Imaging prices at Thayer County Health Services

Hebron, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $265 $331 2.9×
Abdomen 2 views (74019) $342 $428 3.2×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,258 $1,572 3.0×
Ankle 2 views (73600) $209 $261 2.3×
Bone age studies (77072) $199 $249 1.8×
Bone Imaging 3 Phase (78315) $1,668 $2,085 4.0×
Bone Imaging Limited Area (78300) $1,009 $1,261 2.4×
Bone Imaging Multiple Areas (78305) $1,279 $1,599 3.1×
Bone Imaging Whole Body (78306) $1,524 $1,905 3.7×
Bone survey infant (77076) $460 $575 4.2×
Brain Flow Imaging Only (78610) $1,154 $1,442 2.0×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,886 $2,358 3.3×
Chest 1 view (71045) $258 $323 2.9×
Chest 3 views (71047)
range across 4 matching MRF lines		 $275–$347 $344–$434 varies
Clavicle complete (73000) $261 $326 2.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,946 $2,432 17.9×
Contrast X-Ray Bladder (74430) $886 $1,107 2.4×
CT abdomen and pelvis without and with contrast (74178) $5,389 $5,807 14.9×
CT abdomen and pelvis without contrast (74176) $3,548 $4,435 14.3×
CT abdomen w contrast (74160) $2,196 $2,745 12.1×
CT abdomen w wo contrast (74170) $2,898 $3,622 15.9×
CT abdomen w/o contrast (74150) $2,192 $2,740 20.2×
CT Angio Abdomen and Pelvis (74174) $4,717 $5,896 13.0×
CT Angio Chest (71275) $2,911 $3,639 16.0×
CT Angio Head (70496) $2,403 $3,004 13.2×
CT Angio Neck (70498) $2,631 $3,289 14.4×
CT cervical spine w/ contrast (72126) $2,364 $2,955 6.5×
CT cervical spine w/o contrast (72125) $2,111 $2,639 19.4×
CT cervical spine w/wo cont (72127) $2,182 $2,727 12.0×
CT chest w contrast (71260) $2,337 $2,921 12.8×
CT chest w/wo contrast (71270) $2,530 $3,163 13.9×
CT head/brain with contrast (70460) $2,249 $2,811 12.3×
CT head/brain without and with contrast (70470) $2,138 $2,673 11.7×
CT heart no contrast quant eval coronry calcium (75571) $120 $150 1.3×
CT iac w contrast (70481) $2,230 $2,788 12.2×
CT lower ext w/o (73700) $2,042 $2,552 18.8×
CT lower extremity w/contrast material (73701) $2,048 $2,560 11.2×
CT lumbar spine w contrast (72132) $2,338 $2,923 6.5×
CT lumbar spine w/o contrast (72131) $2,047 $2,559 18.9×
CT maxillofacial w contrast (70487) $1,939 $2,424 10.6×
CT maxillofacial wo contrast (70486) $1,570 $1,963 14.5×
CT neck tissue combo (70492) $2,492 $3,115 13.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,363 $2,954 13.0×
CT orbits w/o contrast (70480) $1,881 $2,351 17.3×
CT pelvis w&w/o contrast (72194) $2,628 $3,285 14.4×
CT pelvis w/o contrast (72192) $1,910 $2,387 17.6×
CT scan of leg combo (73702) $2,297 $2,871 12.6×
CT scans face/jaw combo (70488) $2,015 $2,519 11.1×
CT soft tissue neck w contrast (70491) $2,067 $2,584 11.3×
CT soft tissue neck w/o contrast (70490) $1,817 $2,271 16.7×
CT thoracic spine w contrast (72129) $2,096 $2,620 11.5×
CT thoracic spine w/o contrast (72128) $1,936 $2,420 17.8×
CT thoracic spine w/wo cont (72130) $2,105 $2,631 11.6×
CT thorax w/o contrast (71250) $2,001 $2,501 18.4×
CT upper ext wo (73200) $1,884 $2,355 17.4×
CT upper extremity w/o & w/contrast material (73202) $2,377 $2,971 13.1×
CT upper extremity with contrast (73201)
range across 2 matching MRF lines		 $1,866–$1,942 $2,333–$2,427 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,500 $4,375 19.2×
Cta Abdomen (74175) $2,652 $3,315 14.6×
CTA pelvis (72191) $2,949 $3,686 16.2×
Dxa Bone Density Axial (77080) $396 $495 3.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $299 $374 3.3×
Esophagram (74220) $659 $824 3.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $397 $496 3.7×
Fluoroscopy up to 1 hr (76000) $562 $702 2.3×
Foot 2 views (73620) $200 $250 2.2×
Forearm 2 views (73090) $255 $319 2.8×
Gated Heart Planar Single (78472) $1,651 $2,064 4.0×
Hand 2 views (73120) $188 $235 1.7×
Hepatobil Syst Image W/Drug (78227) $1,669 $2,086 3.0×
Hepatobiliary System Imaging (78226) $1,385 $1,731 3.3×
K Flow/Funct Image W/Drug (78708) $1,299 $1,624 2.3×
K Flow/Funct Image W/O Drug (78707) $1,194 $1,492 2.1×
Kidney Imaging Morphol (78700) $1,258 $1,572 3.0×
Knee 3 Views (73562) $308 $385 3.4×
Liver & Spleen Imaging Static Only (78215) $1,292 $1,615 3.1×
Lung Ventilat&Perfus Imaging (78582) $1,752 $2,190 3.1×
Lung Ventilation Imaging (78579) $1,514 $1,893 3.6×
Magnetic Image Jaw Joint (70336) $1,804 $2,255 7.3×
Meckels Divert Exam (78290) $1,218 $1,523 2.9×
Mra Head W/O & W/Contrast Material (70546) $5,670 $7,088 15.7×
MRA head w/o contrast (70544) $2,585 $3,231 10.4×
MRA head with contrast (70545) $4,543 $5,679 12.5×
MRA neck w contrast (70548) $2,589 $3,236 7.1×
Mra Neck W/O &W/Contrast Material (70549) $3,102 $3,878 8.6×
MRA neck w/o contrast (70547) $2,117 $2,646 8.5×
MRI abdomen w/o contrast (74181) $2,913 $3,641 11.8×
MRI any jt lower extrem w/contrast material (73722)
range across 2 matching MRF lines		 $3,037–$3,158 $3,796–$3,948 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,116 $3,895 8.6×
MRI any jt upper extremity w/contrast matrl (73222) $3,158 $3,948 3.9×
MRI cervical spine w contrast (72142) $3,207 $4,009 8.9×
MRI cervical spine w/o cont (72141) $2,846 $3,557 11.5×
MRI chest w/o contrast (71550) $2,974 $3,717 12.0×
MRI chest wo w contrast (71552) $3,345 $4,181 9.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,991 $3,739 8.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,295 $2,869 9.3×
MRI lumbar spine w contrast (72149) $2,683 $3,354 7.4×
Mri Neck Spine W/O & W/Dye (72156) $3,849 $4,811 10.6×
MRI orbit face &/neck w/o contrast (70540) $2,843 $3,554 11.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,964 $3,705 8.2×
MRI pelvis w contrast (72196) $2,751 $3,439 7.6×
MRI pelvis w/o & w contrast (72197) $3,413 $4,266 9.4×
MRI pelvis w/o contrast (72195) $2,259 $2,824 9.1×
MRI thoracic spine w/o contrast (72146) $2,688 $3,360 10.8×
MRI upper extremity oth than jt w/contr matrl (73219) $2,463 $3,079 6.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,142 $2,677 8.6×
Mri Uppr Extremity W/O&W/Dye (73220) $2,778 $3,473 7.7×
MRI, abdomen, combo (74183) $4,109 $5,136 11.3×
MRI, dorsal spine combo (72157) $3,368 $4,210 9.3×
MRI, dorsal spine contrast (72147) $3,230 $4,038 8.9×
MRI, joint upper extrem (73221) $2,189 $2,736 8.8×
MRI, joint upper extrem combo (73223) $2,880 $3,600 7.9×
MRI, lumbar spine combo (72158) $3,346 $4,182 9.2×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $1,257 $1,571 3.0×
Myocardial Spect Multiple Studies (78452) $3,760 $4,700 2.8×
Neck soft tissue (70360) $284 $355 3.1×
Parathyroid Planar Imaging (78070) $1,012 $1,265 2.4×
Pelvis 1 or 2 views (72170) $251 $314 2.3×
PET image w/CT, full body (78816) $5,016 $6,270 3.4×
PET imaging CT attenuation skull base mid-thigh (78815) $6,160 $7,700 4.1×
Pulmonary Perfusion Imaging Particulate (78580) $1,174 $1,467 2.8×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $498 $622 4.6×
Radex Ankle Complete Minimum 3 Views (73610) $280 $350 3.1×
Radex Calcaneus Minimum 2 Views (73650)
range across 2 matching MRF lines		 $194–$202 $242–$252 varies
Radex elbow complete minimum 3 views (73080) $278 $348 3.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $343 $429 3.2×
Radex fingr minimum 2 views (73140) $195 $244 2.2×
Radex foot complete minimum 3 views (73630) $296 $370 3.3×
Radex Hand Minimum 3 Views (73130) $258 $322 2.9×
Radex lower extremity infant minimum 2 views (73592) $196 $245 2.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $295 $369 3.3×
Radex Ribs Unilateral 2 Views (71100) $278 $348 3.1×
Radex shoulder complete minimum 2 views (73030) $327 $409 3.6×
Radex Sinuses Paransl < 3 Views (70210) $188 $235 2.1×
Radex Spine 1 View Specify Level (72020) $201 $251 2.2×
Radex Sternum Minimum 2 Views (71120) $232 $290 2.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $298 $373 3.3×
Radex Toe Minimum 2 Views (73660) $201 $251 2.2×
Radex upper extremity infant minimum 2 views (73092) $154 $193 1.4×
Radex Wrist Complete Minimum 3 Views (73110) $251 $314 2.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $582 $727 5.4×
Radiolog exam mandible compl minimum 4 views (70110) $362 $452 3.3×
Radiologic exam colon double contrast study (74280) $909 $1,136 5.0×
Radiologic exam colon single contrast study (74270) $669 $836 3.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $821 $821 4.5×
Radiologic exam knee complete 4/more views (73564) $344 $430 3.2×
Radiologic Exam Small Int Single Contrast Study (74250) $587 $734 3.2×
Radiologic exam swallow function contrast study (74230) $510 $638 2.8×
Radiologic exam upr gi trc double contrast study (74246) $700 $875 3.8×
Radiologic examination femur 1 view (73551) $222 $278 2.5×
Radiologic examination femur minimum 2 views (73552) $290 $362 3.2×
Radiologic examination knee 1/2 views (73560) $246 $308 2.7×
Radiologic Examination Osseous Survey Limited (77074) $593 $741 5.5×
Radiologic examination tibia & fibula 2 views (73590) $259 $324 2.9×
Ribs bilateral 3 views (71110)
range across 2 matching MRF lines		 $361–$363 $451–$454 varies
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines		 $2,032–$2,190 $2,540–$2,738 varies
Scapula (73010) $305 $381 2.8×
Screening Digital Breast Tomosynthesis Bi (77063) $110 $138 4.7×
Shoulder 1 view (73020) $222 $277 2.5×
Shoulder Arthrography (73040) $791 $989 2.2×
Skull less than 4 views (70250) $275 $344 2.5×
Sternoclavicular joints (71130) $196 $245 2.2×
Testicular Imaging W/Flow (78761) $1,258 $1,572 3.0×
Thoracic spine 2 views (72070) $299 $374 2.8×
Thoracic spine 3 views (72072) $508 $635 4.7×
Thoracolumbar 2 views (72080) $296 $370 3.3×
Ultrasound Breast Limited (76642) $356 $445 3.9×
Ultrasound Exam Aaa Screen (76706) $486 $607 4.5×
Ultrasound, abdomen limited (76705) $622 $777 5.7×
Upper gi w/o kub (74240)
range across 2 matching MRF lines		 $470–$509 $588–$636 varies
Urethrocystogram voiding (74455) $668 $835 2.7×
Us breast unilateral complete (76641) $439 $549 4.0×
Us chest (76604) $472 $590 4.3×
Us complete joint (76881) $444 $555 4.1×
Us exam, pelvic, limited (76857) $378 $472 3.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $484 $605 4.5×
Us ob limited 1 or more fetuses (76815) $398 $498 3.7×
Us ob transvaginal (76817) $504 $630 4.6×
Us pelvic non ob complete (76856) $648 $810 6.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $651 $814 6.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $355 $444 3.3×
Us retroperitoneal complete (76770) $636 $795 5.9×
Us retroperitoneal limited (76775) $584 $730 5.4×
Us scrotum and contents (76870) $577 $721 5.3×
Us thyroid (76536) $602 $752 5.5×
Venous Thrombosis Imaging Venogram Bilateral (78458) $943 $1,179 2.3×
Wrist 2 views (73100) $222 $277 2.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $236 $295 2.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $219 $274 2.4×
X-Ray Exam Entire Spi 1 Vw (72081) $252 $315 2.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $403 $504 3.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $485 $606 4.5×
X-Ray Exam Hip Uni 1 View (73501) $266 $333 2.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $413 $516 4.6×
X-Ray Exam Hip Uni 4/> Views (73503) $270 $337 2.5×
X-Ray Exam Hips Bi 2 Views (73521) $432 $540 4.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $466 $583 4.3×
X-Ray Exam Hips Bi 5/> Views (73523) $501 $626 4.6×
X-Ray Exam L-S Spine Bending (72114) $594 $742 5.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $282 $352 3.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $698 $872 6.4×
X-Ray Exam Unilat Ribs/Chest (71101) $363 $454 3.3×
X-ray humerus (73060) $262 $327 2.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $238 $297 2.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $344 $430 3.2×
X-ray nose-rectum child f.b. (76010) $286 $358 3.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $353 $441 3.3×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $375 $469 3.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $282 $353 3.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $211 $264 2.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $406 $508 3.7×
X-Ray Tmj Unilat (70328) $210 $263 2.3×
X-Rays Bone Length Studies (77073) $352 $440 3.2×
X-Rays Bone Survey Complete (77075) $654 $818 6.0×
Xr c-spine 4 or 5 views (72050) $443 $554 4.1×
Xr facial bones less than 3 views (70140) $180 $225 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.