Imaging prices at Wray Community District Hospital

Wray, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $361.05 $481.40 3.3×
Acute gastrointestinal blood loss imaging (78278) $828.46 $1,104.61 2.0×
Ankle 2 views (73600) $177.56 $236.75 1.9×
Arthrogram shoulder (73040) $582.26 $776.35 1.6×
Bone &/Joint Imaging Limited Area (78300) $778.73 $1,038.31 1.8×
Bone &/Joint Imaging Multiple Areas (78305) $872.53 $1,163.37 2.1×
Bone &/joint imaging whole body (78306) $915.14 $1,220.18 2.2×
Bone Imaging 3 Phase (78315) $956.47 $1,275.30 2.3×
Bone survey complete (77075) $739.79 $986.39 6.7×
Cervical spine 2 or 3 views (72040) $296.59 $395.45 3.2×
Chest 1 view (71045) $222.98 $297.31 2.4×
Chest 3 views (71047) $273.58 $364.78 3.0×
Clavicle complete (73000) $209.63 $279.51 2.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,170.11 $1,560.15 10.6×
CT abdomen and pelvis without and with contrast (74178) $3,061.42 $4,081.90 8.3×
CT abdomen and pelvis without contrast (74176) $2,210.15 $2,946.87 8.8×
CT abdomen w contrast (74160) $1,495.15 $1,993.53 8.1×
CT abdomen w wo contrast (74170) $1,496.16 $1,994.88 8.1×
CT abdomen w/o contrast (74150) $1,300.12 $1,733.50 11.8×
CT c-spine w/o contrast (72125) $1,495.15 $1,993.53 13.6×
CT cervical spine w&w/o contrast (72127) $2,025.58 $2,700.78 10.9×
CT cervical spine with contrast (72126) $1,495.15 $1,993.53 4.1×
CT chest w/wo contrast (71270) $1,760.36 $2,347.16 9.5×
CT chest with contrast (71260) $1,495.15 $1,993.53 8.1×
CT head/brain with contrast (70460) $1,495.15 $1,993.53 8.1×
CT head/brain without and with contrast (70470) $1,761.38 $2,348.50 9.5×
CT iac w contrast (70481) $1,105.11 $1,473.48 6.0×
CT lower ext w/o (73700) $1,105.11 $1,473.48 10.0×
CT lower extremity w wo contrast (73702) $1,497.17 $1,996.23 8.1×
CT lower extremity with contrast (73701) $1,300.12 $1,733.50 7.0×
CT lumbar spine w & w/o contrast (72133) $1,497.17 $1,996.23 8.1×
CT lumbar spine w/o contrast (72131) $1,495.15 $1,993.53 13.6×
CT lumbar spine with contrast (72132) $1,495.15 $1,993.53 4.1×
CT maxillofacial w contrast (70487) $1,495.15 $1,993.53 8.1×
CT maxillofacial w/o contrast (70486) $1,105.11 $1,473.48 10.0×
CT maxillofacial w/wo contrast (70488) $1,497.17 $1,996.23 8.1×
CT neck soft tissue w contrast (70491) $1,350.55 $1,800.73 7.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,497.17 $1,996.23 8.1×
CT orbits w/o contrast (70480) $1,300.12 $1,733.50 11.8×
CT pelvis w & w/o contrast (72194) $1,760.36 $2,347.16 9.5×
CT pelvis w/o contrast (72192) $1,495.15 $1,993.53 13.6×
CT soft tissue neck w/o & w/contrast material (70492) $1,761.38 $2,348.50 9.5×
CT soft tissue neck w/o contrast (70490) $1,300.12 $1,733.50 11.8×
CT thoracic spine w/contrast (72129) $1,495.15 $1,993.53 8.1×
CT thoracic spine w/o contrast (72128) $1,495.15 $1,993.53 13.6×
CT thoracic spine w/wo contrast (72130) $1,585.24 $2,113.65 8.6×
CT thorax w/o contrast (71250) $1,495.15 $1,993.53 13.6×
CT upper extremity w/o & w/contrast material (73202) $1,585.24 $2,113.65 8.6×
CT upper extremity w/o contrast rt (73200) $1,300.12 $1,733.50 11.8×
CT upper extremity with contrast (73201) $1,495.15 $1,993.53 4.1×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,704.27 $3,605.70 14.6×
Cta Abdomen (74175) $1,829.36 $2,439.15 9.9×
CTA abdomen pelvis (74174) $3,085.85 $4,114.47 8.4×
CTA chest (71275) $1,829.36 $2,439.15 9.9×
Cta Head (70496) $1,829.36 $2,439.15 9.9×
CTA lwr ext w&w/o contrast (73706) $1,510.07 $2,013.43 8.2×
Cta Neck (70498) $2,051.93 $2,735.90 11.1×
Cta Pelvis (72191) $1,846.73 $2,462.31 10.0×
Cystography minimum 3 views rs&i (74430) $532.95 $710.60 1.4×
Fetal biophysical profile non-stress testing (76818) $767.40 $1,023.20 7.0×
Fluoroscopy up to 1 hr (76000) $622.12 $829.50 2.5×
Foot 2 views (73620) $177.56 $236.75 1.9×
Forearm 2 views (73090) $209.63 $279.51 2.3×
Gated Heart Planar Single (78472) $1,462.50 $1,950 3.5×
Hand 2 views (73120) $177.56 $236.75 1.6×
Hand 3 views (73130) $209.63 $279.51 2.3×
Heart Infarct Image (78466) $684.26 $912.34 1.6×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $932.30 $1,243.06 1.6×
Hepatobiliary syst imaging including gallbladder (78226) $932.30 $1,243.06 2.2×
Ht muscle image spect sing (78451) $1,119.88 $1,493.18 0.8×
Humerus Min 2 Views Left (73060) $205.59 $274.12 2.2×
Kidney imaging morphology (78700) $804.08 $1,072.11 1.9×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,471.18 $1,961.57 2.6×
Kidney img morphology vascular flow 1 w/rx (78708) $1,208.03 $1,610.70 2.1×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,258.43 $1,677.91 2.2×
Knee 3 views (73562) $248.96 $331.95 2.7×
Liver & spleen imaging static only (78215) $725.01 $966.68 1.7×
Liver & Spleen Imaging W/Vascular Flow (78216) $881.20 $1,174.94 2.1×
Lymphoscintigraphy (78195) $853.61 $1,138.15 1.5×
Meckels Diverticulum (78290) $778.15 $1,037.53 1.8×
MRA head w & w/o contrast (70546) $1,642.94 $2,190.58 4.5×
MRA head w/o contrast (70544) $1,320.38 $1,760.50 5.2×
MRA head with contrast (70545) $1,320.11 $1,760.15 3.6×
Mra Neck W/O &W/Contrast Material (70549) $1,643.25 $2,191 4.5×
MRI abdomen w contrast (74182) $1,320.38 $1,760.50 3.6×
MRI abdomen w/o & w/contrast material (74183) $1,643.25 $2,191 4.5×
MRI abdomen w/o contrast (74181) $1,320.38 $1,760.50 5.2×
MRI any jnt lwr ext with con lt (73722) $1,320.38 $1,760.50 1.6×
MRI any jt upper extremity w/contrast matrl (73222) $1,320.38 $1,760.50 1.6×
MRI c-spine with contrast (72142) $1,320.38 $1,760.50 3.6×
MRI cervical spine w/o contrast (72141) $1,320.38 $1,760.50 5.2×
MRI chest w/o & w/contrast material (71552) $1,643.25 $2,191 4.5×
MRI chest w/o contrast (71550) $1,320.38 $1,760.50 5.2×
MRI chest with contrast (71551) $1,320.38 $1,760.50 1.6×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,320.38 $1,760.50 3.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,320.38 $1,760.50 3.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,320.38 $1,760.50 5.2×
MRI orbit face &/neck w/o contrast (70540) $1,320.38 $1,760.50 5.2×
MRI orbit/face/neck w&w/o cont (70543) $1,643.25 $2,191 4.5×
MRI orbit/face/neck w/contrast (70542) $1,320.38 $1,760.50 3.6×
MRI pelvis w contrast (72196) $1,320.38 $1,760.50 3.6×
MRI pelvis w/o & w/contrast material (72197) $1,643.25 $2,191 4.5×
MRI pelvis w/o contrast (72195) $1,320.38 $1,760.50 5.2×
MRI scan of arm joint before and after contrast (73223) $1,643.25 $2,191 4.5×
MRI scan of leg joint before and after contrast (73723) $1,643.25 $2,191 4.5×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,643.25 $2,191 4.5×
MRI spinal canal lumbar w/contrast material (72149) $1,320.38 $1,760.50 3.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,643.25 $2,191 4.5×
MRI spinal canal thoracic w/contrast matrl (72147) $1,320.38 $1,760.50 3.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,643.25 $2,191 4.5×
MRI thoracic spine w/o contrast (72146) $1,320.38 $1,760.50 5.2×
MRI upper ext joint w/o contrast (73221) $1,320.38 $1,760.50 5.2×
MRI upper extrem other than jt w/o & w/contras (73220) $1,643.25 $2,191 4.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,320.38 $1,760.50 5.2×
Myocardial Spect Multiple Studies (78452) $2,466.65 $3,288.87 1.8×
Neck soft tissue (70360) $190.27 $253.70 2.1×
Nm gastric emptying study (78264) $1,043.44 $1,391.26 2.5×
Nuclear medicine study of kidney and blood flow (78701) $932.30 $1,243.06 2.2×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $1,197.40 $1,596.53 2.8×
Nuclear medicine study to assess blood clot in vein of side (78457) $1,197.40 $1,596.53 2.1×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $487.12 $649.50 4.4×
Osseous survey infant (77076) $739.79 $986.39 6.7×
Parathyroid imaging (78070) $992.16 $1,322.88 2.4×
Pelvis 1 or 2 views (72170) $217.50 $290 2.0×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,643.25 $2,191 4.5×
Pulmonary Perfusion Imaging Particulate (78580) $838.30 $1,117.74 2.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,796.14 $2,394.86 3.1×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $370.54 $494.06 4.0×
Radex hips bilateral with pelvis 2 views (73521) $432.44 $576.58 3.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $221.10 $294.80 2.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $361.05 $481.40 3.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $273.58 $364.78 3.0×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $335.72 $447.63 3.7×
Radiological examination surgical specimen (76098) $76.24 $101.66 0.1×
Ribs bilateral 3 views (71110) $339.92 $453.23 3.1×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,058.32 $2,744.43 4.9×
Rp loclzj tum plnr whole body single day imaging (78802) $1,385.67 $1,847.56 2.4×
Rp loclzj tum spect 1 area single day imaging (78803) $1,026.38 $1,368.51 1.8×
Salivary gland imaging (78230) $752.60 $1,003.47 1.8×
Scapula complete (73010) $241.10 $321.47 2.2×
Screening digital breast tomosynthesis (77063) $45.24 $60.32 1.9×
Testicular Imaging With Vascular Flow (78761) $736.32 $981.76 1.7×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,283.10 $1,710.80 3.0×
Ultrasound, abdomen limited (76705) $465.64 $620.86 4.2×
Upper Extremity Infant (73092) $229.88 $306.50 2.1×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $1,034.86 $1,379.82 2.5×
Urethrocystography retrograde rs&i (74450) $659.85 $879.80 2.6×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $659.78 $879.70 3.6×
Us abdl aorta screen aaa (76706) $252.88 $337.17 2.3×
Us breast unilateral complete (76641) $295.48 $393.97 2.7×
Us breast unilateral limited (76642) $353.96 $471.95 3.9×
Us chest (76604) $323.49 $431.32 2.9×
Us ob transvaginal (76817) $723.97 $965.30 6.6×
Us pelvic non ob complete (76856) $503.36 $671.15 4.6×
Us pregnancy ltd (76815) $429.90 $573.20 3.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $233.10 $310.80 2.1×
Us retroperitoneal complete (76770) $531.12 $708.16 4.8×
Us retroperitoneal limited (76775) $347.17 $462.89 3.1×
Us scrotum and contents (76870) $453.86 $605.14 4.1×
Us soft tissue head/neck (76536) $519.79 $693.05 4.7×
Us transrectal (76872) $767.40 $1,023.20 7.0×
Us xtr non-vasc lmtd (76882) $330.53 $440.71 3.0×
Wrist 2 views (73100) $177.56 $236.75 1.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $361.05 $481.40 3.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $231.10 $308.13 2.5×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $201.54 $268.72 2.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $177.56 $236.75 1.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $300.36 $400.48 3.3×
X-ray exam hip uni 1 view (73501) $351.68 $468.91 3.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $328.10 $437.47 3.6×
X-ray exam of femur 1 (73551) $244.61 $326.15 2.7×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $335.72 $447.63 3.0×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $209.63 $279.51 2.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $209.63 $279.51 2.3×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $434.78 $579.70 3.9×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $229.88 $306.50 2.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $324.04 $432.05 2.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $651.97 $869.29 5.9×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $354.20 $472.27 3.2×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $335.72 $447.63 3.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $268.59 $358.12 2.4×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $667.58 $890.10 1.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $276.84 $369.12 3.0×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $451.42 $601.90 4.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $514.51 $686.01 4.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $268.59 $358.12 2.9×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $205.59 $274.12 2.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $335.72 $447.63 3.7×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $181.91 $242.55 2.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $434.78 $579.70 3.9×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $296.32 $395.09 2.7×
X-Ray Spine One View - Xr Spine (72020) $174.35 $232.47 1.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $268.59 $358.12 2.9×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $252.94 $337.25 2.3×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $158.01 $210.68 1.7×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $209.63 $279.51 2.3×
Xr c-spine 6 or more views (72052) $651.97 $869.29 5.9×
Xr chest 4+ views (71048) $356.95 $475.93 3.2×
Xr finger(s) 2+ views (73140) $158.01 $210.68 1.7×
Xr shoulder 1 view (73020) $174.66 $232.88 1.9×
Xr spine cervical 4 or 5 views (72050) $434.78 $579.70 3.9×
Xr tibia/fibula 2 views (73590) $268.59 $358.12 2.9×
Xray knee 1 or 2 views rt (73560) $197.57 $263.43 2.2×