Imaging prices at WhidbeyHealth Medical Center

Coupeville, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $14,267.50 $14,267.50 9.3×
Abdomen 2 views (74019) $653 $653 5.6×
Acute gi blood loss imaging (78278) $1,890 $1,890 4.2×
Ankle 2 views (73600) $338 $338 3.5×
Arthrogram ankle (73615) $2,597 $2,597 6.7×
Arthrogram elbow (73085) $2,597 $2,597 6.7×
Arthrogram hip (73525) $2,469 $2,469 6.4×
Arthrogram knee (73580) $2,597 $2,597 6.7×
Arthrogram shoulder (73040) $2,597 $2,597 6.7×
Arthrogram wrist (73115) $1,439 $1,439 3.7×
Bone &/Joint Imaging Limited Area (78300) $1,890 $1,890 4.2×
Bone &/Joint Imaging Multiple Areas (78305) $1,890 $1,890 4.2×
Bone &/joint imaging whole body (78306) $1,890 $1,890 4.2×
Bone age studies (77072) $324.50 $324.50 2.8×
Bone Imaging 3 Phase (78315) $1,890 $1,890 4.2×
Bone survey complete (77075) $620 $620 5.3×
Bone survey infant (77076) $620 $620 5.3×
Bowel imaging (78290) $1,890 $1,890 4.2×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $1,890 $1,890 4.2×
Cervical spine 2 or 3 views (72040) $338 $338 3.5×
Chest 1 view (71045) $338 $338 3.5×
Chest xray 3 views (71047) $403 $403 4.2×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $620 $620 3.2×
Clavicle complete (73000) $338 $338 3.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $504 $504 4.3×
CT abdomen and pelvis without and with contrast (74178) $4,463 $4,463 11.5×
CT abdomen and pelvis without contrast (74176) $4,299 $4,299 16.2×
CT abdomen w contrast (74160) $2,051 $2,051 10.5×
CT abdomen w wo contrast (74170) $2,051 $2,051 10.5×
CT abdomen w/o contrast (74150) $929 $929 8.0×
CT angio lwr extr w/o&w/dye (73706) $3,703 $3,703 18.9×
CT angiography upper extremity lt (73206) $2,576 $2,576 13.2×
CT c-spine w/contrast (72126) $2,900 $2,900 7.5×
CT c-spine w/o contrast (72125) $2,104 $2,104 18.1×
CT cervical spine w&w/o contrast (72127) $2,051 $2,051 10.5×
CT chest w contrast (71260) $2,051 $2,051 10.5×
CT chest w/wo contrast (71270) $2,051 $2,051 10.5×
CT head/brain with contrast (70460) $2,051 $2,051 10.5×
CT head/brain without and with contrast (70470) $2,051 $2,051 10.5×
CT heart contrast eval cardiac structure&morph (75572) $1,368 $1,368 3.5×
CT heart w/o contrast quant eval coronary calcium (75571) $131.50 $131.50 1.4×
CT iac w contrast (70481) $2,051 $2,051 10.5×
CT lower ext w/o (73700) $1,998 $1,998 17.2×
CT lower extremity w wo contrast (73702) $2,051 $2,051 10.5×
CT lower extremity w/contrast material (73701) $2,262 $2,262 11.6×
CT lumbar spine w & w/o contrast (72133) $2,051 $2,051 10.5×
CT lumbar spine w/contrast (72132) $2,687 $2,687 6.9×
CT lumbar spine w/o contrast (72131) $1,506 $1,506 12.9×
CT maxillofacial w contrast (70487) $2,051 $2,051 10.5×
CT maxillofacial w/wo contrast (70488) $2,051 $2,051 10.5×
CT maxillofacial wo contrast (70486) $1,596 $1,596 13.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,051 $2,051 10.5×
CT orbits w/o contrast (70480) $543.50 $543.50 4.7×
CT pelvis w/o contrast (72192) $1,596 $1,596 13.7×
CT pelvis w/wo contrast (72194) $2,051 $2,051 10.5×
CT scan of arm combo (73202) $2,467.50 $2,467.50 12.6×
CT soft tissue neck w contrast (70491) $2,051 $2,051 10.5×
CT soft tissue neck w/o & w/contrast material (70492) $2,051 $2,051 10.5×
CT soft tissue neck w/o contrast (70490) $1,869 $1,869 16.0×
CT thoracic spine w/contrast (72129) $2,051 $2,051 10.5×
CT thoracic spine w/o contrast (72128) $1,506 $1,506 12.9×
CT thoracic spine w/wo contrast (72130) $2,051 $2,051 10.5×
CT thorax w/o contrast (71250) $2,005.50 $2,005.50 17.2×
CT upper ext wo (73200) $1,495 $1,495 12.8×
CT upper extremity with contrast (73201) $2,538.50 $2,538.50 6.5×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $3,372 $3,372 17.3×
Cta Abdomen (74175) $2,573 $2,573 13.2×
CTA abdomen pelvis (74174) $3,266 $3,266 8.4×
CTA chest (71275) $4,032 $4,032 20.6×
Cta Head (70496) $2,653 $2,653 13.6×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,641 $2,641 6.8×
Cta Neck (70498) $2,653 $2,653 13.6×
Cta Pelvis (72191) $2,051 $2,051 10.5×
Cystography minimum 3 views rs&i (74430) $1,368 $1,368 3.5×
Dxa bone density study 1/> sites axial skel (77080) $620 $620 5.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $338 $338 3.5×
Esophagus (74220) $1,368 $1,368 7.0×
Facial bones min 3 views (70150) $347.50 $347.50 3.0×
Fetal biophysical profile non-stress testing (76818) $620 $620 5.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $620 $620 5.3×
Fluoroscopy up to 1 hr (76000) $821 $821 3.1×
Foot 2 views (73620) $338 $338 3.5×
Forearm 2 views (73090) $338 $338 3.5×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $1,890 $1,890 4.2×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $2,450 $2,450 4.0×
Hand 2 views (73120) $620 $620 5.3×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $2,450 $2,450 4.0×
Hepatobiliary syst imaging including gallbladder (78226) $1,890 $1,890 4.2×
Hysterosalpingogram (74740) $1,257 $1,257 4.7×
Interstitial radiation source applic complex (77778) $6,330 $6,330 8.2×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $620 $620 5.3×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $2,450 $2,450 4.0×
Kidney img morphology vascular flow 1 w/rx (78708) $2,450 $2,450 4.0×
Kidney Img Morphology Vascular Flow Multiple (78709) $2,450 $2,450 4.0×
Knee 3 views (73562) $338 $338 3.5×
Liver & spleen imaging static only (78215) $1,890 $1,890 4.2×
Lung perfusion differential (78597) $1,890 $1,890 4.2×
Lymphoscintigraphy (78195) $2,450 $2,450 4.0×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $4,212 $4,212 4.8×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $3,509 $3,509 9.0×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $4,171.50 $4,171.50 10.7×
MRA head w & w/o contrast (70546) $3,703 $3,703 9.5×
MRA head w/o contrast (70544) $1,885 $1,885 7.1×
MRA head with contrast (70545) $2,051 $2,051 5.3×
MRA neck w contrast (70548) $2,051 $2,051 5.3×
Mra Neck W/O &W/Contrast Material (70549) $3,703 $3,703 9.5×
MRA neck w/o contrast (70547) $1,885 $1,885 7.1×
MRI abdomen w contrast (74182) $3,703 $3,703 9.5×
MRI abdomen w/o & w/contrast material (74183) $3,703 $3,703 9.5×
MRI abdomen w/o contrast (74181) $1,885 $1,885 7.1×
MRI any jt lower extrem w/contrast material (73722) $4,320 $4,320 4.9×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,703 $3,703 9.5×
MRI bone marrow blood supply (77084) $1,872 $1,872 7.0×
MRI breast w/o contrast bilateral (77047) $2,944 $2,944 11.1×
MRI breast wo contrast unilateral (77046) $2,944 $2,944 11.1×
MRI c-spine with contrast (72142) $3,699 $3,699 9.5×
MRI cervical spine w/o contrast (72141) $1,885 $1,885 7.1×
MRI chest w/o & w/contrast material (71552) $3,703 $3,703 9.5×
MRI chest w/o contrast (71550) $1,885 $1,885 7.1×
MRI chest with contrast (71551) $3,248 $3,248 3.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,755.50 $2,755.50 7.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,273.50 $4,273.50 11.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,327 $2,327 8.8×
MRI orbit face &/neck w/o contrast (70540) $2,397 $2,397 9.0×
MRI orbit face neck w contrast (70542) $3,703 $3,703 9.5×
MRI orbit/face/neck w&w/o cont (70543) $3,703 $3,703 9.5×
MRI pelvis w/contrast (72196) $3,703 $3,703 9.5×
MRI pelvis w/o & w/contrast material (72197) $3,703 $3,703 9.5×
MRI pelvis w/o contrast (72195) $1,885 $1,885 7.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,703 $3,703 9.5×
MRI spinal canal lumbar w/contrast material (72149) $3,703 $3,703 9.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,703 $3,703 9.5×
MRI spinal canal thoracic w/contrast matrl (72147) $3,703 $3,703 9.5×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,703 $3,703 9.5×
MRI temporomandibular joint (70336) $1,084 $1,084 4.1×
MRI thoracic spine w/o contrast (72146) $2,284 $2,284 8.6×
MRI up ext w/o contrast (73218) $1,885 $1,885 7.1×
MRI upper ext joint w/o contrast (73221) $2,290.50 $2,290.50 8.6×
MRI, joint upper extrem combo (73223) $3,894.50 $3,894.50 10.0×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $3,586 $3,586 2.5×
Myocardial Spect Multiple Studies (78452) $4,297 $4,297 3.0×
Neck soft tissue (70360) $192.50 $192.50 2.0×
Nm gastric emptying study (78264) $1,890 $1,890 4.2×
Nm gastroesophageal reflux study (78262) $1,890 $1,890 4.2×
Noncardiac Vascular Flow Imaging (78445) $63 $63 0.1×
Nonvascular shunt X-ray (75809) $620 $620 5.3×
Nuclear Rx Oral Admin (79005) $1,650 $1,650 6.3×
Ob us nuchal meas 1 gest (76813) $620 $620 5.3×
Osseous survey limited (77074) $620 $620 5.3×
Parathyroid Planar Imaging (78070) $1,890 $1,890 4.2×
Parathyroid planar imaging w/wo subtraction (78071) $2,055 $2,055 4.6×
Pelvis 1 or 2 views (72170) $620 $620 5.3×
PET image w/CT, skull-thigh (78815) $5,945 $5,945 3.7×
PET imaging CT for attenuation limited area (78814) $4,352 $4,352 2.7×
PET imaging for CT attenuation whole body (78816) $9,632 $9,632 6.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,890 $1,890 4.2×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,450 $2,450 4.0×
Radex abscess/fistula/sinus tract rs&i (76080) $1,257 $1,257 2.1×
Radex Ankle Compl Minimum 3 Views (73610) $338 $338 3.5×
Radex Calcaneus Minimum 2 Views (73650) $338 $338 3.5×
Radex Elbw Compl Minimum 3 Views (73080) $338 $338 3.5×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $338 $338 3.5×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $620 $620 5.3×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $620 $620 5.3×
Radex fingr minimum 2 views (73140) $356 $356 3.7×
Radex Foot Compl Minimum 3 Views (73630) $338 $338 3.5×
Radex Hand Minimum 3 Views (73130) $344 $344 3.5×
Radex Hip Unilateral With Pelvis 1 View (73501) $338 $338 3.5×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $620 $620 5.3×
Radex Hips Bilateral With Pelvis 2 Views (73521) $620 $620 5.3×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $620 $620 5.3×
Radex Humerus Minimum 2 Views (73060) $338 $338 3.5×
Radex Kne 1/2 Views (73560) $338 $338 3.5×
Radex Kne Compl 4/More Views (73564) $620 $620 5.3×
Radex Mndbl Compl Minimum 4 Views (70110) $620 $620 5.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $199 $199 2.1×
Radex Pelvis Compl Minimum 3 Views (72190) $620 $620 5.3×
Radex Sho Compl Minimum 2 Views (73030) $299 $299 3.1×
Radex Sinuses Paransl < 3 Views (70210) $197 $197 2.0×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $620 $620 5.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $338 $338 3.5×
Radex Toe Minimum 2 Views (73660) $279 $279 2.9×
Radex upper extremity infant minimum 2 views (73092) $620 $620 5.3×
Radex Wrst Compl Minimum 3 Views (73110) $338 $338 3.5×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $620 $620 5.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $338 $338 3.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $653 $653 5.6×
Radiologic exam chest 2 views (71046) $370 $370 3.8×
Radiologic exam colon single contrast study (74270) $1,368 $1,368 7.0×
Radiologic exam upr gi trc double contrast study (74246) $867 $867 4.4×
Radiologic exam upr gi trc single contrast study (74240) $871.50 $871.50 4.5×
Radiologic examination femur 1 view (73551) $338 $338 3.5×
Radiologic examination tibia & fibula 2 views (73590) $338 $338 3.5×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $620 $620 5.3×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $620 $620 5.3×
Radiological examination surgical specimen (76098) $528 $528 0.9×
Ribs bilateral 3 views (71110) $620 $620 5.3×
Rp loclzj tum spect 1 area single day imaging (78803) $2,450 $2,450 4.0×
Sacroiliac Joints < 3 Views (72200) $53 $53 0.5×
Saline Infus Sonohysterography W/Color Doppler (76831) $1,257 $1,257 4.7×
Scapula (73010) $620 $620 5.3×
Screening Digital Breast Tomosynthesis Bi (77063) $109 $109 4.7×
Shoulder 1 view (73020) $338 $338 3.5×
Small bowel series (74250) $620 $620 3.2×
Special dosimetry (77331) $407.50 $407.50 2.7×
Special Physics Consult (77370) $1,519 $1,519 10.1×
Special treatment procedure (77470) $3,465 $3,465 5.6×
Spine thoracic 3 views (72072) $620 $620 5.3×
Ther rad simulaj-aided field setting complex (77290) $2,009 $2,009 4.8×
Thoracolumbar 2 views (72080) $338 $338 3.5×
Thyroid imaging w/blood flow (78013) $1,890 $1,890 4.2×
Thyroid uptake measurement (78012) $1,890 $1,890 4.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,890 $1,890 4.2×
Tmj unilateral (70328) $248 $248 2.6×
Tomogram (76100) $620 $620 5.3×
Treatment devices simple (77332) $1,235 $1,235 8.2×
Ultrasound breast complete (76641) $620 $620 5.3×
Ultrasound Exam Aaa Screen (76706) $620 $620 5.3×
Ultrasound, abdomen limited (76705) $620 $620 5.3×
Unlisted ultrasound procedure (76999) $356 $356 3.7×
Urethrocystogram voiding (74455) $1,257 $1,257 4.7×
Urethrocystography retrograde rs&i (74450) $1,257 $1,257 4.7×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) $1,368 $1,368 7.0×
Us breast unilateral limited (76642) $380.50 $380.50 3.9×
Us chest (76604) $620 $620 5.3×
Us infant hips w manipulation (76885) $338 $338 3.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $620 $620 5.3×
Us ob detailed single fetus (76811) $620 $620 2.3×
Us ob limited (76815) $620 $620 5.3×
Us ob transvaginal (76817) $620 $620 5.3×
Us pelvic non ob complete (76856) $442 $442 3.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $620 $620 5.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $620 $620 5.3×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $620 $620 5.3×
Us retroperitoneal complete (76770) $620 $620 5.3×
Us retroperitoneal limited (76775) $653 $653 5.6×
Us scrotum and contents (76870) $620 $620 5.3×
Us soft tissue head/neck (76536) $620 $620 5.3×
Us spinal canal and contents (76800) $620 $620 5.3×
Us transrectal prostate volume (76873) $1,057.50 $1,057.50 9.1×
Us,transplanted kidney, real time/ doppler (76776) $620 $620 5.3×
Wrist 2 views (73100) $338 $338 3.5×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $620 $620 5.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $338 $338 3.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,368 $1,368 7.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $338 $338 3.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $338 $338 3.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $620 $620 5.3×
X-ray exam of femur 2/> (73552) $358 $358 3.7×
X-ray eye for foreign body (70030) $338 $338 3.5×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $197 $197 2.0×
X-ray IV pyelogram (ivp) (74400) $1,368 $1,368 7.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $64 $64 0.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $340 $340 3.5×
X-ray leg, infant (73592) $338 $338 3.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $620 $620 5.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $620 $620 5.3×
X-ray nose-rectum child f.b. (76010) $338 $338 3.5×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $347.50 $347.50 3.0×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $338 $338 3.5×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $620 $620 5.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $620 $620 5.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $620 $620 5.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $338 $338 3.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $202 $202 2.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $348 $348 3.0×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $341 $341 2.9×
X-Ray Spine One View - Xr Spine (72020) $338 $338 3.5×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $338 $338 3.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $338 $338 3.5×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $620 $620 5.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $83 $83 0.7×
Xr bone length studies (77073) $620 $620 5.3×
Xr c-spine 4 or 5 views (72050) $620 $620 5.3×
Xr c-spine 6 or more views (72052) $620 $620 5.3×
Xr chest 4+ views (71048) $620 $620 5.3×