Imaging prices at Windom Area Health

Windom, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $361.76 $532 3.4×
Acute gi blood loss imaging (78278) $764.94 $1,124.90 1.9×
Ankle 2 views (73600) $102.88 $151.30 1.1×
Arthrogram hip (73525) $811.92 $1,194 2.3×
Arthrogram shoulder (73040) $436.38 $641.74 1.2×
Arthrogram wrist (73115) $679.32 $999 1.9×
Bone &/Joint Imaging Limited Area (78300) $752.94 $1,107.27 1.8×
Bone &/joint imaging whole body (78306) $796.68 $1,171.59 1.9×
Bone age studies (77072) $313.48 $461 2.9×
Bone Imaging 3 Phase (78315) $959.76 $1,411.40 2.3×
Bone survey complete (77075) $276.30 $406.32 2.6×
Bone survey infant (77076) $670.48 $986 6.2×
Bowel imaging (78290) $773.46 $1,137.44 1.9×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $790.58 $1,162.62 1.4×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $825.40 $1,213.82 2.0×
Cervical spine 2 or 3 views (72040) $207.52 $305.16 2.3×
Chest 1 view (71045) $76.74 $112.84 0.9×
Chest xray 3 views (71047) $290.36 $427 3.2×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $180.52 $265.48 1.0×
Clavicle complete (73000) $120.97 $177.89 1.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $578 $850 5.4×
CT abdomen and pelvis without and with contrast (74178) $2,109.16 $3,101.70 5.9×
CT abdomen and pelvis without contrast (74176) $1,743.60 $2,564.12 7.1×
CT abdomen w contrast (74160) $1,159.93 $1,705.78 6.4×
CT abdomen w wo contrast (74170) $1,236.04 $1,817.70 6.8×
CT abdomen w/o contrast (74150) $883.40 $1,299.10 8.2×
CT angio lwr extr w/o&w/dye (73706) $1,259.88 $1,852.76 7.0×
CT angiography upper extremity lt (73206) $1,252.04 $1,841.24 6.9×
CT c-spine w/contrast (72126) $1,159.80 $1,705.60 3.2×
CT c-spine w/o contrast (72125) $897.75 $1,320.22 8.3×
CT cervical spine w&w/o contrast (72127) $1,241.11 $1,825.16 6.9×
CT chest w contrast (71260) $1,148.42 $1,688.86 6.3×
CT chest w/wo contrast (71270) $1,226.88 $1,804.23 6.8×
CT head/brain with contrast (70460) $908.80 $1,336.48 5.0×
CT head/brain without and with contrast (70470) $992.86 $1,460.08 5.5×
CT iac w contrast (70481) $943.82 $1,387.98 5.2×
CT limited/localized follow up study (76380) $608.52 $894.88 6.8×
CT lower ext w/o (73700) $791.85 $1,164.48 7.3×
CT lower extremity w wo contrast (73702) $1,180.56 $1,736.12 6.5×
CT lower extremity w/contrast material (73701) $1,054.32 $1,550.46 5.8×
CT lumbar spine w & w/o contrast (72133) $1,240.74 $1,824.61 6.9×
CT lumbar spine w/contrast (72132) $1,159.80 $1,705.60 3.2×
CT lumbar spine w/o contrast (72131) $897.25 $1,319.48 8.3×
CT maxillofacial w contrast (70487) $910.54 $1,339.02 5.0×
CT maxillofacial w/wo contrast (70488) $997.31 $1,466.63 5.5×
CT maxillofacial wo contrast (70486) $780.22 $1,147.38 7.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,027.80 $1,511.46 5.7×
CT orbits w/o contrast (70480) $805.59 $1,184.68 7.5×
CT pelvis w/o contrast (72192) $883.89 $1,299.84 8.2×
CT pelvis w/wo contrast (72194) $1,238.39 $1,821.16 6.8×
CT scan of arm combo (73202) $1,148.36 $1,688.76 6.3×
CT soft tissue neck w contrast (70491) $1,042.56 $1,533.17 5.8×
CT soft tissue neck w/o & w/contrast material (70492) $1,158.69 $1,703.96 6.4×
CT soft tissue neck w/o contrast (70490) $782.82 $1,151.20 7.3×
CT thoracic spine w/contrast (72129) $1,160.18 $1,706.14 6.4×
CT thoracic spine w/o contrast (72128) $897.50 $1,319.85 8.3×
CT thoracic spine w/wo contrast (72130) $1,241.60 $1,825.88 6.9×
CT thorax w/o contrast (71250) $888.46 $1,306.56 8.2×
CT upper ext wo (73200) $791.73 $1,164.30 7.3×
CT upper extremity with contrast (73201) $1,053.20 $1,548.82 2.9×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $2,615.28 $3,846 14.4×
Cta Abdomen (74175) $1,244.50 $1,830.14 6.9×
CTA abdomen pelvis (74174) $2,118.32 $3,115.16 5.9×
CTA chest (71275) $1,241.78 $1,826.14 6.9×
Cta Head (70496) $727.82 $1,070.32 4.0×
Cta Neck (70498) $1,240.29 $1,823.95 6.9×
Cta Pelvis (72191) $1,244.12 $1,829.59 6.9×
Cystography minimum 3 views rs&i (74430) $89.20 $131.16 0.2×
Dxa bone density study 1/> sites axial skel (77080) $335.42 $493.26 3.1×
Esophagus (74220) $260.35 $382.86 1.4×
Facial bones min 3 views (70150) $162.36 $238.76 1.5×
Fetal biophysical profile non-stress testing (76818) $575.28 $846 5.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $191.14 $281.09 1.8×
Fluoroscopy up to 1 hr (76000) $302.88 $445.40 1.2×
Foot 2 views (73620) $101.90 $149.84 1.1×
Forearm 2 views (73090) $120.22 $176.80 1.3×
Hand 2 views (73120) $102.40 $150.58 0.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $728.82 $1,071.79 1.3×
Hepatobiliary syst imaging including gallbladder (78226) $1,164.16 $1,712 2.8×
Hysterosalpingogram (74740) $113.87 $167.46 0.5×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $290.36 $427 2.7×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $552.20 $812.06 1.0×
Kidney img morphology vascular flow 1 w/rx (78708) $1,719.72 $2,529 3.1×
Knee 3 views (73562) $159.02 $233.85 1.8×
Liver & spleen imaging static only (78215) $636.02 $935.32 1.5×
Lung ventilation imaging (78579) $862.24 $1,268 2.1×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,329.86 $1,955.68 1.6×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,338.28 $1,968.05 3.7×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $1,421.72 $2,090.76 3.9×
MRA head w & w/o contrast (70546) $1,427.83 $2,099.74 4.0×
MRA head w/o contrast (70544) $1,319.22 $1,940.02 5.4×
MRA head with contrast (70545) $1,318.23 $1,938.57 3.7×
MRA neck w contrast (70548) $1,325.16 $1,948.76 3.7×
Mra Neck W/O &W/Contrast Material (70549) $1,428.82 $2,101.20 4.0×
MRA neck w/o contrast (70547) $1,319.71 $1,940.75 5.4×
MRI abdomen w contrast (74182) $1,329.24 $1,954.76 3.7×
MRI abdomen w/o & w/contrast material (74183) $1,395.36 $2,052 3.9×
MRI abdomen w/o contrast (74181) $1,298.88 $1,910.12 5.3×
MRI any jt lower extrem w/contrast material (73722) $1,330.73 $1,956.95 1.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,411.32 $2,075.48 3.9×
MRI c-spine with contrast (72142) $1,308.45 $1,924.19 3.6×
MRI cervical spine w/o contrast (72141) $1,278.22 $1,879.72 5.2×
MRI chest w/o & w/contrast material (71552) $1,447.62 $2,128.86 4.0×
MRI chest w/o contrast (71550) $1,345.33 $1,978.42 5.5×
MRI chest with contrast (71551) $1,355.35 $1,993.16 1.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,316.86 $1,936.56 3.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,396.08 $2,053.04 3.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,309.40 $1,925.58 5.3×
MRI orbit face &/neck w/o contrast (70540) $1,296.90 $1,907.20 5.3×
MRI orbit face neck w contrast (70542) $1,309.69 $1,926.01 3.6×
MRI orbit/face/neck w&w/o cont (70543) $1,388.31 $2,041.63 3.9×
MRI pelvis w/contrast (72196) $1,316.86 $1,936.56 3.7×
MRI pelvis w/o & w/contrast material (72197) $1,394.99 $2,051.46 3.9×
MRI pelvis w/o contrast (72195) $1,310.88 $1,927.76 5.3×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,725.58 $2,537.62 4.8×
MRI spinal canal lumbar w/contrast material (72149) $1,306.97 $1,922.01 3.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,377.05 $2,025.07 3.8×
MRI spinal canal thoracic w/contrast matrl (72147) $1,307.71 $1,923.10 3.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,377.67 $2,025.98 3.8×
MRI temporomandibular joint (70336) $1,312.54 $1,930.20 5.3×
MRI thoracic spine w/o contrast (72146) $1,278.34 $1,879.90 5.2×
MRI up ext w/o contrast (73218) $1,330.23 $1,956.22 5.4×
MRI upper ext joint w/o contrast (73221) $1,284.82 $1,889.44 5.2×
MRI, joint upper extrem combo (73223) $1,535.21 $2,257.66 4.3×
Myelogram Lumbar (72265) $876.52 $670.40 1.1×
Myocardial Spect Multiple Studies (78452) $1,669.61 $2,455.30 1.2×
Myocardial spect single study at rest or stress (78451) $1,100.51 $1,618.39 0.8×
Neck soft tissue (70360) $93.56 $137.58 1.0×
Nm gastric emptying study (78264) $741.04 $1,089.76 1.8×
Noncardiac Vascular Flow Imaging (78445) $542.61 $797.96 1.3×
Osseous survey limited (77074) $199.70 $293.68 1.9×
Parathyrd planar w/spect&CT (78072) $555.63 $817.10 1.0×
Parathyroid planar imaging w/wo subtraction (78071) $865.64 $1,273 2.1×
Pelvis 1 or 2 views (72170) $131.38 $193.21 1.2×
PET image w/CT, skull-thigh (78815) $4,760 $7,000 3.2×
PET imaging for CT attenuation whole body (78816) $4,964 $7,300 3.4×
Pulmonary Perfusion Imaging Particulate (78580) $752.16 $1,106.11 1.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,141.44 $1,678.58 2.0×
Radex abscess/fistula/sinus tract rs&i (76080) $104.46 $153.62 0.2×
Radex Ankle Compl Minimum 3 Views (73610) $122.08 $179.53 1.4×
Radex Calcaneus Minimum 2 Views (73650) $120.84 $177.71 1.3×
Radex Elbw Compl Minimum 3 Views (73080) $122.08 $179.53 1.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $246.84 $363 2.7×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $550.12 $809 5.1×
Radex fingr minimum 2 views (73140) $71.95 $105.80 0.8×
Radex Foot Compl Minimum 3 Views (73630) $121.46 $178.62 1.4×
Radex Hand Minimum 3 Views (73130) $122.20 $179.71 1.4×
Radex Hip Unilateral With Pelvis 1 View (73501) $246.84 $363 2.7×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $429.08 $631 4.0×
Radex Hips Bilateral With Pelvis 2 Views (73521) $295.80 $435 2.7×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $672.52 $989 6.2×
Radex Humerus Minimum 2 Views (73060) $121.34 $178.44 1.4×
Radex Kne 1/2 Views (73560) $131.26 $193.03 1.5×
Radex Kne Compl 4/More Views (73564) $176.08 $258.94 1.6×
Radex Mndbl Compl Minimum 4 Views (70110) $163.07 $239.80 1.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $122.58 $180.26 1.4×
Radex Pelvis Compl Minimum 3 Views (72190) $360.40 $530 3.3×
Radex Sho Compl Minimum 2 Views (73030) $130.28 $191.58 1.5×
Radex Sinuses Paransl < 3 Views (70210) $58.90 $86.62 0.7×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $319.60 $470 3.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $182.73 $268.72 2.0×
Radex Toe Minimum 2 Views (73660) $59.15 $86.98 0.7×
Radex upper extremity infant minimum 2 views (73092) $102.14 $150.21 0.9×
Radex Wrst Compl Minimum 3 Views (73110) $123.32 $181.35 1.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $830.28 $1,221 7.7×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $143.60 $211.16 1.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $447.44 $658 4.1×
Radiologic exam chest 2 views (71046) $242.76 $357 2.7×
Radiologic exam colon single contrast study (74270) $334.70 $492.21 1.8×
Radiologic Exam Esophagus Double Contrast Study (74221) $568.48 $836 3.1×
Radiologic exam upr gi trc double contrast study (74246) $356.34 $524.02 2.0×
Radiologic exam upr gi trc single contrast study (74240) $264.81 $389.42 1.5×
Radiologic examination femur 1 view (73551) $208.76 $307 2.3×
Radiologic examination tibia & fibula 2 views (73590) $130.40 $191.76 1.5×
Radiological examination surgical specimen (76098) $43.48 $63.94 0.1×
Ribs bilateral 3 views (71110) $251.47 $369.80 2.3×
Rp loclzj tum spect 1 area single day imaging (78803) $722.16 $1,061.99 1.3×
Saline Infus Sonohysterography W/Color Doppler (76831) $652.12 $959 2.6×
Scapula (73010) $135.86 $199.80 1.3×
Screening Digital Breast Tomosynthesis Bi (77063) $80.92 $119 3.5×
Shoulder 1 view (73020) $56.80 $83.52 0.6×
Small bowel series (74250) $114.46 $168.33 0.6×
Spine thoracic 3 views (72072) $158.16 $232.58 1.5×
Spleen imaging only (78185) $241.58 $355.27 0.6×
Thoracolumbar 2 views (72080) $131.14 $192.85 1.5×
Thyroid imaging w/blood flow (78013) $693.36 $1,019.64 1.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $729.13 $1,072.25 1.8×
Tmj unilateral (70328) $285.60 $420 3.2×
Tomogram (76100) $146.30 $215.14 1.4×
Ultrasound breast complete (76641) $686.12 $1,009 6.4×
Ultrasound Exam Aaa Screen (76706) $538.56 $792 5.0×
Ultrasound, abdomen limited (76705) $383.92 $564.60 3.6×
Unlisted Diagnostic Radiographic Procedure (76499) $830.96 $1,222 9.3×
Unlisted ultrasound procedure (76999) $612.68 $901 6.8×
Urethrocystogram voiding (74455) $123.92 $182.23 0.5×
Urethrocystography retrograde rs&i (74450) $100.12 $147.24 0.4×
Us breast unilateral limited (76642) $612.68 $901 6.8×
Us chest (76604) $414.86 $610.10 3.8×
Us compl joint r-t w/image documentation (76881) $417.58 $614.10 3.9×
Us infant hips w manipulation (76885) $170 $250 1.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $412.08 $606 3.8×
Us ob detailed single fetus (76811) $372.97 $548.48 1.5×
Us ob limited (76815) $301.12 $442.82 2.8×
Us ob transvaginal (76817) $424.42 $624.14 3.9×
Us pelvic non ob complete (76856) $341.83 $502.69 3.2×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $217.66 $320.08 2.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $299.27 $440.10 2.8×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $193.25 $284.19 1.8×
Us retroperitoneal complete (76770) $434.90 $639.56 4.0×
Us retroperitoneal limited (76775) $347.13 $510.48 3.2×
Us scrotum and contents (76870) $329.08 $483.94 3.0×
Us soft tissue head/neck (76536) $391.16 $575.24 3.6×
Venogram Extremity Unilateral (75820) $122.66 $180.38 0.1×
Vertebral fracture assessment via dxa (77086) $648.72 $954 7.2×
Wrist 2 views (73100) $103.38 $152.03 1.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $197.84 $290.94 1.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $122.61 $180.30 1.4×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $447.29 $657.78 2.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $102.14 $150.21 1.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $147.12 $216.35 1.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $537.20 $790 5.0×
X-ray exam of femur 2/> (73552) $131.51 $193.40 1.5×
X-ray eye for foreign body (70030) $159.73 $234.89 1.8×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $120.84 $177.71 1.3×
X-ray IV pyelogram (ivp) (74400) $387.30 $569.56 2.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $131.30 $193.08 1.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $132.75 $195.22 1.5×
X-ray leg, infant (73592) $102.14 $150.21 1.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $170.06 $250.08 1.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $281.52 $414 2.6×
X-ray nose-rectum child f.b. (76010) $278.12 $409 3.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $162.36 $238.76 1.5×
X-ray retrograde pyelogram (74420) $412.08 $606 1.1×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $167.40 $246.16 1.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $251.22 $369.44 2.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $279.16 $410.54 2.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $134.57 $197.90 1.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $133.21 $195.89 1.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $182.66 $268.62 2.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $247.36 $363.76 2.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $131.64 $193.58 1.2×
X-Ray Spine One View - Xr Spine (72020) $72.32 $106.34 0.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $122.82 $180.62 1.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $161.09 $236.89 1.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $131.26 $193.03 1.2×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $215.74 $317.26 2.0×
Xr bone length studies (77073) $346.80 $510 3.2×
Xr c-spine 4 or 5 views (72050) $252.95 $371.98 2.3×
Xr c-spine 6 or more views (72052) $306.12 $450.18 2.8×
Xr chest 4+ views (71048) $339.32 $499 3.1×