Imaging prices at Vernon Health Hospital

Viroqua, WI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $405 $405 4.8×
Abdomen 2 views (74019) $615 $615 6.1×
Ankle 2 views (73600) $319 $319 3.8×
Bone age studies (77072) $247 $247 2.4×
Bone Imaging 3 Phase (78315) $3,483 $3,483 9.0×
Bone Imaging Whole Body (78306) $1,407 $1,407 3.6×
Chest 1 view (71045) $346 $346 4.1×
Chest 2 views (71046) $472 $472 5.6×
Clavicle complete (73000) $370 $370 4.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $332 $332 3.3×
CT abdomen and pelvis without and with contrast (74178) $7,188 $7,188 21.2×
CT abdomen and pelvis without contrast (74176) $3,288 $3,288 14.2×
CT abdomen w contrast (74160) $3,204 $3,204 18.8×
CT abdomen w wo contrast (74170) $4,006 $4,006 23.5×
CT abdomen w/o contrast (74150) $2,576 $2,576 25.4×
CT Angio Abdomen and Pelvis (74174) $4,215 $4,215 12.4×
CT Angio Chest (71275) $3,442 $3,442 20.2×
CT Angio Head (70496) $5,368 $5,368 31.5×
Ct Angio Lwr Extr W/O&W/Dye (73706) $5,374 $5,374 31.5×
CT Angio Neck (70498) $3,670 $3,670 21.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $5,149 $5,149 30.2×
CT cervical spine w/ contrast (72126) $2,290 $2,290 6.8×
CT cervical spine w/o contrast (72125) $2,773 $2,773 27.3×
CT chest w contrast (71260) $3,184 $3,184 18.7×
CT chest w/wo contrast (71270) $2,707 $2,707 15.9×
CT head/brain with contrast (70460) $2,551 $2,551 15.0×
CT head/brain without and with contrast (70470) $3,461 $3,461 20.3×
CT iac w contrast (70481) $2,704 $2,704 15.9×
CT lower ext w/o (73700) $2,457 $2,457 24.2×
CT lower extremity w/contrast material (73701) $2,707 $2,707 15.9×
CT lumbar spine w contrast (72132) $1,274 $1,274 3.8×
CT lumbar spine w/o contrast (72131) $2,747 $2,747 27.1×
CT maxillofacial w contrast (70487) $2,704 $2,704 15.9×
CT maxillofacial wo contrast (70486) $2,255 $2,255 22.2×
CT neck tissue combo (70492) $3,461 $3,461 20.3×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,338 $2,338 13.7×
CT orbits w/o contrast (70480) $2,332 $2,332 23.0×
CT pelvis w/o contrast (72192) $2,789 $2,789 27.5×
CT soft tissue neck w contrast (70491) $2,704 $2,704 15.9×
CT soft tissue neck w/o contrast (70490) $2,332 $2,332 23.0×
CT thoracic spine w contrast (72129) $3,196 $3,196 18.8×
CT thoracic spine w/o contrast (72128) $2,747 $2,747 27.1×
CT thorax w/o contrast (71250) $2,803 $2,803 27.6×
CT upper ext wo (73200) $2,434 $2,434 24.0×
CT upper extremity with contrast (73201) $674 $674 2.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,215 $4,215 24.7×
Cta Abdomen (74175) $4,209 $4,209 24.7×
Dxa Bone Density Axial (77080) $696 $696 6.9×
Dxa bone density study (77085) $671 $671 6.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $687 $687 8.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $809 $809 8.0×
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines		 $930–$986 $930–$986 varies
Foot 2 views (73620) $418 $418 4.9×
Forearm 2 views (73090) $370 $370 4.4×
Hand 2 views (73120) $444 $444 4.4×
Hepatobil Syst Image W/Drug (78227) $1,261 $1,261 2.4×
Ht Muscle Image Spect Sing (78451) $1,841 $1,841 1.5×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,321 $1,321 15.6×
Knee 3 Views (73562) $448 $448 5.3×
Mra Head W/O & W/Contrast Material (70546) $5,624 $5,624 16.6×
MRA head w/o contrast (70544) $4,093 $4,093 17.7×
Mra Neck W/O &W/Contrast Material (70549) $4,217 $4,217 12.4×
MRA neck w/o contrast (70547) $3,727 $3,727 16.1×
MRI abdomen w/o contrast (74181) $3,091 $3,091 13.3×
MRI any jt lower extrem w/contrast material (73722) $3,298 $3,298 4.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,974 $3,974 11.7×
MRI any jt upper extremity w/contrast matrl (73222) $3,917 $3,917 5.1×
MRI cervical spine w/o cont (72141) $3,215 $3,215 13.9×
MRI chest wo w contrast (71552) $5,038 $5,038 14.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,327 $4,327 12.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,215 $3,215 13.9×
Mri Neck Spine W/O & W/Dye (72156) $4,093 $4,093 12.1×
MRI orbit face &/neck w/o contrast (70540) $3,033 $3,033 13.1×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,225 $4,225 12.5×
MRI pelvis w/o contrast (72195) $3,091 $3,091 13.3×
MRI thoracic spine w/o contrast (72146) $3,215 $3,215 13.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,378 $3,378 14.6×
MRI, abdomen, combo (74183) $4,093 $4,093 12.1×
MRI, dorsal spine combo (72157) $4,093 $4,093 12.1×
MRI, joint upper extrem (73221) $3,215 $3,215 13.9×
MRI, joint upper extrem combo (73223) $3,861 $3,861 11.4×
MRI, lumbar spine combo (72158) $4,093 $4,093 12.1×
Myocardial Spect Multiple Studies (78452) $2,783 $2,783 2.2×
Neck soft tissue (70360) $296 $296 3.5×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $96 $96 0.9×
Pelvis 1 or 2 views (72170) $492 $492 4.8×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $805 $805 7.9×
Radex Ankle Complete Minimum 3 Views (73610) $444 $444 5.3×
Radex Calcaneus Minimum 2 Views (73650) $357 $357 4.2×
Radex elbow complete minimum 3 views (73080) $418 $418 4.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $639 $639 6.3×
Radex fingr minimum 2 views (73140) $109 $109 1.3×
Radex foot complete minimum 3 views (73630) $397 $397 4.7×
Radex Hand Minimum 3 Views (73130) $444 $444 5.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $492 $492 5.8×
Radex Ribs Unilateral 2 Views (71100) $492 $492 5.8×
Radex shoulder complete minimum 2 views (73030) $614 $614 7.3×
Radex Spine 1 View Specify Level (72020) $250 $250 3.0×
Radex Sternum Minimum 2 Views (71120) $474 $474 5.6×
Radex Toe Minimum 2 Views (73660) $319 $319 3.8×
Radex Wrist Complete Minimum 3 Views (73110) $419 $419 5.0×
Radiologic exam knee complete 4/more views (73564) $621 $621 6.1×
Radiologic exam pelvis compl minimum 3 views (72190) $584 $584 5.8×
Radiologic Exam Small Int Single Contrast Study (74250) $2,120 $2,120 12.4×
Radiologic exam swallow function contrast study (74230) $1,508 $1,508 8.9×
Radiologic examination femur minimum 2 views (73552) $444 $444 5.3×
Radiologic examination knee 1/2 views (73560) $392 $392 4.6×
Radiologic examination tibia & fibula 2 views (73590) $418 $418 4.9×
Scapula (73010) $418 $418 4.1×
Screening Digital Breast Tomosynthesis Bi (77063) $143 $143 6.1×
Shoulder 1 view (73020) $492 $492 5.8×
Skull less than 4 views (70250) $444 $444 4.4×
Thoracic spine 2 views (72070) $492 $492 4.8×
Thoracic spine 3 views (72072) $492 $492 4.8×
Thoracolumbar 2 views (72080) $492 $492 5.8×
Ultrasound Breast Limited (76642) $309 $309 3.7×
Ultrasound Exam Aaa Screen (76706) $953 $953 9.4×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $96–$925 $96–$925 varies
Umbilical-artery Doppler (OB) (76820) $220 $220 2.2×
Us chest (76604)
range across 2 matching MRF lines		 $92–$925 $92–$925 varies
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $96–$751 $96–$751 varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $96–$708 $96–$708 varies
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $96–$578 $96–$578 varies
Us ob transvaginal (76817) $578 $578 5.7×
Us pelvic non ob complete (76856) $925 $925 9.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $720 $720 7.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $789 $789 7.8×
Us retroperitoneal complete (76770) $1,386 $1,386 13.6×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $96–$925 $96–$925 varies
Us scrotum and contents (76870) $1,040 $1,040 10.2×
Us thyroid (76536) $925 $925 9.1×
Wrist 2 views (73100) $363 $363 4.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $470 $470 5.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $444 $444 5.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $187 $187 1.8×
X-Ray Exam Hip Uni 1 View (73501) $492 $492 5.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $497 $497 5.9×
X-Ray Exam Hip Uni 4/> Views (73503) $671 $671 6.6×
X-Ray Exam Hips Bi 2 Views (73521) $433 $433 4.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $527 $527 5.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $492 $492 5.8×
X-Ray Exam Unilat Ribs/Chest (71101) $567 $567 5.6×
X-ray eye for foreign body (70030) $399 $399 4.7×
X-ray humerus (73060) $444 $444 5.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $421 $421 5.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $754 $754 8.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $492 $492 4.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,007 $1,007 9.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $418 $418 4.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $418 $418 4.9×
X-Rays Bone Length Studies (77073) $322 $322 3.2×
Xr c-spine 4 or 5 views (72050) $762 $762 7.5×

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.