Imaging prices at Sullivan County Memorial Hospital

Milan, MO · every code in this section with a posted price and a Medicare benchmark.

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

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $261 $261 3.0×
Abdomen 2 views (74019) $321 $321 3.1×
Ankle 2 views (73600) $261 $261 3.0×
Chest 1 view (71045) $261 $261 3.0×
Chest 2 views (71046) $261 $261 3.0×
Chest 3 views (71047) $261 $261 3.0×
Clavicle complete (73000) $261 $261 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $500 $500 4.8×
Contrast X-Ray Bladder (74430) $1,105 $1,105 3.2×
CT abdomen and pelvis without and with contrast (74178) $2,211 $2,211 6.3×
CT abdomen and pelvis without contrast (74176) $1,401 $1,401 5.9×
CT abdomen w contrast (74160) $1,082 $1,082 6.2×
CT abdomen w wo contrast (74170) $1,082 $1,082 6.2×
CT abdomen w/o contrast (74150) $641 $641 6.1×
CT Angio Abdomen and Pelvis (74174) $2,211 $2,211 6.3×
CT Angio Chest (71275) $1,082 $1,082 6.2×
CT Angio Head (70496) $1,082 $1,082 6.2×
CT Angio Neck (70498) $1,082 $1,082 6.2×
CT bone density (77078) $521 $521 6.0×
CT cervical spine w/ contrast (72126) $2,211 $2,211 6.3×
CT cervical spine w/o contrast (72125) $641 $641 6.1×
CT cervical spine w/wo cont (72127) $2,211 $2,211 12.6×
CT chest w contrast (71260) $1,082 $1,082 6.2×
CT chest w/wo contrast (71270) $1,082 $1,082 6.2×
CT head/brain with contrast (70460) $1,082 $1,082 6.2×
CT head/brain without and with contrast (70470) $1,082 $1,082 6.2×
CT iac w contrast (70481) $1,082 $1,082 6.2×
CT l-spine w&w/o contrast (72133) $1,082 $1,082 6.2×
CT lower ext w/o (73700) $641 $641 6.1×
CT lower extremity w/contrast material (73701) $1,082 $1,082 6.2×
CT lumbar spine w contrast (72132) $2,211 $2,211 6.3×
CT lumbar spine w/o contrast (72131) $641 $641 6.1×
CT maxillofacial w contrast (70487) $1,082 $1,082 6.2×
CT maxillofacial wo contrast (70486) $641 $641 6.1×
CT neck tissue combo (70492) $1,082 $1,082 6.2×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,082 $1,082 6.2×
CT orbits w/o contrast (70480) $641 $641 6.1×
CT pelvis w&w/o contrast (72194) $1,082 $1,082 6.2×
CT pelvis w/o contrast (72192) $641 $641 6.1×
CT scan of leg combo (73702) $1,082 $1,082 6.2×
CT scans face/jaw combo (70488) $1,082 $1,082 6.2×
CT soft tissue neck w contrast (70491) $1,082 $1,082 6.2×
CT soft tissue neck w/o contrast (70490) $641 $641 6.1×
CT thoracic spine w/o contrast (72128) $641 $641 6.1×
CT thoracic spine w/wo cont (72130) $1,082 $1,082 6.2×
CT thorax w/o contrast (71250) $641 $641 6.1×
CT upper ext wo (73200) $641 $641 6.1×
CT upper extremity w/o & w/contrast material (73202) $1,082 $1,082 6.2×
CT upper extremity with contrast (73201) $2,211 $2,211 6.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,000 $2,000 11.4×
Dxa Bone Density Axial (77080) $321 $321 3.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $261 $261 3.0×
Esophagram (74220) $541 $541 3.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $428 $428 4.1×
Foot 2 views (73620) $261 $261 3.0×
Forearm 2 views (73090) $261 $261 3.0×
Hand 2 views (73120) $321 $321 3.1×
Knee 3 Views (73562) $261 $261 3.0×
MRA head w/o contrast (70544) $1,401 $1,401 5.9×
Mra Neck W/O &W/Contrast Material (70549) $2,211 $2,211 6.3×
MRI abdomen w contrast (74182) $2,211 $2,211 6.3×
MRI abdomen w/o contrast (74181) $1,401 $1,401 5.9×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,211 $2,211 6.3×
MRI any jt upper extremity w/contrast matrl (73222) $4,445 $4,445 5.7×
MRI cervical spine w contrast (72142) $2,211 $2,211 6.3×
MRI cervical spine w/o cont (72141) $1,401 $1,401 5.9×
MRI chest w/o contrast (71550) $1,401 $1,401 5.9×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,211 $2,211 6.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,211 $2,211 6.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,401 $1,401 5.9×
MRI lumbar spine w contrast (72149) $2,211 $2,211 6.3×
Mri Neck Spine W/O & W/Dye (72156) $2,211 $2,211 6.3×
MRI orbit face &/neck w/o contrast (70540) $1,401 $1,401 5.9×
MRI orbit face neck w contrast (70542) $2,211 $2,211 6.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,211 $2,211 6.3×
MRI pelvis w/o & w contrast (72197) $2,211 $2,211 6.3×
MRI pelvis w/o contrast (72195) $1,401 $1,401 5.9×
MRI thoracic spine w/o contrast (72146) $1,401 $1,401 5.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,401 $1,401 5.9×
MRI, abdomen, combo (74183) $2,211 $2,211 6.3×
MRI, dorsal spine combo (72157) $2,211 $2,211 6.3×
MRI, dorsal spine contrast (72147) $2,211 $2,211 6.3×
MRI, joint upper extrem (73221) $1,401 $1,401 5.9×
MRI, joint upper extrem combo (73223) $2,211 $2,211 6.3×
MRI, lumbar spine combo (72158) $2,211 $2,211 6.3×
Neck soft tissue (70360) $261 $261 3.0×
Pelvis 1 or 2 views (72170) $321 $321 3.1×
Radex abscess/fistula/sinus tract rs&i (76080) $1,509 $1,509 2.8×
Radex Ankle Complete Minimum 3 Views (73610) $261 $261 3.0×
Radex Calcaneus Minimum 2 Views (73650) $261 $261 3.0×
Radex elbow complete minimum 3 views (73080) $261 $261 3.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $321 $321 3.1×
Radex fingr minimum 2 views (73140) $261 $261 3.0×
Radex foot complete minimum 3 views (73630) $261 $261 3.0×
Radex Hand Minimum 3 Views (73130) $261 $261 3.0×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $321 $321 3.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $261 $261 3.0×
Radex Ribs Unilateral 2 Views (71100) $261 $261 3.0×
Radex shoulder complete minimum 2 views (73030) $261 $261 3.0×
Radex Sinuses Paransl < 3 Views (70210) $261 $261 3.0×
Radex Spine 1 View Specify Level (72020) $261 $261 3.0×
Radex Sternum Minimum 2 Views (71120) $261 $261 3.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $261 $261 3.0×
Radex Toe Minimum 2 Views (73660) $261 $261 3.0×
Radex Wrist Complete Minimum 3 Views (73110) $261 $261 3.0×
Radiolog exam mandible compl minimum 4 views (70110) $321 $321 3.1×
Radiologic exam colon single contrast study (74270) $541 $541 3.1×
Radiologic exam knee complete 4/more views (73564) $321 $321 3.1×
Radiologic Exam Small Int Single Contrast Study (74250) $541 $541 3.1×
Radiologic exam swallow function contrast study (74230) $541 $541 3.1×
Radiologic examination femur minimum 2 views (73552) $261 $261 3.0×
Radiologic examination knee 1/2 views (73560) $261 $261 3.0×
Radiologic Examination Osseous Survey Limited (77074) $321 $321 3.1×
Radiologic examination tibia & fibula 2 views (73590) $261 $261 3.0×
Ribs bilateral 3 views (71110) $321 $321 3.1×
Scapula (73010) $321 $321 3.1×
Sella turcica (70240) $261 $261 3.0×
Shoulder 1 view (73020) $261 $261 3.0×
Skull less than 4 views (70250) $321 $321 3.1×
Sternoclavicular joints (71130) $261 $261 3.0×
Thoracic spine 2 views (72070) $321 $321 3.1×
Thoracic spine 3 views (72072) $321 $321 3.1×
Thoracolumbar 2 views (72080) $261 $261 3.0×
Ultrasound Breast Limited (76642) $348 $348 4.0×
Ultrasound Exam Aaa Screen (76706) $428 $428 4.1×
Ultrasound, abdomen limited (76705) $428 $428 4.1×
Unlisted Dx Radiographic Procedure (76499) $261 $261 3.0×
Unlisted us procedure (76999) $348 $348 4.0×
Upper gi w/o kub (74240) $360 $360 2.0×
Urethrocystogram voiding (74455) $701 $701 2.9×
Urethrocystography retrograde (74450) $701 $701 2.9×
Us breast unilateral complete (76641) $428 $428 4.1×
Us complete joint (76881) $428 $428 4.1×
Us exam, pelvic, limited (76857) $428 $428 4.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $428 $428 4.1×
Us ob limited 1 or more fetuses (76815) $428 $428 4.1×
Us ob transvaginal (76817) $428 $428 4.1×
Us pelvic non ob complete (76856) $428 $428 4.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $428 $428 4.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $428 $428 4.1×
Us retroperitoneal complete (76770) $428 $428 4.1×
Us retroperitoneal limited (76775) $428 $428 4.1×
Us scrotum and contents (76870) $428 $428 4.1×
Us thyroid (76536) $428 $428 4.1×
Vertebral fracture assessment via dxa (77086) $261 $261 3.0×
Wrist 2 views (73100) $261 $261 3.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $261 $261 3.0×
X-Ray Bend Only L-S Spine (72120) $321 $321 3.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $261 $261 3.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $321 $321 3.1×
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 4 matching MRF lines		 $261–$275 $261–$275 varies
X-Ray Exam Hip Uni 4/> Views (73503) $321 $321 3.1×
X-Ray Exam Hips Bi 5/> Views (73523) $321 $321 3.1×
X-Ray Exam L-S Spine Bending (72114) $321 $321 3.1×
X-Ray Exam Neck Spine 2-3 Vw (72040) $261 $261 3.0×
X-Ray Exam Neck Spine 6/>Vws (72052) $321 $321 3.1×
X-Ray Exam Unilat Ribs/Chest (71101) $321 $321 3.1×
X-ray humerus (73060) $261 $261 3.0×
X-ray IV pyelogram (ivp) (74400) $541 $541 3.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $261 $261 3.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $321 $321 3.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $321 $321 3.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $321 $321 3.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $261 $261 3.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $261 $261 3.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $321 $321 3.1×
X-Ray Tmj Unilat (70328) $261 $261 3.0×
X-Rays Bone Length Studies (77073) $321 $321 3.1×
X-Rays Bone Survey Complete (77075) $321 $321 3.1×
Xr c-spine 4 or 5 views (72050) $321 $321 3.1×
Xr facial bones less than 3 views (70140) $261 $261 3.0×
Xr orbits complete 4 views (70200) $321 $321 3.1×

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.