Imaging prices at South Big Horn County Hospital (Three Rivers Health)
Basin, WY · every code in this section with a posted price and a Medicare benchmark.
196 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) | $223.88 | $298.50 | 2.5× |
| Abdomen 2 views (74019) | $194.92 | $259.90 | 1.8× |
| Ankle 2 views (73600) | $123.82 | $165.10 | 1.4× |
| Bone age studies (77072) | $58.20 | $77.60 | 0.5× |
| Bone survey infant (77076) | $333 | $444 | 3.1× |
| Cat Scan Follow-Up Study (76380) | $519.38 | $692.50 | 5.8× |
| Chest 1 view (71045) | $165 | $220 | 1.9× |
| Chest 2 views (71046) | $185.85 | $247.80 | 2.1× |
| Chest 3 views (71047) | $178.27 | $237.70 | 2.0× |
| Chest 4 or more views (71048) | $151.50 | $202 | 1.4× |
| Clavicle complete (73000) | $109.28 | $145.70 | 1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $871.65 | $1,162.20 | 8.2× |
| CT abdomen and pelvis without and with contrast (74178) | $2,765.18 | $3,686.90 | 7.8× |
| CT abdomen and pelvis without contrast (74176) | $1,161.90 | $1,549.20 | 4.8× |
| CT abdomen w contrast (74160) | $1,271.55 | $1,695.40 | 7.1× |
| CT abdomen w wo contrast (74170) | $1,881.90 | $2,509.20 | 10.5× |
| CT abdomen w/o contrast (74150) | $735 | $980 | 6.9× |
| CT Angio Abdomen and Pelvis (74174) | $1,716.98 | $2,289.30 | 4.8× |
| CT Angio Chest (71275) | $1,435.57 | $1,914.10 | 8.0× |
| CT Angio Head (70496) | $1,180.57 | $1,574.10 | 6.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,556.32 | $2,075.10 | 8.7× |
| CT Angio Neck (70498) | $1,325.32 | $1,767.10 | 7.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,336.95 | $1,782.60 | 7.5× |
| CT bone density (77078) | $385.72 | $514.30 | 4.3× |
| CT cervical spine w/ contrast (72126) | $1,386.22 | $1,848.30 | 3.9× |
| CT cervical spine w/o contrast (72125) | $1,110 | $1,480 | 10.4× |
| CT cervical spine w/wo cont (72127) | $1,485.15 | $1,980.20 | 8.3× |
| CT chest w contrast (71260) | $1,459.88 | $1,946.50 | 8.1× |
| CT chest w/wo contrast (71270) | $1,783.35 | $2,377.80 | 10.0× |
| CT head/brain with contrast (70460) | $1,420.80 | $1,894.40 | 7.9× |
| CT head/brain without and with contrast (70470) | $1,296.82 | $1,729.10 | 7.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $141.98 | $189.30 | 1.6× |
| CT iac w contrast (70481) | $988.20 | $1,317.60 | 5.5× |
| CT l-spine w&w/o contrast (72133) | $1,935.75 | $2,581 | 10.8× |
| CT lower ext w/o (73700) | $964.50 | $1,286 | 9.0× |
| CT lower extremity w/contrast material (73701) | $976.58 | $1,302.10 | 5.4× |
| CT lumbar spine w contrast (72132) | $1,565.93 | $2,087.90 | 4.4× |
| CT lumbar spine w/o contrast (72131) | $1,327.05 | $1,769.40 | 12.4× |
| CT maxillofacial w contrast (70487) | $1,059.60 | $1,412.80 | 5.9× |
| CT maxillofacial wo contrast (70486) | $1,022.62 | $1,363.50 | 9.6× |
| CT neck tissue combo (70492) | $1,281.07 | $1,708.10 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,141.28 | $1,521.70 | 6.4× |
| CT orbits w/o contrast (70480) | $855.82 | $1,141.10 | 8.0× |
| CT pelvis w&w/o contrast (72194) | $2,157.68 | $2,876.90 | 12.0× |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$848.78–$2,765.18 | $1,131.70–$3,686.90 | varies |
| CT scan of leg combo (73702) | $1,271.70 | $1,695.60 | 7.1× |
| CT scans face/jaw combo (70488) | $1,141.28 | $1,521.70 | 6.4× |
| CT soft tissue neck w contrast (70491) | $1,179.60 | $1,572.80 | 6.6× |
| CT soft tissue neck w/o contrast (70490) | $1,001.40 | $1,335.20 | 9.4× |
| CT thoracic spine w contrast (72129) | $1,565.93 | $2,087.90 | 8.7× |
| CT thoracic spine w/o contrast (72128) | $1,327.05 | $1,769.40 | 12.4× |
| CT thoracic spine w/wo cont (72130) | $1,692.15 | $2,256.20 | 9.4× |
| CT thorax w/o contrast (71250) | $1,144.43 | $1,525.90 | 10.7× |
| CT upper ext wo (73200) | $1,029.68 | $1,372.90 | 9.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,475.25 | $1,967 | 8.2× |
| CT upper extremity with contrast (73201) | $1,175.18 | $1,566.90 | 3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,964.25 | $2,619 | 11.0× |
| Cta Abdomen (74175) | $1,435.57 | $1,914.10 | 8.0× |
| CTA pelvis (72191) | $1,815.68 | $2,420.90 | 10.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $208.65 | $278.20 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $378.22 | $504.30 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $254.18 | $338.90 | 2.4× |
| Foot 2 views (73620) | $123.82 | $165.10 | 1.4× |
| Forearm 2 views (73090) | $123.82 | $165.10 | 1.4× |
| Hand 2 views (73120) | $123.82 | $165.10 | 1.2× |
| Joint Survey Single View (77077) | $195.38 | $260.50 | 1.8× |
| Knee 3 Views (73562) | $161.02 | $214.70 | 1.8× |
| MRA head w/o contrast (70544) | $1,125 | $1,500 | 4.6× |
| MRI abdomen w contrast (74182) | $1,224.97 | $1,633.30 | 3.4× |
| MRI abdomen w/o contrast (74181) | $962.18 | $1,282.90 | 3.9× |
| MRI any jt lower extrem w/contrast material (73722) | $1,052.78 | $1,403.70 | 1.3× |
| MRI cervical spine w contrast (72142) | $1,359.60 | $1,812.80 | 3.8× |
| MRI cervical spine w/o cont (72141) | $1,011.75 | $1,349 | 4.2× |
| MRI chest w/o contrast (71550) | $1,114.57 | $1,486.10 | 4.6× |
| MRI chest with contrast (71551) | $1,010.32 | $1,347.10 | 1.3× |
| MRI chest wo w contrast (71552) | $1,578 | $2,104 | 4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,052.78 | $1,403.70 | 3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,035.38 | $1,380.50 | 4.2× |
| MRI lumbar spine w contrast (72149) | $1,050.60 | $1,400.80 | 2.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,572.60 | $2,096.80 | 4.4× |
| MRI orbit face &/neck w/o contrast (70540) | $923.70 | $1,231.60 | 3.8× |
| MRI orbit face neck w contrast (70542) | $1,112.40 | $1,483.20 | 3.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,579.31 | $2,105.75 | 4.4× |
| MRI pelvis w contrast (72196) | $1,378.95 | $1,838.60 | 3.9× |
| MRI pelvis w/o & w contrast (72197) | $1,661.25 | $2,215 | 4.7× |
| MRI pelvis w/o contrast (72195) | $950.55 | $1,267.40 | 3.9× |
| MRI thoracic spine w/o contrast (72146) | $1,106.85 | $1,475.80 | 4.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,112.40 | $1,483.20 | 3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $904.05 | $1,205.40 | 3.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,317.30 | $1,756.40 | 3.7× |
| MRI, abdomen, combo (74183) | $1,707.82 | $2,277.10 | 4.8× |
| MRI, dorsal spine combo (72157) | $1,603.50 | $2,138 | 4.5× |
| MRI, dorsal spine contrast (72147) | $990.97 | $1,321.30 | 2.8× |
| MRI, joint upper extrem (73221) | $1,027.65 | $1,370.20 | 4.2× |
| MRI, joint upper extrem combo (73223) | $1,464.07 | $1,952.10 | 4.1× |
| MRI, lumbar spine combo (72158) | $1,603.50 | $2,138 | 4.5× |
| Neck soft tissue (70360) | $110.10 | $146.80 | 1.2× |
| Ob us nuchal meas 1 gest (76813) | $234.08 | $312.10 | 2.2× |
| Pelvis 1 or 2 views (72170) | $176.40 | $235.20 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $281.33 | $375.10 | 2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $132.90 | $177.20 | 1.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $123.82 | $165.10 | 1.4× |
| Radex elbow complete minimum 3 views (73080) | $132.90 | $177.20 | 1.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $237.75 | $317 | 2.2× |
| Radex fingr minimum 2 views (73140) | $105.98 | $141.30 | 1.2× |
| Radex foot complete minimum 3 views (73630) | $132.90 | $177.20 | 1.5× |
| Radex Hand Minimum 3 Views (73130) | $132.90 | $177.20 | 1.5× |
| Radex lower extremity infant minimum 2 views (73592) | $123.82 | $165.10 | 1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $180.75 | $241 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $179.70 | $239.60 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $141.82 | $189.10 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) | $272.25 | $363 | 3.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $121.35 | $161.80 | 1.4× |
| Radex Spine 1 View Specify Level (72020) | $124.20 | $165.60 | 1.4× |
| Radex Sternum Minimum 2 Views (71120) | $125.25 | $167 | 1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $206.10 | $274.80 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $105.98 | $141.30 | 1.2× |
| Radex upper extremity infant minimum 2 views (73092) | $98.40 | $131.20 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $152.62 | $203.50 | 1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $484.12 | $645.50 | 4.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $159.38 | $212.50 | 1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $287.17 | $382.90 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) | $166.12 | $221.50 | 1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $333.15 | $444.20 | 3.1× |
| Radiologic examination femur 1 view (73551) | $123.82 | $165.10 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) | $163.73 | $218.30 | 1.8× |
| Radiologic examination knee 1/2 views (73560) | $126 | $168 | 1.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $277.27 | $369.70 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $123.82 | $165.10 | 1.4× |
| Ribs bilateral 3 views (71110) | $244.35 | $325.80 | 2.3× |
| Scapula (73010) | $123.45 | $164.60 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $105.45 | $140.60 | 4.5× |
| Sella turcica (70240) | $149.18 | $198.90 | 1.7× |
| Shoulder 1 view (73020) | $111.82 | $149.10 | 1.3× |
| Skull less than 4 views (70250) | $177.15 | $236.20 | 1.7× |
| Sternoclavicular joints (71130) | $191.48 | $255.30 | 2.2× |
| Thoracic spine 2 views (72070) | $169.65 | $226.20 | 1.6× |
| Thoracic spine 3 views (72072) | $258.38 | $344.50 | 2.4× |
| Thoracolumbar 2 views (72080) | $144.38 | $192.50 | 1.6× |
| Ultrasound Breast Limited (76642) | $40.80 | $54.40 | 0.5× |
| Ultrasound Exam Aaa Screen (76706) | $243.38 | $324.50 | 2.3× |
| Ultrasound, abdomen limited (76705) | $368.85 | $491.80 | 3.5× |
| Us breast unilateral complete (76641) | $292.65 | $390.20 | 2.7× |
| Us chest (76604) | $266.70 | $355.60 | 2.5× |
| Us complete joint (76881) | $276.38 | $368.50 | 2.6× |
| Us exam, pelvic, limited (76857) | $382.80 | $510.40 | 3.6× |
| Us kidney transplant (76776) | $555.45 | $740.60 | 5.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $368.85 | $491.80 | 3.5× |
| Us ob detailed single fetus (76811) | $148.12 | $197.50 | 0.6× |
| Us ob limited 1 or more fetuses (76815) | $308.02 | $410.70 | 2.9× |
| Us ob transvaginal (76817) | $176.85 | $235.80 | 1.7× |
| Us pelvic non ob complete (76856) | $458.62 | $611.50 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $185.62 | $247.50 | 1.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $151.73 | $202.30 | 1.4× |
| Us retroperitoneal complete (76770) | $510.60 | $680.80 | 4.8× |
| Us retroperitoneal limited (76775) | $302.77 | $403.70 | 2.8× |
| Us scrotum and contents (76870) | $293.92 | $391.90 | 2.8× |
| Us spinal canal and contents (76800) | $482.78 | $643.70 | 4.5× |
| Us thyroid (76536) | $470.10 | $626.80 | 4.4× |
| Wrist 2 views (73100) | $123.82 | $165.10 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $227.70 | $303.60 | 2.6× |
| X-Ray Bend Only L-S Spine (72120) | $187.50 | $250 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $123.82 | $165.10 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $131.85 | $175.80 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $119.25 | $159 | 1.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $379.80 | $506.40 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $118.80 | $158.40 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $262.12 | $349.50 | 2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $152.02 | $202.70 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $281.77 | $375.70 | 2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $245.40 | $327.20 | 2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $286.20 | $381.60 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) | $310.05 | $413.40 | 2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $108.98 | $145.30 | 1.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $388.28 | $517.70 | 3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $154.35 | $205.80 | 1.4× |
| X-ray eye for foreign body (70030) | $166.12 | $221.50 | 1.9× |
| X-ray humerus (73060) | $135.38 | $180.50 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $183.60 | $244.80 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $126 | $168 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $214.05 | $285.40 | 2.0× |
| X-ray nose-rectum child f.b. (76010) | $117.75 | $157 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $245.02 | $326.70 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $259.58 | $346.10 | 2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $152.32 | $203.10 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $274.73 | $366.30 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $146.55 | $195.40 | 1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $195.98 | $261.30 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $253.27 | $337.70 | 2.4× |
| X-Ray Tmj Unilat (70328) | $177.15 | $236.20 | 2.0× |
| X-Rays Bone Length Studies (77073) | $203.18 | $270.90 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $549.75 | $733 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $298.95 | $398.60 | 2.8× |
| Xr facial bones less than 3 views (70140) | $108.82 | $145.10 | 1.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $166.12 | $221.50 | 1.6× |
| Xr orbits complete 4 views (70200) | $124.88 | $166.50 | 1.2× |
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.