 | 9.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,598.20 | $4,724 | 11.2× |
| MRI lumbar spine w contrast (72149) | $3,276.14 | $5,956.62 | 9.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,258.75 | $5,925 | 9.6× |
| MRI orbit face &/neck w/o contrast (70540) | $200.32 | $364.22 | 0.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,655.30 | $6,646 | 10.8× |
| MRI pelvis w contrast (72196) | $2,426.31 | $4,411.47 | 7.2× |
| MRI pelvis w/o & w contrast (72197) | $3,074.50 | $5,590 | 9.1× |
| MRI pelvis w/o contrast (72195) | $2,351.25 | $4,275 | 10.1× |
| MRI thoracic spine w/o contrast (72146) | $2,599.85 | $4,727 | 11.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,174.15 | $3,953 | 9.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,290.10 | $5,982 | 9.7× |
| MRI, abdomen, combo (74183) | $3,080 | $5,600 | 9.1× |
| MRI, dorsal spine combo (72157) | $3,377 | $6,140 | 10.0× |
| MRI, dorsal spine contrast (72147) | $3,043.47 | $5,533.59 | 9.0× |
| MRI, joint upper extrem (73221) | $2,365 | $4,300 | 10.2× |
| MRI, joint upper extrem combo (73223) | $2,988.70 | $5,434 | 8.8× |
| MRI, lumbar spine combo (72158) | $3,389.65 | $6,163 | 10.0× |
| Myelogram Lumbar (72265) | $1,582.36 | $2,877.02 | 2.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,116.17–$3,351.70 | $2,029.40–$6,094 | varies |
| Neck soft tissue (70360) | $258.50 | $470 | 3.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $337.72 | $614.03 | 0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $233.95 | $425.36 | 2.3× |
| Panoramic X-ray of jaws (70355) | $375.31 | $682.39 | 4.4× |
| Parathyroid Planar Imaging (78070) | $1,043 | $1,896.36 | 2.7× |
| Pelvis 1 or 2 views (72170) | $295.90 | $538 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $886.05 | $1,611 | 2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $468.60 | $852 | 4.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $276.65 | $503 | 3.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $208.66 | $379.38 | 2.5× |
| Radex elbow complete minimum 3 views (73080) | $301.40 | $548 | 3.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $326.57 | $593.77 | 3.2× |
| Radex fingr minimum 2 views (73140) | $211.20 | $384 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $287.65 | $523 | 3.4× |
| Radex Hand Minimum 3 Views (73130) | $260.70 | $474 | 3.1× |
| Radex lower extremity infant minimum 2 views (73592) | $281.39 | $511.61 | 3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $269.86 | $490.65 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $306.90 | $558 | 3.6× |
| Radex shoulder complete minimum 2 views (73030) | $272.80 | $496 | 3.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $175.84 | $319.70 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $87.08 | $158.33 | 1.0× |
| Radex Sternum Minimum 2 Views (71120) | $246.05 | $447.37 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $545.78 | $992.33 | 6.5× |
| Radex Toe Minimum 2 Views (73660) | $227.15 | $413 | 2.7× |
| Radex upper extremity infant minimum 2 views (73092) | $281.39 | $511.61 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $289.85 | $527 | 3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $146.97 | $267.21 | 1.4× |
| Radiologic exam colon double contrast study (74280) | $949.55 | $1,726.45 | 5.6× |
| Radiologic exam colon single contrast study (74270) | $617.65 | $1,123 | 3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $363.15 | $660.28 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $315.70 | $574 | 3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $288.75 | $525 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $594.55 | $1,081 | 3.5× |
| Radiologic exam swallow function contrast study (74230) | $574.20 | $1,044 | 3.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $611.60 | $1,112 | 3.6× |
| Radiologic examination femur minimum 2 views (73552) | $295.90 | $538 | 3.5× |
| Radiologic examination knee 1/2 views (73560) | $270.05 | $491 | 3.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $297 | $540 | 3.5× |
| Ribs bilateral 3 views (71110) | $257.40 | $468 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $893.05 | $1,623.73 | 1.7× |
| Scapula (73010) | $279.41 | $508.02 | 2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $71.52 | $130.04 | 3.1× |
| Shoulder 1 view (73020) | $222.75 | $405 | 2.6× |
| Shoulder Arthrography (73040) | $609.95 | $1,109 | 1.8× |
| Skull less than 4 views (70250) | $281.05 | $511 | 2.8× |
| Testicular Imaging W/Flow (78761) | $514.93 | $936.23 | 1.3× |
| Thoracic spine 2 views (72070) | $308.55 | $561 | 3.0× |
| Thoracolumbar 2 views (72080) | $287.65 | $523 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $971.34 | $1,766.07 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,138.73 | $2,070.41 | 2.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$420.07–$510.92 | $763.76–$928.94 | varies |
| Ultrasound Exam Aaa Screen (76706) | $429.24 | $780.44 | 4.2× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$119.82–$718.30 | $217.86–$1,306 | varies |
| Umbilical-artery Doppler (OB) (76820) | $569.81 | $1,036.02 | 5.6× |
| Upper gi w/o kub (74240) | $639.10 | $1,162 | 3.8× |
| Ureteral Reflux Study (78740) | $580.39 | $1,055.25 | 1.5× |
| Urethrocystogram voiding (74455) | $585.67 | $1,064.86 | 2.5× |
| Us breast unilateral complete (76641) | $476.51 | $866.39 | 4.7× |
| Us chest (76604) range across 2 matching MRF lines |
$129.51–$208.52 | $235.47–$379.13 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$149.43–$469.07 | $271.69–$852.85 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$89.91–$455.95 | $163.47–$829 | varies |
| Us head (76506) | $318.29 | $578.71 | 3.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$206.81–$422.95 | $376.02–$769 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$96.91–$460.90 | $176.20–$838 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$107.48–$541.75 | $195.41–$985 | varies |
| Us pelvic non ob complete (76856) | $834.90 | $1,518 | 8.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$166.67–$586.30 | $303.04–$1,066 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $489.03 | $889.15 | 4.8× |
| Us retroperitoneal complete (76770) | $723.25 | $1,315 | 7.1× |
| Us retroperitoneal limited (76775) | $601.15 | $1,093 | 5.9× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$147.13–$669.35 | $267.51–$1,217 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$135.58–$736.45 | $246.50–$1,339 | varies |
| Wrist 2 views (73100) | $228.77 | $415.95 | 2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $231.55 | $421 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $163.76 | $297.74 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $245.30 | $446 | 2.9× |
| X-Ray Exam Breast Specimen (76098) | $449.90 | $818 | 0.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $206.76 | $375.93 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $295.35 | $537 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $203.03 | $369.15 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $292.08 | $531.05 | 2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $234.20 | $425.82 | 2.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $305.25 | $555 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $382.45 | $695.36 | 3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $434.50 | $790 | 4.3× |
| X-ray eye for foreign body (70030) | $229.35 | $417 | 2.7× |
| X-ray humerus (73060) | $277.20 | $504 | 3.3× |
| X-ray IV pyelogram+tomography (74415) | $653.32 | $1,187.86 | 3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $326.13 | $592.96 | 3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $194.82 | $354.22 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $340.45 | $619 | 3.4× |
| X-ray nose-rectum child f.b. (76010) | $254.66 | $463.02 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $493.90 | $898 | 4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $301.14 | $547.53 | 3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $276.65 | $503 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $304.52 | $553.68 | 3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $224.44 | $408.08 | 2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $754.05 | $1,371 | 2.2× |
| X-Rays Bone Length Studies (77073) | $257.40 | $468 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $616.55 | $1,121 | 6.1× |
| Xr c-spine 4 or 5 views (72050) | $398.20 | $724 | 3.9× |
| Xr facial bones less than 3 views (70140) | $199.44 | $362.62 | 2.4× |
| Xr orbits complete 4 views (70200) | $101.95 | $185.37 | 1.0× |
| Xr Tomogram Single Plane (76100) | $357.53 | $650.05 | 3.5× |
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.