Imaging prices at Waverly Health Center
Waverly, IA · every code in this section with a posted price and a Medicare benchmark.
223 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) range across 2 matching MRF lines |
$109.20–$151.84 | $210–$292 | varies |
| Abdomen 2 views (74019) | $210.08 | $404 | 2.1× |
| Ankle 2 views (73600) | $151.84 | $292 | 1.8× |
| Arthrogram ankle (73615) | $290.16 | $558 | 0.9× |
| Arthrogram hip (73525) | $530.40 | $1,020 | 1.6× |
| Arthrogram Wrist (73115) | $520 | $1,000 | 1.6× |
| Bone age studies (77072) | $90.48 | $174 | 0.9× |
| Bone Imaging 3 Phase (78315) | $799.76 | $1,538 | 2.1× |
| Bone Imaging Limited Area (78300) | $799.76 | $1,538 | 2.1× |
| Bone Imaging Whole Body (78306) | $799.76 | $1,538 | 2.1× |
| Bone survey infant (77076) | $408.20 | $785 | 4.1× |
| Cat Scan Follow-Up Study (76380) | $536.12 | $1,031 | 6.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$97.24–$140.92 | $187–$271 | varies |
| Chest 2 views (71046) | $158.08 | $304 | 1.9× |
| Clavicle complete (73000) | $162.24 | $312 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $239.20 | $460 | 2.4× |
| Contrast X-Ray Bladder (74430) | $342.16 | $658 | 1.0× |
| Contrast X-Ray Of Elbow (73085) | $524.16 | $1,008 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,444.52–$2,834.52 | $4,701–$5,451 | varies |
| CT abdomen and pelvis without contrast (74176) | $1,913.60 | $3,680 | 8.3× |
| CT abdomen w contrast (74160) | $1,131 | $2,175 | 6.7× |
| CT abdomen w wo contrast (74170) | $1,528.80 | $2,940 | 9.1× |
| CT abdomen w/o contrast (74150) | $916.76 | $1,763 | 9.1× |
| CT Angio Abdomen and Pelvis (74174) | $2,376.40 | $4,570 | 7.1× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,086.80–$1,733.68 | $2,090–$3,334 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,144–$1,643.20 | $2,200–$3,160 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,643.20 | $3,160 | 9.7× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,144–$1,643.20 | $2,200–$3,160 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$785.20–$1,643.20 | $1,510–$3,160 | varies |
| CT cervical spine w/ contrast (72126) | $1,225.64 | $2,357 | 3.7× |
| CT cervical spine w/o contrast (72125) | $1,032.20 | $1,985 | 10.3× |
| CT cervical spine w/wo cont (72127) | $1,469 | $2,825 | 8.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,339.52–$1,341.60 | $2,576–$2,580 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$726.96–$1,524.12 | $1,398–$2,931 | varies |
| CT head/brain with contrast (70460) | $1,117.48 | $2,149 | 6.6× |
| CT head/brain without and with contrast (70470) | $1,238.64 | $2,382 | 7.3× |
| CT iac w contrast (70481) | $1,193.92 | $2,296 | 7.1× |
| CT l-spine w&w/o contrast (72133) | $1,431.56 | $2,753 | 8.5× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$862.16–$1,396.72 | $1,658–$2,686 | varies |
| CT lower extremity w/contrast material (73701) | $1,012.44 | $1,947 | 6.0× |
| CT lumbar spine w contrast (72132) | $1,250.60 | $2,405 | 3.7× |
| CT lumbar spine w/o contrast (72131) | $1,056.64 | $2,032 | 10.5× |
| CT maxillofacial w contrast (70487) | $1,087.84 | $2,092 | 6.5× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$942.24–$1,049.36 | $1,812–$2,018 | varies |
| CT neck tissue combo (70492) | $1,464.84 | $2,817 | 8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,393.60 | $2,680 | 8.3× |
| CT orbits w/o contrast (70480) | $997.36 | $1,918 | 9.9× |
| CT pelvis w&w/o contrast (72194) | $1,593.80 | $3,065 | 9.5× |
| CT pelvis w/o contrast (72192) | $963.04 | $1,852 | 9.6× |
| CT scan of leg combo (73702) | $1,118.52 | $2,151 | 6.6× |
| CT scans face/jaw combo (70488) | $1,289.08 | $2,479 | 7.6× |
| CT soft tissue neck w contrast (70491) | $1,361.36 | $2,618 | 8.1× |
| CT soft tissue neck w/o contrast (70490) | $1,049.36 | $2,018 | 10.4× |
| CT thoracic spine w contrast (72129) | $1,060.80 | $2,040 | 6.3× |
| CT thoracic spine w/o contrast (72128) | $969.80 | $1,865 | 9.6× |
| CT thoracic spine w/wo cont (72130) | $1,333.28 | $2,564 | 7.9× |
| CT thorax w/o contrast (71250) | $1,144 | $2,200 | 11.4× |
| CT upper ext wo (73200) | $901.68 | $1,734 | 9.0× |
| CT upper extremity w/o & w/contrast material (73202) | $1,333.80 | $2,565 | 7.9× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,113.32–$1,124.24 | $2,141–$2,162 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,643.20 | $3,160 | 9.7× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,201.20–$1,643.20 | $2,310–$3,160 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$832–$1,733.68 | $1,600–$3,334 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $194.48 | $374 | 1.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $197.08 | $379 | 2.0× |
| Dxa Bone Density Axial (77080) | $529.36 | $1,018 | 5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $162.24 | $312 | 1.9× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$159.12–$515.32 | $306–$991 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$134.68–$188.76 | $259–$363 | varies |
| Esophagram (74220) | $288.60 | $555 | 1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $197.08 | $379 | 2.0× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$328.64–$342.16 | $632–$658 | varies |
| Foot 2 views (73620) | $144.56 | $278 | 1.7× |
| Forearm 2 views (73090) | $144.56 | $278 | 1.7× |
| Gastric emptying imaging study (78264) | $799.76 | $1,538 | 2.1× |
| Gated Heart Planar Single (78472) | $837.20 | $1,610 | 2.2× |
| Hand 2 views (73120) | $122.72 | $236 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $843.96 | $1,623 | 1.6× |
| Hepatobiliary System Imaging (78226) | $769.60 | $1,480 | 2.0× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$130–$1,443 | $250–$2,775 | varies |
| Hysterosalpingogram (74740) | $399.36 | $768 | 1.7× |
| Infusion Ivp (74410) | $416 | $800 | 2.5× |
| K Flow/Funct Image W/Drug (78708) | $843.96 | $1,623 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $709.80 | $1,365 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $923 | $1,775 | 2.4× |
| Knee 3 Views (73562) | $162.24 | $312 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $843.96 | $1,623 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) | $923 | $1,775 | 1.8× |
| Lymph System Imaging (78195) | $738.92 | $1,421 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $1,588.60 | $3,055 | 6.9× |
| Meckels Divert Exam (78290) | $528.32 | $1,016 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,221.96 | $4,273 | 6.6× |
| MRA head w/o contrast (70544) | $1,776.32 | $3,416 | 7.7× |
| MRA head with contrast (70545) | $1,926.60 | $3,705 | 5.7× |
| MRA neck w contrast (70548) | $1,852.24 | $3,562 | 5.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,788.24 | $5,362 | 8.3× |
| MRA neck w/o contrast (70547) | $1,588.60 | $3,055 | 6.9× |
| MRI abdomen w contrast (74182) | $1,852.24 | $3,562 | 5.5× |
| MRI abdomen w/o contrast (74181) | $1,776.32 | $3,416 | 7.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,852.24 | $3,562 | 2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,633.32–$2,860 | $3,141–$5,500 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,852.24 | $3,562 | 2.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $936 | $1,800 | 4.1× |
| MRI cervical spine w contrast (72142) | $1,921.92 | $3,696 | 5.7× |
| MRI cervical spine w/o cont (72141) | $1,776.32 | $3,416 | 7.7× |
| MRI chest w/o contrast (71550) | $1,588.08 | $3,054 | 6.9× |
| MRI chest wo w contrast (71552) | $2,903.16 | $5,583 | 8.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,852.24 | $3,562 | 5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,860 | $5,500 | 8.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,634.36 | $3,143 | 7.1× |
| MRI lumbar spine w contrast (72149) | $2,065.44 | $3,972 | 6.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,903.16 | $5,583 | 8.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,776.32 | $3,416 | 7.7× |
| MRI orbit face neck w contrast (70542) | $1,852.24 | $3,562 | 5.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,193.84 | $6,142 | 9.5× |
| MRI pelvis w contrast (72196) | $1,044.16 | $2,008 | 3.1× |
| MRI pelvis w/o & w contrast (72197) | $2,868.32 | $5,516 | 8.6× |
| MRI pelvis w/o contrast (72195) | $1,754.48 | $3,374 | 7.6× |
| MRI thoracic spine w/o contrast (72146) | $1,700.40 | $3,270 | 7.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$919.36–$1,983.80 | $1,768–$3,815 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$919.36–$1,776.32 | $1,768–$3,416 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,480.96–$2,860 | $2,848–$5,500 | varies |
| MRI, abdomen, combo (74183) | $2,868.32 | $5,516 | 8.6× |
| MRI, dorsal spine combo (72157) | $2,903.16 | $5,583 | 8.7× |
| MRI, dorsal spine contrast (72147) | $1,839.76 | $3,538 | 5.5× |
| MRI, joint upper extrem (73221) | $1,776.32 | $3,416 | 7.7× |
| MRI, joint upper extrem combo (73223) | $2,221.96 | $4,273 | 6.6× |
| MRI, lumbar spine combo (72158) | $2,903.16 | $5,583 | 8.7× |
| Myelogram cervical (72240) | $498.68 | $959 | 0.7× |
| Myelogram Lumbar (72265) | $958.88 | $1,844 | 1.3× |
| Myelography thoracic (72255) | $465.40 | $895 | 0.6× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$146.64–$2,323.88 | $282–$4,469 | varies |
| Neck soft tissue (70360) | $130.52 | $251 | 1.6× |
| Parathyroid Planar Imaging (78070) | $520 | $1,000 | 1.4× |
| Pelvis 1 or 2 views (72170) | $119.60 | $230 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $267.28 | $514 | 2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $428.48 | $824 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $162.24 | $312 | 1.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $140.40 | $270 | 1.7× |
| Radex elbow complete minimum 3 views (73080) | $162.24 | $312 | 1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $194.48 | $374 | 1.9× |
| Radex fingr minimum 2 views (73140) | $144.56 | $278 | 1.7× |
| Radex foot complete minimum 3 views (73630) | $151.84 | $292 | 1.8× |
| Radex Hand Minimum 3 Views (73130) | $151.84 | $292 | 1.8× |
| Radex lower extremity infant minimum 2 views (73592) | $179.92 | $346 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $92.04 | $177 | 1.1× |
| Radex Ribs Unilateral 2 Views (71100) | $162.24 | $312 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) | $210.08 | $404 | 2.5× |
| Radex Spine 1 View Specify Level (72020) | $124.80 | $240 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $144.56 | $278 | 1.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $190.84 | $367 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $135.20 | $260 | 1.6× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$94.64–$144.56 | $182–$278 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $148.72 | $286 | 1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $162.24 | $312 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $529.36 | $1,018 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $408.20 | $785 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) | $170.56 | $328 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $371.28 | $714 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $398.32 | $766 | 2.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $435.76 | $838 | 2.6× |
| Radiologic examination femur minimum 2 views (73552) | $170.56 | $328 | 2.0× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$52–$226.72 | $100–$436 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $166.92 | $321 | 1.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $144.56 | $278 | 1.7× |
| Ribs bilateral 3 views (71110) | $217.88 | $419 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,239.16 | $2,383 | 2.4× |
| Scapula (73010) | $144.56 | $278 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$23.92–$39 | $46–$75 | varies |
| Shoulder 1 view (73020) | $159.12 | $306 | 1.9× |
| Shoulder Arthrography (73040) | $417.04 | $802 | 1.2× |
| Skull less than 4 views (70250) | $198.64 | $382 | 2.0× |
| Sternoclavicular joints (71130) | $162.24 | $312 | 1.9× |
| Thoracic spine 2 views (72070) | $162.24 | $312 | 1.6× |
| Thoracic spine 3 views (72072) | $205.40 | $395 | 2.0× |
| Thyroid Uptake Measurement (78012) | $343.20 | $660 | 0.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$239.20–$357.76 | $460–$688 | varies |
| Ultrasound Exam Aaa Screen (76706) | $490.88 | $944 | 4.9× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$431.08–$552.24 | $829–$1,062 | varies |
| Unlisted us procedure (76999) | $414.44 | $797 | 5.0× |
| Upper gi w/o kub (74240) | $371.28 | $714 | 2.2× |
| Urethrocystogram voiding (74455) | $364 | $700 | 1.6× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$340.60–$509.60 | $655–$980 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$111.80–$112.32 | $215–$216 | varies |
| Us complete joint (76881) | $431.08 | $829 | 4.3× |
| Us exam, pelvic, limited (76857) | $431.08 | $829 | 4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $141.44 | $272 | 1.4× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$203.84–$509.08 | $392–$979 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$229.84–$398.32 | $442–$766 | varies |
| Us pelvic non ob complete (76856) | $512.20 | $985 | 5.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $318.76 | $613 | 3.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$244.40–$371.28 | $470–$714 | varies |
| Us retroperitoneal complete (76770) | $535.60 | $1,030 | 5.3× |
| Us retroperitoneal limited (76775) | $490.88 | $944 | 4.9× |
| Us scrotum and contents (76870) | $490.88 | $944 | 4.9× |
| Us spinal canal and contents (76800) | $371.80 | $715 | 3.7× |
| Us thyroid (76536) | $420.68 | $809 | 4.2× |
| Venography extremity bilateral rs&i (75822) | $438.36 | $843 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $365.04 | $702 | 0.2× |
| Wrist 2 views (73100) | $144.56 | $278 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $115.44 | $222 | 1.4× |
| X-ray antegrade pyelogram tube (74425) | $368.16 | $708 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $209.56 | $403 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $144.56 | $278 | 1.7× |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$45.24–$202.80 | $87–$390 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $135.20 | $260 | 1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$144.56–$391.56 | $278–$753 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$188.76–$231.40 | $363–$445 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $151.84 | $292 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $294.84 | $567 | 2.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $179.92 | $346 | 1.8× |
| X-ray eye for foreign body (70030) | $151.84 | $292 | 1.8× |
| X-ray humerus (73060) | $144.56 | $278 | 1.7× |
| X-ray IV pyelogram+tomography (74415) | $407.68 | $784 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $145.60 | $280 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $179.92 | $346 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $144.56 | $278 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $144.56 | $278 | 1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $210.08 | $404 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $222.04 | $427 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $408.20 | $785 | 4.1× |
| Xr c-spine 4 or 5 views (72050) | $271.96 | $523 | 2.7× |
| Xr orbits complete 4 views (70200) | $170.56 | $328 | 1.7× |
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.