Imaging prices at Upland Hills Health
Dodgeville, WI · every code in this section with a posted price and a Medicare benchmark.
234 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) | $180.82 | $334.85 | 2.1× |
| Abdomen 2 views (74019) | $261.98 | $485.15 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,352.97 | $2,505.50 | 3.5× |
| Ankle 2 views (73600) | $258.39 | $478.50 | 3.1× |
| Arthrogram hip (73525) | $378.97 | $701.80 | 1.1× |
| Arthrogram Wrist (73115) | $884.79 | $1,638.50 | 2.6× |
| Bone age studies (77072) | $175.93 | $325.80 | 1.7× |
| Bone Imaging 3 Phase (78315) | $1,334.34 | $2,471 | 3.4× |
| Bone Imaging Limited Area (78300) | $881.42 | $1,632.25 | 2.3× |
| Bone Imaging Whole Body (78306) | $1,292.71 | $2,393.90 | 3.3× |
| Bone survey infant (77076) | $627.08 | $1,161.25 | 6.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,086.29 | $3,863.50 | 1.5× |
| Chest 1 view (71045) | $224.80 | $416.30 | 2.7× |
| Chest 2 views (71046) | $257.45 | $476.75 | 3.0× |
| Chest 3 views (71047) | $284.31 | $526.50 | 3.4× |
| Clavicle complete (73000) | $209.30 | $387.60 | 2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,094.23 | $2,026.35 | 10.8× |
| Contrast X-Ray Bladder (74430) | $223.59 | $414.05 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $3,413.37 | $6,321.05 | 10.1× |
| CT abdomen and pelvis without contrast (74176) | $2,739.58 | $5,073.30 | 11.8× |
| CT abdomen w contrast (74160) | $2,148.39 | $3,978.50 | 12.6× |
| CT abdomen w wo contrast (74170) | $2,436.67 | $4,512.35 | 14.3× |
| CT abdomen w/o contrast (74150) | $1,508.46 | $2,793.45 | 14.9× |
| CT Angio Abdomen and Pelvis (74174) | $3,477.28 | $6,439.40 | 10.3× |
| CT Angio Chest (71275) | $2,685.96 | $4,974 | 15.8× |
| CT Angio Head (70496) | $2,661.90 | $4,929.45 | 15.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,476.79 | $2,734.80 | 8.7× |
| CT Angio Neck (70498) | $2,752.46 | $5,097.15 | 16.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,674.27 | $4,952.35 | 15.7× |
| CT cervical spine w/ contrast (72126) | $1,455.41 | $2,695.20 | 4.3× |
| CT cervical spine w/o contrast (72125) | $1,742.74 | $3,227.30 | 17.2× |
| CT chest w contrast (71260) | $1,785.83 | $3,307.10 | 10.5× |
| CT chest w/wo contrast (71270) | $1,820.31 | $3,370.95 | 10.7× |
| CT head/brain with contrast (70460) | $1,404.24 | $2,600.45 | 8.2× |
| CT head/brain without and with contrast (70470) | $1,468.88 | $2,720.15 | 8.6× |
| CT iac w contrast (70481) | $1,642.09 | $3,040.90 | 9.6× |
| CT l-spine w&w/o contrast (72133) | $1,728.41 | $3,200.75 | 10.1× |
| CT lower ext w/o (73700) | $1,407.54 | $2,606.55 | 13.9× |
| CT lower extremity w/contrast material (73701) | $1,411.24 | $2,613.40 | 8.3× |
| CT lumbar spine w/o contrast (72131) | $1,612.39 | $2,985.90 | 15.9× |
| CT maxillofacial w contrast (70487) | $1,278.77 | $2,368.10 | 7.5× |
| CT maxillofacial wo contrast (70486) | $1,409.99 | $2,611.10 | 13.9× |
| CT neck tissue combo (70492) | $1,874.50 | $3,471.30 | 11.0× |
| CT orbits w/o contrast (70480) | $1,584.41 | $2,934.10 | 15.6× |
| CT pelvis w&w/o contrast (72194) | $2,428.43 | $4,497.10 | 14.3× |
| CT pelvis w/o contrast (72192) | $1,549.64 | $2,869.70 | 15.3× |
| CT scan of leg combo (73702) | $1,740.77 | $3,223.65 | 10.2× |
| CT scans face/jaw combo (70488) | $1,608.36 | $2,978.45 | 9.4× |
| CT soft tissue neck w contrast (70491) | $1,559.71 | $2,888.35 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,175.85 | $2,177.50 | 11.6× |
| CT thoracic spine w contrast (72129) | $1,419.50 | $2,628.70 | 8.3× |
| CT thoracic spine w/o contrast (72128) | $1,408.43 | $2,608.20 | 13.9× |
| CT thoracic spine w/wo cont (72130) | $1,749.03 | $3,238.95 | 10.3× |
| CT thorax w/o contrast (71250) | $1,530.39 | $2,834.05 | 15.1× |
| CT upper ext wo (73200) | $1,431.86 | $2,651.60 | 14.1× |
| CT upper extremity with contrast (73201) | $1,827.25 | $3,383.80 | 5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,765.56 | $6,973.25 | 22.1× |
| Cta Abdomen (74175) | $2,771.66 | $5,132.70 | 16.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,375.43 | $6,250.80 | 10.0× |
| CTA pelvis (72191) | $2,767.53 | $5,125.05 | 16.2× |
| Dxa Bone Density Axial (77080) | $470.18 | $870.70 | 4.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $451.76 | $836.60 | 5.3× |
| Echo exam uterus (76831) | $546.10 | $1,011.30 | 2.4× |
| Esophagram (74220) | $577.56 | $1,069.55 | 3.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $464.67 | $860.50 | 4.6× |
| Fluoroscopy up to 1 hr (76000) | $340.77 | $631.05 | 1.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$144.23–$209.79 | $267.10–$388.50 | varies |
| Forearm 2 views (73090) | $235.28 | $435.70 | 2.8× |
| Gastric emptying imaging study (78264) | $1,618.62 | $2,997.45 | 4.2× |
| Gated Heart Planar Single (78472) | $1,049.76 | $1,944 | 2.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$197.96–$210.22 | $366.60–$389.30 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,764.53 | $3,267.65 | 3.3× |
| Hepatobiliary System Imaging (78226) | $1,298.08 | $2,403.85 | 3.3× |
| Ht Muscle Image Spect Sing (78451) | $1,233.55 | $2,284.35 | 1.0× |
| Hysterosalpingogram (74740) | $617.49 | $1,143.50 | 2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $466.59 | $864.05 | 5.5× |
| Joint Survey Single View (77077) | $261.23 | $483.75 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $1,155.65 | $2,140.10 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $854.87 | $1,583.10 | 1.6× |
| Knee 3 Views (73562) | $269.33 | $498.75 | 3.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,849.34 | $3,424.70 | 3.5× |
| Lymph System Imaging (78195) | $1,330.94 | $2,464.70 | 2.5× |
| Magnetic Image Jaw Joint (70336) | $2,025.32 | $3,750.60 | 8.7× |
| Mammary ductogram or galactogram single (77053) | $312.12 | $578 | 1.3× |
| Meckels Divert Exam (78290) | $1,337.74 | $2,477.30 | 3.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,735.69 | $5,066.10 | 8.1× |
| MRA head w/o contrast (70544) | $1,901.12 | $3,520.60 | 8.2× |
| MRA head with contrast (70545) | $1,803.49 | $3,339.80 | 5.3× |
| MRA neck w contrast (70548) | $1,851.71 | $3,429.10 | 5.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,746.06 | $5,085.30 | 8.1× |
| MRA neck w/o contrast (70547) | $1,811.16 | $3,354 | 7.8× |
| MRI abdomen w contrast (74182) | $2,321.51 | $4,299.10 | 6.9× |
| MRI abdomen w/o contrast (74181) | $1,338.74 | $2,479.15 | 5.8× |
| MRI any jt lower extrem w/contrast material (73722) | $2,476.49 | $4,586.10 | 3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,962.17 | $5,485.50 | 8.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,459.27 | $4,554.20 | 3.2× |
| MRI cervical spine w/o cont (72141) | $2,372.90 | $4,394.25 | 10.2× |
| MRI chest w/o contrast (71550) | $2,793.39 | $5,172.95 | 12.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,223.48 | $4,117.55 | 6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,885.81 | $5,344.10 | 8.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,132 | $3,948.15 | 9.2× |
| MRI lumbar spine w contrast (72149) | $2,857.06 | $5,290.85 | 8.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,254.31 | $6,026.50 | 9.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,658.66 | $4,923.45 | 7.8× |
| MRI pelvis w/o & w contrast (72197) | $2,781.95 | $5,151.75 | 8.2× |
| MRI pelvis w/o contrast (72195) | $2,080.65 | $3,853.05 | 9.0× |
| MRI thoracic spine w/o contrast (72146) | $2,609.77 | $4,832.90 | 11.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,490.29 | $4,611.65 | 10.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,221.64 | $5,966 | 9.5× |
| MRI, abdomen, combo (74183) | $2,708.34 | $5,015.45 | 8.0× |
| MRI, dorsal spine combo (72157) | $3,264.38 | $6,045.15 | 9.6× |
| MRI, dorsal spine contrast (72147) | $2,897.34 | $5,365.45 | 8.6× |
| MRI, joint upper extrem (73221) | $2,236.49 | $4,141.65 | 9.7× |
| MRI, joint upper extrem combo (73223) | $2,972.51 | $5,504.65 | 8.8× |
| MRI, lumbar spine combo (72158) | $3,244.40 | $6,008.15 | 9.6× |
| Myocardial Spect Multiple Studies (78452) | $4,529.74 | $8,388.40 | 3.6× |
| Neck soft tissue (70360) | $198.50 | $367.60 | 2.3× |
| Parathyroid Planar Imaging (78070) | $1,153.74 | $2,136.55 | 3.0× |
| Pelvis 1 or 2 views (72170) | $251.13 | $465.05 | 2.5× |
| Pet Image W/Ct Lmtd (78814) | $3,060.56 | $5,667.70 | 2.2× |
| PET image w/CT, full body (78816) | $4,451.33 | $8,243.20 | 3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,451.33 | $8,243.20 | 3.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $905.77 | $1,677.35 | 2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $294.98 | $546.25 | 2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $261.71 | $484.65 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $175.10 | $324.25 | 2.1× |
| Radex elbow complete minimum 3 views (73080) | $244.84 | $453.40 | 2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $292.11 | $540.95 | 2.9× |
| Radex fingr minimum 2 views (73140) | $269.33 | $498.75 | 3.2× |
| Radex foot complete minimum 3 views (73630) | $241.08 | $446.45 | 2.9× |
| Radex Hand Minimum 3 Views (73130) | $268.30 | $496.85 | 3.2× |
| Radex lower extremity infant minimum 2 views (73592) | $205.93 | $381.35 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $252.50 | $467.60 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $264.87 | $490.50 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) | $264.65 | $490.10 | 3.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $203.69 | $377.20 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $152.74 | $282.85 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $235.14 | $435.45 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $354.89 | $657.20 | 4.2× |
| Radex Toe Minimum 2 Views (73660) | $192.24 | $356 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $200.83 | $371.90 | 2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $280.67 | $519.75 | 3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $666.98 | $1,235.15 | 6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $269.33 | $498.75 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $1,332.05 | $2,466.75 | 7.8× |
| Radiologic exam colon single contrast study (74270) | $874.34 | $1,619.15 | 5.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $640.36 | $1,185.85 | 3.8× |
| Radiologic exam knee complete 4/more views (73564) | $309.39 | $572.95 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $374.65 | $693.80 | 3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $700.27 | $1,296.80 | 4.1× |
| Radiologic exam swallow function contrast study (74230) | $825.85 | $1,529.35 | 4.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $805.84 | $1,492.30 | 4.7× |
| Radiologic examination femur 1 view (73551) | $183.68 | $340.15 | 2.2× |
| Radiologic examination femur minimum 2 views (73552) | $283.66 | $525.30 | 3.4× |
| Radiologic examination knee 1/2 views (73560) | $242.68 | $449.40 | 2.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $380.62 | $704.85 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $249.78 | $462.55 | 3.0× |
| Ribs bilateral 3 views (71110) | $332.34 | $615.45 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,466.21 | $2,715.20 | 2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,821.69 | $3,373.50 | 1.4× |
| Scapula (73010) | $274.62 | $508.55 | 2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $27 | $50 | 1.2× |
| Shoulder 1 view (73020) | $207.63 | $384.50 | 2.5× |
| Shoulder Arthrography (73040) | $873.40 | $1,617.40 | 2.6× |
| Skull less than 4 views (70250) | $232.17 | $429.95 | 2.3× |
| Sternoclavicular joints (71130) | $260.77 | $482.90 | 3.1× |
| Thoracic spine 2 views (72070) | $329.99 | $611.10 | 3.2× |
| Thoracic spine 3 views (72072) | $243.62 | $451.15 | 2.4× |
| Thoracolumbar 2 views (72080) | $315.98 | $585.15 | 3.7× |
| Thyroid Imaging With Vascular Flow (78013) | $766.56 | $1,419.55 | 2.0× |
| Thyroid Uptake Measurement (78012) | $365.20 | $676.30 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $977.59 | $1,810.35 | 2.5× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$474.61–$491.89 | $878.90–$910.90 | varies |
| Ultrasound Exam Aaa Screen (76706) | $524.96 | $972.15 | 5.2× |
| Ultrasound, abdomen limited (76705) | $554.80 | $1,027.40 | 5.5× |
| Umbilical-artery Doppler (OB) (76820) | $321.30 | $595 | 3.2× |
| Unlisted us procedure (76999) | $87.16 | $161.40 | 1.0× |
| Upper gi w/o kub (74240) | $706 | $1,307.40 | 4.1× |
| Urethrocystogram voiding (74455) | $734.48 | $1,360.15 | 3.2× |
| Urethrocystography retrograde (74450) | $133.70 | $247.60 | 0.6× |
| Us breast unilateral complete (76641) | $473.12 | $876.15 | 4.7× |
| Us chest (76604) | $417.91 | $773.90 | 4.1× |
| Us complete joint (76881) | $439.45 | $813.80 | 4.3× |
| Us exam, pelvic, limited (76857) | $415.15 | $768.80 | 4.1× |
| Us head (76506) | $375.54 | $695.45 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $486.78 | $901.45 | 4.8× |
| Us ob limited 1 or more fetuses (76815) | $371.68 | $688.30 | 3.7× |
| Us ob transvaginal (76817) | $349.19 | $646.65 | 3.4× |
| Us pelvic non ob complete (76856) | $555.90 | $1,029.45 | 5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $587.66 | $1,088.25 | 5.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$276.64–$507.95 | $512.30–$940.65 | varies |
| Us retroperitoneal complete (76770) | $684.88 | $1,268.30 | 6.7× |
| Us retroperitoneal limited (76775) | $515.97 | $955.50 | 5.1× |
| Us scrotum and contents (76870) | $545.51 | $1,010.20 | 5.4× |
| Us spinal canal and contents (76800) | $563.27 | $1,043.10 | 5.5× |
| Us thyroid (76536) | $537.08 | $994.60 | 5.3× |
| Us transrectal (76872) | $353.30 | $654.25 | 3.5× |
| Wrist 2 views (73100) | $237.33 | $439.50 | 2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $250.91 | $464.65 | 3.0× |
| X-ray antegrade pyelogram tube (74425) | $934.28 | $1,730.15 | 2.8× |
| X-Ray Bend Only L-S Spine (72120) | $339.07 | $627.90 | 3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $222.64 | $412.30 | 2.6× |
| X-Ray Exam Breast Specimen (76098) | $237.90 | $440.55 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $260.77 | $482.90 | 3.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $471.91 | $873.90 | 4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $535.71 | $992.05 | 5.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $206.55 | $382.50 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $368.31 | $682.05 | 4.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $403.38 | $747 | 4.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $407.97 | $755.50 | 4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $450.28 | $833.85 | 4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $538.73 | $997.65 | 5.3× |
| X-Ray Exam L-S Spine Bending (72114) | $397.76 | $736.60 | 3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $304.61 | $564.10 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $406.24 | $752.30 | 4.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $325.81 | $603.35 | 3.2× |
| X-ray eye for foreign body (70030) | $206.55 | $382.50 | 2.4× |
| X-ray humerus (73060) | $255.58 | $473.30 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $255.04 | $472.30 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $269.33 | $498.75 | 3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $314.55 | $582.50 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $175.10 | $324.25 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $314.98 | $583.30 | 3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $282.26 | $522.70 | 2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $215.03 | $398.20 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $280.99 | $520.35 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $232.17 | $429.95 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $266.46 | $493.45 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $457.70 | $847.60 | 1.4× |
| X-Rays Bone Length Studies (77073) | $274.97 | $509.20 | 2.7× |
| X-Rays Bone Survey Complete (77075) | $718.01 | $1,329.65 | 7.1× |
| Xr c-spine 4 or 5 views (72050) | $410.94 | $761 | 4.0× |
| Xr facial bones less than 3 views (70140) | $189.41 | $350.75 | 2.2× |
| Xr orbits complete 4 views (70200) | $292.11 | $540.95 | 2.9× |
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.