Imaging prices at Woodlawn Hospital
Rochester, IN · every code in this section with a posted price and a Medicare benchmark.
204 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) | $303.75 | $405 | 3.3× |
| Abdomen 2 views (74019) | $423 | $564 | 3.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,711.50 | $2,282 | 4.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$256.50–$384.75 | $342–$513 | varies |
| Bone age studies (77072) | $385.50 | $514 | 3.5× |
| Bone Imaging 3 Phase (78315) | $1,775.25 | $2,367 | 4.2× |
| Bone Imaging Limited Area (78300) | $1,524.75 | $2,033 | 3.6× |
| Bone Imaging Whole Body (78306) | $1,775.25 | $2,367 | 4.2× |
| Bone survey infant (77076) | $345 | $460 | 3.1× |
| Cat Scan Follow-Up Study (76380) | $559.50 | $746 | 6.1× |
| Chest 1 view (71045) | $271.50 | $362 | 2.9× |
| Chest 2 views (71046) | $348 | $464 | 3.8× |
| Chest 3 views (71047) | $390 | $520 | 4.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$327.75–$491.25 | $437–$655 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,030.50 | $1,374 | 9.3× |
| CT abdomen and pelvis without and with contrast (74178) | $4,241.25 | $5,655 | 11.5× |
| CT abdomen and pelvis without contrast (74176) | $2,862.75 | $3,817 | 11.3× |
| CT abdomen w contrast (74160) | $2,148.75 | $2,865 | 11.6× |
| CT abdomen w wo contrast (74170) | $2,519.25 | $3,359 | 13.6× |
| CT abdomen w/o contrast (74150) | $1,812 | $2,416 | 16.4× |
| CT Angio Abdomen and Pelvis (74174) | $4,028.25 | $5,371 | 10.9× |
| CT Angio Chest (71275) | $2,418.75 | $3,225 | 13.0× |
| CT Angio Head (70496) | $2,305.50 | $3,074 | 12.4× |
| CT Angio Neck (70498) | $2,232 | $2,976 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,245.50 | $2,994 | 12.1× |
| CT cervical spine w/o contrast (72125) | $1,910.25 | $2,547 | 17.3× |
| CT chest w contrast (71260) | $2,061.75 | $2,749 | 11.1× |
| CT chest w/wo contrast (71270) | $2,471.25 | $3,295 | 13.3× |
| CT head/brain with contrast (70460) | $1,848.75 | $2,465 | 10.0× |
| CT head/brain without and with contrast (70470) | $2,180.25 | $2,907 | 11.7× |
| CT iac w contrast (70481) | $2,214 | $2,952 | 11.9× |
| CT l-spine w&w/o contrast (72133) | $3,148.50 | $4,198 | 17.0× |
| CT lower ext w/o (73700) | $1,654.50 | $2,206 | 15.0× |
| CT lower extremity w/contrast material (73701) | $1,932.75 | $2,577 | 10.4× |
| CT lumbar spine w contrast (72132) | $2,897.25 | $3,863 | 7.8× |
| CT lumbar spine w/o contrast (72131) | $1,977.75 | $2,637 | 17.9× |
| CT maxillofacial w contrast (70487) | $1,869 | $2,492 | 10.1× |
| CT maxillofacial wo contrast (70486) | $1,557.75 | $2,077 | 14.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,371.50 | $3,162 | 12.8× |
| CT orbits w/o contrast (70480) | $1,493.25 | $1,991 | 13.5× |
| CT pelvis w&w/o contrast (72194) | $2,643.75 | $3,525 | 14.2× |
| CT pelvis w/o contrast (72192) | $1,623 | $2,164 | 14.7× |
| CT scan of leg combo (73702) | $2,214.75 | $2,953 | 11.9× |
| CT scans face/jaw combo (70488) | $2,583 | $3,444 | 13.9× |
| CT soft tissue neck w contrast (70491) | $1,873.50 | $2,498 | 10.1× |
| CT soft tissue neck w/o contrast (70490) | $1,633.50 | $2,178 | 14.8× |
| CT thoracic spine w/o contrast (72128) | $1,820.25 | $2,427 | 16.5× |
| CT thoracic spine w/wo cont (72130) | $2,613.75 | $3,485 | 14.1× |
| CT thorax w/o contrast (71250) | $1,683.75 | $2,245 | 15.2× |
| CT upper ext wo (73200) | $1,600.50 | $2,134 | 14.5× |
| CT upper extremity with contrast (73201) | $2,105.25 | $2,807 | 5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,152.25 | $4,203 | 17.0× |
| Cta Abdomen (74175) | $2,385.75 | $3,181 | 12.9× |
| CTA pelvis (72191) | $2,166.75 | $2,889 | 11.7× |
| Dxa Bone Density Axial (77080) | $530.25 | $707 | 4.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $375 | $500 | 4.1× |
| Esophagram (74220) | $602.25 | $803 | 3.2× |
| Fetal Biophys Profile W/Nst (76818) | $483.75 | $645 | 4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$328.50–$780.75 | $438–$1,041 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$293.25–$440.25 | $391–$587 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$322.50–$484.50 | $430–$646 | varies |
| Gastric emptying imaging study (78264) | $1,677 | $2,236 | 4.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$268.50–$403.50 | $358–$538 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,095.50 | $2,794 | 3.6× |
| Hepatobiliary System Imaging (78226) | $1,725.75 | $2,301 | 4.1× |
| Ht Muscle Image Spect Sing (78451) | $2,784 | $3,712 | 2.0× |
| Hysterosalpingogram (74740) | $309 | $412 | 1.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $621 | $828 | 6.7× |
| Infant hip ultrasound, limited static exam (76886) | $510 | $680 | 5.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$361.50–$543 | $482–$724 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $2,481 | $3,308 | 4.3× |
| Lymph System Imaging (78195) | $1,372.50 | $1,830 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,219.75 | $4,293 | 8.7× |
| MRA head w/o contrast (70544) | $2,538.75 | $3,385 | 10.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,559.50 | $4,746 | 9.6× |
| MRA neck w/o contrast (70547) | $3,252 | $4,336 | 12.9× |
| MRI abdomen w/o contrast (74181) | $3,147.75 | $4,197 | 12.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,683.25–$5,525.25 | $4,911–$7,367 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,992.25 | $5,323 | 10.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,427.50 | $4,570 | 4.1× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,246.25–$2,994.75 | $2,995–$3,993 | varies |
| MRI chest w/o contrast (71550) | $3,237 | $4,316 | 12.8× |
| MRI chest wo w contrast (71552) | $3,601.50 | $4,802 | 9.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$3,898.50–$5,847.75 | $5,198–$7,797 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,992.25–$5,989.50 | $5,323–$7,986 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,427.50 | $4,570 | 13.6× |
| MRI lumbar spine w contrast (72149) | $3,183 | $4,244 | 8.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,561.75 | $4,749 | 9.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,334.50 | $4,446 | 9.0× |
| MRI pelvis w/o & w contrast (72197) | $3,539.25 | $4,719 | 9.6× |
| MRI pelvis w/o contrast (72195) | $2,623.50 | $3,498 | 10.4× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,060.25–$2,747.25 | $2,747–$3,663 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,745.50 | $4,994 | 10.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$3,104.25–$4,656.75 | $4,139–$6,209 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,992.25–$5,989.50 | $5,323–$7,986 | varies |
| MRI, abdomen, combo (74183) | $3,554.25 | $4,739 | 9.6× |
| MRI, dorsal spine combo (72157) | $3,747.75 | $4,997 | 10.2× |
| MRI, joint upper extrem (73221) | $3,107.25 | $4,143 | 12.3× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,768–$5,652 | $5,024–$7,536 | varies |
| MRI, lumbar spine combo (72158) | $3,505.50 | $4,674 | 9.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$176.25–$5,060.25 | $235–$6,747 | varies |
| Neck soft tissue (70360) | $303 | $404 | 3.3× |
| Parathyroid Planar Imaging (78070) | $1,354.50 | $1,806 | 3.2× |
| Pelvis 1 or 2 views (72170) | $345.75 | $461 | 3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,593 | $2,124 | 3.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $615.75 | $821 | 5.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$341.25–$511.50 | $455–$682 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$303–$454.50 | $404–$606 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$324–$509.25 | $432–$679 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $510.75 | $681 | 4.6× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$229.50–$394.50 | $306–$526 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$333.75–$500.25 | $445–$667 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$333.75–$500.25 | $445–$667 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$207.75–$312 | $277–$416 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $282.75 | $377 | 3.1× |
| Radex Ribs Unilateral 2 Views (71100) | $318 | $424 | 3.5× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$348.75–$523.50 | $465–$698 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $264.75 | $353 | 2.9× |
| Radex Spine 1 View Specify Level (72020) | $327 | $436 | 3.6× |
| Radex Sternum Minimum 2 Views (71120) | $294.75 | $393 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $510 | $680 | 5.5× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$219–$369 | $292–$492 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$172.50–$258.75 | $230–$345 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$336.75–$504.75 | $449–$673 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $661.50 | $882 | 6.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $424.50 | $566 | 3.8× |
| Radiologic exam colon double contrast study (74280) | $1,231.50 | $1,642 | 6.6× |
| Radiologic exam colon single contrast study (74270) | $831.75 | $1,109 | 4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $696.75 | $929 | 3.8× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$462–$693 | $616–$924 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $444 | $592 | 4.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $660 | $880 | 3.6× |
| Radiologic exam swallow function contrast study (74230) | $648.75 | $865 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $896.25 | $1,195 | 4.8× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$347.25–$521.25 | $463–$695 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$292.50–$438 | $390–$584 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $704.25 | $939 | 6.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$336–$504 | $448–$672 | varies |
| Ribs bilateral 3 views (71110) | $541.50 | $722 | 4.9× |
| Scapula (73010) range across 2 matching MRF lines |
$333.75–$500.25 | $445–$667 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $90.75 | $121 | 3.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$250.50–$375.75 | $334–$501 | varies |
| Shoulder Arthrography (73040) | $1,010.25 | $1,347 | 2.7× |
| Skull less than 4 views (70250) | $332.25 | $443 | 3.0× |
| Speech evaluation, complex (70371) | $195 | $260 | 0.8× |
| Sternoclavicular joints (71130) | $345 | $460 | 3.7× |
| Thoracic spine 2 views (72070) | $372 | $496 | 3.4× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$432–$456 | $576–$608 | varies |
| Thoracolumbar 2 views (72080) | $405 | $540 | 4.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,354.50 | $1,806 | 3.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$480.75–$720.75 | $641–$961 | varies |
| Ultrasound Elastography Parenchyma (76981) | $336 | $448 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $779.25 | $1,039 | 7.0× |
| Ultrasound, abdomen limited (76705) | $758.25 | $1,011 | 6.9× |
| Umbilical-artery Doppler (OB) (76820) | $752.25 | $1,003 | 6.8× |
| Unlisted us procedure (76999) | $472.50 | $630 | 5.1× |
| Upper gi w/o kub (74240) | $951.75 | $1,269 | 5.1× |
| Urethrocystogram voiding (74455) | $720 | $960 | 2.9× |
| Us breast unilateral complete (76641) | $529.50 | $706 | 4.8× |
| Us chest (76604) | $585 | $780 | 5.3× |
| Us exam, pelvic, limited (76857) | $522.75 | $697 | 4.7× |
| Us head (76506) | $621 | $828 | 5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $474 | $632 | 4.3× |
| Us ob limited 1 or more fetuses (76815) | $502.50 | $670 | 4.5× |
| Us ob transvaginal (76817) | $726 | $968 | 6.6× |
| Us pelvic non ob complete (76856) | $852 | $1,136 | 7.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $708 | $944 | 6.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $454.50 | $606 | 4.1× |
| Us retroperitoneal complete (76770) | $911.25 | $1,215 | 8.2× |
| Us retroperitoneal limited (76775) | $779.25 | $1,039 | 7.0× |
| Us scrotum and contents (76870) | $839.25 | $1,119 | 7.6× |
| Us thyroid (76536) | $768.75 | $1,025 | 7.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$240–$360 | $320–$480 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $353.25 | $471 | 3.8× |
| X-Ray Bend Only L-S Spine (72120) | $551.25 | $735 | 5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$249.75–$374.25 | $333–$499 | varies |
| X-Ray Exam Breast Specimen (76098) | $497.25 | $663 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $440.25 | $587 | 4.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $744 | $992 | 6.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $665.25 | $887 | 6.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $249 | $332 | 2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$345.75–$417 | $461–$556 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $543 | $724 | 4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $459 | $612 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $612 | $816 | 5.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$371.25–$378 | $495–$504 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $675 | $900 | 6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$459–$480 | $612–$640 | varies |
| X-ray eye for foreign body (70030) | $458.25 | $611 | 5.0× |
| X-ray humerus (73060) | $357 | $476 | 3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $313.50 | $418 | 3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $420.75 | $561 | 3.8× |
| X-ray nose-rectum child f.b. (76010) | $264.75 | $353 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $588 | $784 | 5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $337.50 | $450 | 3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $375.75 | $501 | 4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $510.75 | $681 | 5.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $483.75 | $645 | 4.4× |
| X-ray thoracic spine 4 vw (72074) | $606.75 | $809 | 5.5× |
| X-Rays Bone Length Studies (77073) | $558.75 | $745 | 5.1× |
| X-Rays Bone Survey Complete (77075) | $1,275.75 | $1,701 | 11.5× |
| Xr c-spine 4 or 5 views (72050) | $537 | $716 | 4.9× |
| Xr facial bones less than 3 views (70140) | $321 | $428 | 3.5× |
| Xr orbits complete 4 views (70200) | $489.75 | $653 | 4.4× |
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.