Imaging prices at Welia Health
Mora, MN · 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 |
$222.60–$255.50 | $318–$365 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Arthrogram hip (73525) | $434.70 | $621 | 1.2× |
| Arthrogram Wrist (73115) | $295.40 | $422 | 0.8× |
| Bone age studies (77072) | $239.40 | $342 | 2.2× |
| Bone Imaging 3 Phase (78315) | $2,120.30 | $3,029 | 5.1× |
| Bone Imaging Limited Area (78300) | $1,921.50 | $2,745 | 4.7× |
| Bone Imaging Multiple Areas (78305) | $2,059.40 | $2,942 | 5.0× |
| Bone Imaging Whole Body (78306) | $2,287.60 | $3,268 | 5.5× |
| Bone survey infant (77076) | $812.70 | $1,161 | 7.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$222.60–$255.50 | $318–$365 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Chest 4 or more views (71048) | $340.20 | $486 | 3.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$222.60–$255.50 | $318–$365 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,526.70 | $2,181 | 14.1× |
| Contrast X-Ray Bladder (74430) | $411.60 | $588 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $434.70 | $621 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $434.70 | $621 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $2,819.60 | $4,028 | 7.8× |
| CT abdomen and pelvis without contrast (74176) | $2,074.10 | $2,963 | 8.4× |
| CT abdomen w contrast (74160) | $1,778.70 | $2,541 | 9.8× |
| CT abdomen w wo contrast (74170) | $2,279.20 | $3,256 | 12.6× |
| CT abdomen w/o contrast (74150) | $1,526.70 | $2,181 | 14.1× |
| CT Angio Abdomen and Pelvis (74174) | $2,053.80 | $2,934 | 5.7× |
| CT Angio Chest (71275) | $1,953 | $2,790 | 10.8× |
| CT Angio Head (70496) | $2,053.80 | $2,934 | 11.3× |
| CT angio hrt w/3d image (75574) | $3,127.60 | $4,468 | 8.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,128 | $3,040 | 11.8× |
| CT Angio Neck (70498) | $2,053.80 | $2,934 | 11.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,953 | $2,790 | 10.8× |
| CT cervical spine w/ contrast (72126) | $1,778.70 | $2,541 | 4.9× |
| CT cervical spine w/o contrast (72125) | $2,204.30 | $3,149 | 20.4× |
| CT cervical spine w/wo cont (72127) | $3,103.80 | $4,434 | 17.1× |
| CT chest w contrast (71260) | $1,778.70 | $2,541 | 9.8× |
| CT chest w/wo contrast (71270) | $2,279.20 | $3,256 | 12.6× |
| CT head/brain with contrast (70460) | $1,778.70 | $2,541 | 9.8× |
| CT head/brain without and with contrast (70470) | $2,279.20 | $3,256 | 12.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,703.10 | $2,433 | 19.0× |
| CT iac w contrast (70481) | $1,778.70 | $2,541 | 9.8× |
| CT l-spine w&w/o contrast (72133) | $2,279.20 | $3,256 | 12.6× |
| CT lower ext w/o (73700) | $1,526.70 | $2,181 | 14.1× |
| CT lower extremity w/contrast material (73701) | $1,852.90 | $2,647 | 10.2× |
| CT lumbar spine w contrast (72132) | $1,778.70 | $2,541 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $1,526.70 | $2,181 | 14.1× |
| CT maxillofacial w contrast (70487) | $1,778.70 | $2,541 | 9.8× |
| CT maxillofacial wo contrast (70486) | $2,204.30 | $3,149 | 20.4× |
| CT neck tissue combo (70492) | $2,279.20 | $3,256 | 12.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,279.20 | $3,256 | 12.6× |
| CT orbits w/o contrast (70480) | $1,526.70 | $2,181 | 14.1× |
| CT pelvis w&w/o contrast (72194) | $2,279.20 | $3,256 | 12.6× |
| CT pelvis w/o contrast (72192) | $1,526.70 | $2,181 | 14.1× |
| CT scan of leg combo (73702) | $2,279.20 | $3,256 | 12.6× |
| CT scans face/jaw combo (70488) | $2,279.20 | $3,256 | 12.6× |
| CT soft tissue neck w contrast (70491) | $1,778.70 | $2,541 | 9.8× |
| CT soft tissue neck w/o contrast (70490) | $1,526.70 | $2,181 | 14.1× |
| CT thoracic spine w contrast (72129) | $1,778.70 | $2,541 | 9.8× |
| CT thoracic spine w/o contrast (72128) | $1,526.70 | $2,181 | 14.1× |
| CT thorax w/o contrast (71250) | $1,526.70 | $2,181 | 14.1× |
| CT upper ext wo (73200) | $1,525.30 | $2,179 | 14.1× |
| CT upper extremity w/o & w/contrast material (73202) | $3,103.80 | $4,434 | 17.1× |
| CT upper extremity with contrast (73201) | $1,778.70 | $2,541 | 4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,796.50 | $3,995 | 15.4× |
| Cta Abdomen (74175) | $2,053.80 | $2,934 | 11.3× |
| CTA pelvis (72191) | $1,778.70 | $2,541 | 9.8× |
| Dxa Bone Density Axial (77080) | $336.70 | $481 | 3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $233.10 | $333 | 2.6× |
| Esophagram (74220) | $295.40 | $422 | 1.6× |
| Fetal Biophys Profile W/Nst (76818) | $753.90 | $1,077 | 7.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $753.90 | $1,077 | 7.0× |
| Fluoroscopy up to 1 hr (76000) | $298.20 | $426 | 1.2× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Gastric emptying imaging study (78264) | $1,914.50 | $2,735 | 4.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,914.50 | $2,735 | 4.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$255.50–$287.70 | $365–$411 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,207.50 | $1,725 | 2.2× |
| Hepatobiliary System Imaging (78226) | $1,207.50 | $1,725 | 2.9× |
| Ht Muscle Image Spect Sing (78451) | $2,464.70 | $3,521 | 1.8× |
| Hysterosalpingogram (74740) | $448 | $640 | 1.8× |
| K Flow/Funct Image Multiple (78709) | $1,628.20 | $2,326 | 2.9× |
| K Flow/Funct Image W/Drug (78708) | $1,442 | $2,060 | 2.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$295.40–$328.30 | $422–$469 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $1,988 | $2,840 | 3.5× |
| Lung perfusion differential (78597) | $1,988 | $2,840 | 4.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,988 | $2,840 | 3.5× |
| Lung Ventilation Imaging (78579) | $1,988 | $2,840 | 4.8× |
| Mra Head W/O & W/Contrast Material (70546) | $3,346 | $4,780 | 9.3× |
| MRA head w/o contrast (70544) | $2,791.60 | $3,988 | 11.3× |
| MRA head with contrast (70545) | $2,864.40 | $4,092 | 8.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,346 | $4,780 | 9.3× |
| MRA neck w/o contrast (70547) | $2,791.60 | $3,988 | 11.3× |
| MRI abdomen w/o contrast (74181) | $2,791.60 | $3,988 | 11.3× |
| MRI any jt lower extrem w/contrast material (73722) | $2,864.40 | $4,092 | 3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,103.80 | $4,434 | 8.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,864.40 | $4,092 | 3.5× |
| MRI cervical spine w/o cont (72141) | $2,791.60 | $3,988 | 11.3× |
| MRI chest w/o contrast (71550) | $2,791.60 | $3,988 | 11.3× |
| MRI chest wo w contrast (71552) | $3,103.80 | $4,434 | 8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,103.80 | $4,434 | 8.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,791.60 | $3,988 | 11.3× |
| MRI lumbar spine w contrast (72149) | $2,864.40 | $4,092 | 8.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,103.80 | $4,434 | 8.6× |
| MRI orbit face &/neck w/o contrast (70540) | $2,791.60 | $3,988 | 11.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,103.80 | $4,434 | 8.6× |
| MRI pelvis w contrast (72196) | $2,864.40 | $4,092 | 8.0× |
| MRI pelvis w/o & w contrast (72197) | $3,103.80 | $4,434 | 8.6× |
| MRI pelvis w/o contrast (72195) | $2,791.60 | $3,988 | 11.3× |
| MRI thoracic spine w/o contrast (72146) | $2,791.60 | $3,988 | 11.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,791.60 | $3,988 | 11.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,103.80 | $4,434 | 8.6× |
| MRI, abdomen, combo (74183) | $3,103.80 | $4,434 | 8.6× |
| MRI, dorsal spine combo (72157) | $3,103.80 | $4,434 | 8.6× |
| MRI, joint upper extrem (73221) | $2,791.60 | $3,988 | 11.3× |
| MRI, joint upper extrem combo (73223) | $3,103.80 | $4,434 | 8.6× |
| MRI, lumbar spine combo (72158) | $3,103.80 | $4,434 | 8.6× |
| Myocardial Spect Multiple Studies (78452) | $4,925.20 | $7,036 | 3.7× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$222.60–$255.50 | $318–$365 | varies |
| Parathyroid Planar Imaging (78070) | $1,605.80 | $2,294 | 3.9× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$222.60–$254.80 | $318–$364 | varies |
| PET image w/CT, full body (78816) | $1,899.10 | $2,713 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,899.10 | $2,713 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,988 | $2,840 | 4.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $255.50 | $365 | 2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $298.20 | $426 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$295.40–$328.30 | $422–$469 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $255.50 | $365 | 2.8× |
| Radex elbow complete minimum 3 views (73080) | $295.40 | $422 | 3.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $295.40 | $422 | 2.7× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$295.40–$328.30 | $422–$469 | varies |
| Radex Hand Minimum 3 Views (73130) | $295.40 | $422 | 3.3× |
| Radex lower extremity infant minimum 2 views (73592) | $255.50 | $365 | 2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $295.40 | $422 | 3.3× |
| Radex Ribs Unilateral 2 Views (71100) | $255.50 | $365 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$255.50–$282.10 | $365–$403 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $255.50 | $365 | 2.8× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$222.60–$254.80 | $318–$364 | varies |
| Radex Sternum Minimum 2 Views (71120) | $255.50 | $365 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $255.50 | $365 | 2.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $255.50 | $365 | 2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$295.40–$328.30 | $422–$469 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $340.20 | $486 | 3.2× |
| Radiologic exam colon double contrast study (74280) | $469.70 | $671 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $429.10 | $613 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) | $340.20 | $486 | 3.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $295.40 | $422 | 2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $455.70 | $651 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $191.80 | $274 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $429.10 | $613 | 2.4× |
| Radiologic examination femur 1 view (73551) | $255.50 | $365 | 2.8× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| Ribs bilateral 3 views (71110) | $295.40 | $422 | 2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,988 | $2,840 | 3.5× |
| Scapula (73010) | $246.40 | $352 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $38.50 | $55 | 1.6× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$222.60–$255.50 | $318–$365 | varies |
| Shoulder Arthrography (73040) | $434.70 | $621 | 1.2× |
| Skull less than 4 views (70250) | $295.40 | $422 | 2.7× |
| Thoracic spine 2 views (72070) | $255.50 | $365 | 2.4× |
| Thoracic spine 3 views (72072) | $295.40 | $422 | 2.7× |
| Thoracolumbar 2 views (72080) | $255.50 | $365 | 2.8× |
| Thyroid Uptake Measurement (78012) | $2,009.70 | $2,871 | 4.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,009.70 | $2,871 | 4.9× |
| Ultrasound Breast Limited (76642) | $742.70 | $1,061 | 8.3× |
| Ultrasound Exam Aaa Screen (76706) | $742.70 | $1,061 | 6.9× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$742.70–$772.80 | $1,061–$1,104 | varies |
| Umbilical-artery Doppler (OB) (76820) | $753.90 | $1,077 | 7.0× |
| Unlisted Dx Radiographic Procedure (76499) | $191.80 | $274 | 2.1× |
| Upper gi w/o kub (74240) | $429.10 | $613 | 2.4× |
| Urethrocystogram voiding (74455) | $443.10 | $633 | 1.8× |
| Urethrocystography retrograde (74450) | $443.10 | $633 | 1.8× |
| Us breast unilateral complete (76641) | $998.90 | $1,427 | 9.3× |
| Us chest (76604) range across 2 matching MRF lines |
$742.70–$772.80 | $1,061–$1,104 | varies |
| Us complete joint (76881) | $742.70 | $1,061 | 6.9× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$550.20–$582.40 | $786–$832 | varies |
| Us head (76506) | $742.70 | $1,061 | 6.9× |
| Us kidney transplant (76776) | $443.10 | $633 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $742.70 | $1,061 | 6.9× |
| Us ob detailed single fetus (76811) | $742.70 | $1,061 | 3.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$384.30–$414.40 | $549–$592 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$443.10–$473.90 | $633–$677 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$742.70–$773.50 | $1,061–$1,105 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $742.70 | $1,061 | 6.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $384.30 | $549 | 3.6× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$863.10–$894.60 | $1,233–$1,278 | varies |
| Us retroperitoneal limited (76775) | $742.70 | $1,061 | 6.9× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$742.70–$774.20 | $1,061–$1,106 | varies |
| Us spinal canal and contents (76800) | $742.70 | $1,061 | 6.9× |
| Us thyroid (76536) | $742.70 | $1,061 | 6.9× |
| Us transrectal (76872) | $742.70 | $1,061 | 6.9× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| X-ray antegrade pyelogram tube (74425) | $800.10 | $1,143 | 2.2× |
| X-Ray Bend Only L-S Spine (72120) | $255.50 | $365 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| X-Ray Exam Breast Specimen (76098) | $222.60 | $318 | 0.4× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$222.60–$254.80 | $318–$364 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$295.40–$326.20 | $422–$466 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $373.10 | $533 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$340.20–$373.10 | $486–$533 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $401.10 | $573 | 3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$295.40–$328.30 | $422–$469 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $401.10 | $573 | 3.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $295.40 | $422 | 2.7× |
| X-ray eye for foreign body (70030) | $255.50 | $365 | 2.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $295.40 | $422 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $222.60 | $318 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$255.50–$288.40 | $365–$412 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $390.60 | $558 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $295.40 | $422 | 2.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $255.50 | $365 | 2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $255.50 | $365 | 2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $295.40 | $422 | 3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $340.20 | $486 | 3.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $800.10 | $1,143 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $812.70 | $1,161 | 7.5× |
| Xr c-spine 4 or 5 views (72050) | $340.20 | $486 | 3.2× |
| Xr facial bones less than 3 views (70140) | $255.50 | $365 | 2.8× |
| Xr orbits complete 4 views (70200) | $340.20 | $486 | 3.2× |
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.