2011 SRMC Pricing Disclosure.xlsx
2011 SRMC Pricing Disclosure.xlsx
2011 SRMC Pricing Disclosure.xlsx
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CT, MRI, Nuclear Medicine, & Ultrasound Charges<br />
The following charges reflect the hospital's most common CT, MRI, Nuclear Medicine, and Ultrasound procedures.Charges do not include the services of the Radiologist<br />
or contrast material. Please contact Lima Radiological Associates to obtain the charges of the Radiologist.<br />
Charges<br />
CT-ABDOMEN-W/CONTRAST $1,495.56 74160<br />
CT HEAD $1,127.37 70450<br />
CT HEAD WO&W CONTRAST $1,363.97 70470<br />
CT-PELVIS-W/CONTRAST $1,927.02 72193<br />
CT-SIMPLE SINUSES $805.98 70486<br />
CT-THORAX-LUNGS-W/WO $1,666.37 71270<br />
MRI ANY JT UPPER EXTREMITY W/CO $3,653.22 73222<br />
MRI BRAIN/B-STEM W/O&W CON $2,816.64 70553<br />
MRI C SPINE CANAL&CONT W/O $3,436.99 72141<br />
NM PULMONARY PERFUSION $797.13 78580<br />
NM BONE SCAN-WHOLE BODY $1,432.41 78306<br />
NM SPECT CARDIOLITE STR & REST $4,603.16 -<br />
NM PET CT WHOLE BODY $4,057.64 78816<br />
NM MYOCARD PERF W/WALL STUDY $4,303.16 -<br />
US GALL BLADDER $804.92 76705<br />
US KIDNEY $569.85 76775<br />
US PELVIC - LMTD (NON-OB) $457.84 76857<br />
CPT
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