Imaging prices at Wallowa Memorial Hospital

Enterprise, OR · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $324 $324 3.3×
Abdomen 2 views (74019) $449 $449 3.9×
Ankle 2 views (73600)
range across 2 matching MRF lines		 $264–$277 $264–$277 varies
Bone age studies (77072) $387 $387 3.3×
Chest 1 view (71045) $357 $357 3.7×
Chest 2 views (71046) $415 $415 4.3×
Chest 4 or more views (71048) $408 $408 3.5×
Clavicle complete (73000) $308 $308 3.2×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,909 $1,909 16.4×
CT abdomen and pelvis without and with contrast (74178) $4,835 $4,835 12.5×
CT abdomen and pelvis without contrast (74176) $3,990 $3,990 15.0×
CT abdomen w contrast (74160) $2,554 $2,554 13.1×
CT abdomen w wo contrast (74170) $2,762 $2,762 14.2×
CT abdomen w/o contrast (74150) $2,130 $2,130 18.3×
CT Angio Abdomen and Pelvis (74174) $4,374 $4,374 11.3×
CT Angio Chest (71275) $3,286 $3,286 16.9×
CT Angio Head (70496) $3,230 $3,230 16.6×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,980 $2,980 15.3×
CT Angio Neck (70498) $3,230 $3,230 16.6×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,870 $2,870 14.7×
CT cervical spine w/ contrast (72126) $2,389 $2,389 6.2×
CT cervical spine w/o contrast (72125) $2,101 $2,101 18.1×
CT cervical spine w/wo cont (72127) $2,619 $2,619 13.4×
CT chest w contrast (71260) $2,562 $2,562 13.1×
CT chest w/wo contrast (71270) $3,260 $3,260 16.7×
CT head/brain with contrast (70460) $2,010 $2,010 10.3×
CT head/brain without and with contrast (70470) $2,694 $2,694 13.8×
CT iac w contrast (70481) $1,976 $1,976 10.1×
CT lower ext w/o (73700) $1,957 $1,957 16.8×
CT lower extremity w/contrast material (73701) $2,294 $2,294 11.8×
CT lumbar spine w contrast (72132) $2,486 $2,486 6.4×
CT lumbar spine w/o contrast (72131) $2,052 $2,052 17.7×
CT maxillofacial w contrast (70487) $2,112 $2,112 10.8×
CT maxillofacial wo contrast (70486) $1,599 $1,599 13.8×
CT neck tissue combo (70492) $2,549 $2,549 13.1×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,300 $2,300 11.8×
CT orbits w/o contrast (70480) $1,805 $1,805 15.5×
CT pelvis w/o contrast (72192) $2,065 $2,065 17.8×
CT scan of leg combo (73702) $2,250 $2,250 11.5×
CT scans face/jaw combo (70488) $2,348 $2,348 12.0×
CT soft tissue neck w contrast (70491) $2,187 $2,187 11.2×
CT soft tissue neck w/o contrast (70490) $1,886 $1,886 16.2×
CT thoracic spine w/o contrast (72128) $2,098 $2,098 18.1×
CT thorax w/o contrast (71250)
range across 2 matching MRF lines		 $2,087–$2,113 $2,087–$2,113 varies
CT upper ext wo (73200) $1,890 $1,890 16.3×
CT upper extremity with contrast (73201) $2,172 $2,172 5.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,138 $3,138 16.1×
Cta Abdomen (74175) $3,238 $3,238 16.6×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $4,845 $4,845 12.5×
Dxa Bone Density Axial (77080) $548 $548 4.7×
Fetal Biophys Profile W/Nst (76818) $525 $525 4.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $732 $732 6.3×
Fluoroscopy up to 1 hr (76000) $510 $510 1.9×
Foot 2 views (73620) $288 $288 3.0×
Forearm 2 views (73090) $340 $340 3.5×
Hand 2 views (73120) $345 $345 3.0×
Knee 3 Views (73562) $458 $458 4.7×
Magnetic Image Jaw Joint (70336) $2,674 $2,674 10.1×
Mra Head W/O & W/Contrast Material (70546) $3,296 $3,296 8.5×
MRA head w/o contrast (70544) $3,627 $3,627 13.7×
MRA head with contrast (70545) $2,702 $2,702 7.0×
MRA neck w contrast (70548) $2,827 $2,827 7.3×
Mra Neck W/O &W/Contrast Material (70549) $4,899 $4,899 12.6×
MRA neck w/o contrast (70547) $3,572 $3,572 13.5×
MRI abdomen w/o contrast (74181) $3,366 $3,366 12.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,511 $3,511 9.1×
MRI cervical spine w/o cont (72141) $2,993 $2,993 11.3×
MRI chest with contrast (71551) $3,133 $3,133 3.6×
MRI chest wo w contrast (71552) $4,219 $4,219 10.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,511 $3,511 9.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,936 $2,936 11.1×
MRI lumbar spine w contrast (72149) $4,244 $4,244 10.9×
Mri Neck Spine W/O & W/Dye (72156) $3,627 $3,627 9.4×
MRI orbit face &/neck w/o contrast (70540) $2,758 $2,758 10.4×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,742 $3,742 9.6×
MRI pelvis w/o & w contrast (72197) $3,511 $3,511 9.1×
MRI pelvis w/o contrast (72195) $2,821 $2,821 10.6×
MRI thoracic spine w/o contrast (72146) $3,223 $3,223 12.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,146 $3,146 11.9×
Mri Uppr Extremity W/O&W/Dye (73220) $3,282 $3,282 8.5×
MRI, abdomen, combo (74183) $3,511 $3,511 9.1×
MRI, dorsal spine combo (72157) $4,777 $4,777 12.3×
MRI, dorsal spine contrast (72147) $3,943 $3,943 10.2×
MRI, joint upper extrem (73221) $2,762 $2,762 10.4×
MRI, joint upper extrem combo (73223) $3,579 $3,579 9.2×
MRI, lumbar spine combo (72158) $4,777 $4,777 12.3×
Neck soft tissue (70360) $317 $317 3.3×
Ob us nuchal meas 1 gest (76813) $327 $327 2.8×
Pelvis 1 or 2 views (72170) $352 $352 3.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $685 $685 5.9×
Radex Ankle Complete Minimum 3 Views (73610) $387 $387 4.0×
Radex Calcaneus Minimum 2 Views (73650) $269 $269 2.8×
Radex elbow complete minimum 3 views (73080) $479 $479 5.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $552 $552 4.8×
Radex fingr minimum 2 views (73140) $272 $272 2.8×
Radex foot complete minimum 3 views (73630) $387 $387 4.0×
Radex Hand Minimum 3 Views (73130) $387 $387 4.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $359 $359 3.7×
Radex Ribs Unilateral 2 Views (71100) $380 $380 3.9×
Radex shoulder complete minimum 2 views (73030) $433 $433 4.5×
Radex Sinuses Paransl < 3 Views (70210) $270 $270 2.8×
Radex Sternum Minimum 2 Views (71120) $359 $359 3.7×
Radex Toe Minimum 2 Views (73660) $270 $270 2.8×
Radex Wrist Complete Minimum 3 Views (73110) $473 $473 4.9×
Radiolog exam mandible compl minimum 4 views (70110) $460 $460 4.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $481 $481 4.1×
Radiologic exam knee complete 4/more views (73564) $645 $645 5.6×
Radiologic exam pelvis compl minimum 3 views (72190) $543 $543 4.7×
Radiologic examination femur 1 view (73551) $300 $300 3.1×
Radiologic examination femur minimum 2 views (73552) $398 $398 4.1×
Radiologic examination knee 1/2 views (73560) $398 $398 4.1×
Radiologic examination tibia & fibula 2 views (73590) $345 $345 3.6×
Scapula (73010) $387 $387 3.3×
Screening Digital Breast Tomosynthesis Bi (77063) $139 $139 5.9×
Shoulder 1 view (73020) $268 $268 2.8×
Skull less than 4 views (70250) $389 $389 3.3×
Thoracic spine 2 views (72070) $460 $460 4.0×
Thoracic spine 3 views (72072) $508 $508 4.4×
Thoracolumbar 2 views (72080) $404 $404 4.2×
Ultrasound Breast Limited (76642) $621 $621 6.4×
Ultrasound Exam Aaa Screen (76706) $497 $497 4.3×
Ultrasound, abdomen limited (76705) $603 $603 5.2×
Umbilical-artery Doppler (OB) (76820) $537 $537 4.6×
Us breast unilateral complete (76641) $671 $671 5.8×
Us chest (76604) $608 $608 5.2×
Us complete joint (76881) $497 $497 4.3×
Us exam, pelvic, limited (76857) $540 $540 4.6×
Us kidney transplant (76776) $516 $516 4.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $507–$528 $507–$528 varies
Us ob detailed single fetus (76811) $883 $883 3.3×
Us ob limited 1 or more fetuses (76815) $575 $575 4.9×
Us ob transvaginal (76817) $369 $369 3.2×
Us pelvic non ob complete (76856) $834 $834 7.2×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $702 $702 6.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $507 $507 4.4×
Us retroperitoneal complete (76770) $851 $851 7.3×
Us retroperitoneal limited (76775) $564 $564 4.9×
Us scrotum and contents (76870) $805 $805 6.9×
Us spinal canal and contents (76800) $648 $648 5.6×
Us thyroid (76536) $671 $671 5.8×
Us transrectal (76872) $320 $320 2.8×
Wrist 2 views (73100) $294 $294 3.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $420 $420 4.3×
X-Ray Bend Only L-S Spine (72120) $683 $683 5.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $392 $392 4.1×
X-Ray Exam Breast Specimen (76098) $332 $332 0.5×
X-Ray Exam Entire Spi 1 Vw (72081) $347 $347 3.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $785 $785 6.8×
X-Ray Exam Hip Uni 1 View (73501) $313 $313 3.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $460 $460 4.8×
X-Ray Exam Hips Bi 2 Views (73521) $525 $525 4.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $627 $627 5.4×
X-Ray Exam Hips Bi 5/> Views (73523) $694 $694 6.0×
X-Ray Exam L-S Spine Bending (72114) $432 $432 3.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $397 $397 4.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $554 $554 4.8×
X-Ray Exam Unilat Ribs/Chest (71101) $518 $518 4.5×
X-ray eye for foreign body (70030) $230 $230 2.4×
X-ray humerus (73060) $364 $364 3.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $280 $280 2.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $418 $418 3.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $648 $648 5.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $460 $460 4.0×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $354 $354 3.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $309 $309 3.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $552 $552 5.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $469 $469 4.0×
X-Rays Bone Length Studies (77073) $387 $387 3.3×
X-Rays Bone Survey Complete (77075) $837 $837 7.2×
Xr c-spine 4 or 5 views (72050) $562 $562 4.8×

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.