Imaging prices at Androscoggin Valley Hospital
Berlin, NH · every code in this section with a posted price and a Medicare benchmark.
152 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) | $221.13 | $351 | 2.4× |
| Abdomen 2 views (74019) | $263.97 | $419 | 2.4× |
| Ankle 2 views (73600) | $259.56 | $412 | 2.8× |
| Bone age studies (77072) | $199.08 | $316 | 1.8× |
| Bone Imaging Whole Body (78306) | $1,328.04 | $2,108 | 3.1× |
| Chest 1 view (71045) | $174.51 | $277 | 1.9× |
| Chest 2 views (71046) | $238.14 | $378 | 2.6× |
| Clavicle complete (73000) | $253.89 | $403 | 2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $715.68 | $1,136 | 6.4× |
| CT abdomen and pelvis without and with contrast (74178) | $3,183.39 | $5,053 | 8.5× |
| CT abdomen and pelvis without contrast (74176) | $2,795.31 | $4,437 | 11.0× |
| CT abdomen w contrast (74160) | $1,665.72 | $2,644 | 8.9× |
| CT abdomen w wo contrast (74170) | $1,910.79 | $3,033 | 10.2× |
| CT abdomen w/o contrast (74150) | $1,471.68 | $2,336 | 13.2× |
| CT Angio Abdomen and Pelvis (74174) | $2,489.76 | $3,952 | 6.7× |
| CT Angio Chest (71275) | $2,374.47 | $3,769 | 12.7× |
| CT Angio Head (70496) | $2,190.51 | $3,477 | 11.7× |
| CT Angio Neck (70498) | $2,190.51 | $3,477 | 11.7× |
| CT cervical spine w/ contrast (72126) | $1,561.14 | $2,478 | 4.2× |
| CT cervical spine w/o contrast (72125) | $1,471.68 | $2,336 | 13.2× |
| CT chest w contrast (71260) | $1,665.72 | $2,644 | 8.9× |
| CT head/brain with contrast (70460) | $1,665.72 | $2,644 | 8.9× |
| CT head/brain without and with contrast (70470) | $1,859.76 | $2,952 | 9.9× |
| CT lower ext w/o (73700) | $1,471.68 | $2,336 | 13.2× |
| CT lower extremity w/contrast material (73701) | $1,665.72 | $2,644 | 8.9× |
| CT lumbar spine w/o contrast (72131) | $1,471.68 | $2,336 | 13.2× |
| CT maxillofacial w contrast (70487) | $1,665.72 | $2,644 | 8.9× |
| CT maxillofacial wo contrast (70486) | $1,471.68 | $2,336 | 13.2× |
| CT orbits w/o contrast (70480) | $1,471.68 | $2,336 | 13.2× |
| CT pelvis w&w/o contrast (72194) | $1,859.76 | $2,952 | 9.9× |
| CT pelvis w/o contrast (72192) | $1,471.68 | $2,336 | 13.2× |
| CT soft tissue neck w contrast (70491) | $1,665.72 | $2,644 | 8.9× |
| CT soft tissue neck w/o contrast (70490) | $1,471.68 | $2,336 | 13.2× |
| CT thoracic spine w/o contrast (72128) | $1,256.22 | $1,994 | 11.3× |
| CT thorax w/o contrast (71250) | $1,471.68 | $2,336 | 13.2× |
| CT upper ext wo (73200) | $1,471.68 | $2,336 | 13.2× |
| CT upper extremity with contrast (73201) | $1,665.72 | $2,644 | 4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,598.75 | $4,125 | 13.9× |
| Cta Abdomen (74175) | $2,511.81 | $3,987 | 13.4× |
| Dxa Bone Density Axial (77080) | $471.24 | $748 | 4.2× |
| Echo exam uterus (76831) | $523.53 | $831 | 2.1× |
| Esophagram (74220) | $399.42 | $634 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $465.57 | $739 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $346.50 | $550 | 3.1× |
| Fluoroscopy up to 1 hr (76000) | $498.33 | $791 | 2.0× |
| Foot 2 views (73620) | $224.91 | $357 | 2.4× |
| Forearm 2 views (73090) | $245.07 | $389 | 2.6× |
| Gastric emptying imaging study (78264) | $1,469.16 | $2,332 | 3.4× |
| Hand 2 views (73120) | $242.55 | $385 | 2.2× |
| Hepatobil Syst Image W/Drug (78227) | $2,331.63 | $3,701 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,282.68 | $2,036 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $507.15 | $805 | 5.5× |
| K Flow/Funct Image W/Drug (78708) | $1,318.59 | $2,093 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,410.57 | $2,239 | 2.4× |
| Knee 3 Views (73562) | $389.34 | $618 | 4.2× |
| Lymph System Imaging (78195) | $1,764.63 | $2,801 | 3.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,885.40 | $4,580 | 7.7× |
| MRA head w/o contrast (70544) | $2,206.89 | $3,503 | 8.7× |
| MRA head with contrast (70545) | $2,574.81 | $4,087 | 6.9× |
| MRA neck w contrast (70548) | $2,426.13 | $3,851 | 6.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,078.81 | $4,887 | 8.3× |
| MRI abdomen w/o contrast (74181) | $2,778.93 | $4,411 | 10.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,912.93 | $6,211 | 10.5× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,400.93–$2,812.32 | $3,811–$4,464 | varies |
| MRI cervical spine w/o cont (72141) | $2,753.73 | $4,371 | 10.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,860.01 | $6,127 | 10.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,343.60 | $3,720 | 9.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,471.93 | $5,511 | 9.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,206.89 | $3,503 | 8.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,051.09 | $4,843 | 8.2× |
| MRI pelvis w/o & w contrast (72197) | $3,466.89 | $5,503 | 9.3× |
| MRI pelvis w/o contrast (72195) | $2,806.02 | $4,454 | 11.0× |
| MRI thoracic spine w/o contrast (72146) | $2,753.73 | $4,371 | 10.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,206.89 | $3,503 | 8.7× |
| MRI, abdomen, combo (74183) | $3,858.12 | $6,124 | 10.4× |
| MRI, dorsal spine combo (72157) | $3,471.93 | $5,511 | 9.3× |
| MRI, joint upper extrem (73221) | $2,206.89 | $3,503 | 8.7× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,049.20–$3,385.62 | $4,840–$5,374 | varies |
| MRI, lumbar spine combo (72158) | $3,703.77 | $5,879 | 9.9× |
| Myocardial Spect Multiple Studies (78452) | $3,226.86 | $5,122 | 2.3× |
| Neck soft tissue (70360) | $242.55 | $385 | 2.6× |
| Pelvis 1 or 2 views (72170) | $281.61 | $447 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $347.13 | $551 | 3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $277.83 | $441 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $245.07 | $389 | 2.6× |
| Radex elbow complete minimum 3 views (73080) | $277.83 | $441 | 3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $341.46 | $542 | 3.1× |
| Radex fingr minimum 2 views (73140) | $233.10 | $370 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $315 | $500 | 3.4× |
| Radex Hand Minimum 3 Views (73130) | $281.61 | $447 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $294.21 | $467 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $268.38 | $426 | 2.9× |
| Radex shoulder complete minimum 2 views (73030) | $260.19 | $413 | 2.8× |
| Radex Sternum Minimum 2 Views (71120) | $238.14 | $378 | 2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $397.53 | $631 | 4.3× |
| Radex Toe Minimum 2 Views (73660) | $263.97 | $419 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $251.37 | $399 | 2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $307.44 | $488 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) | $347.13 | $551 | 3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $328.86 | $522 | 2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $612.36 | $972 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $626.22 | $994 | 3.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $614.88 | $976 | 3.3× |
| Radiologic examination femur minimum 2 views (73552) | $285.39 | $453 | 3.1× |
| Radiologic examination knee 1/2 views (73560) | $277.83 | $441 | 3.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $247.59 | $393 | 2.7× |
| Scapula (73010) | $259.56 | $412 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $48.51 | $77 | 2.1× |
| Skull less than 4 views (70250) | $290.43 | $461 | 2.6× |
| Thoracic spine 2 views (72070) | $277.83 | $441 | 2.5× |
| Thoracic spine 3 views (72072) | $290.43 | $461 | 2.6× |
| Thoracolumbar 2 views (72080) | $272.79 | $433 | 2.9× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$364.14–$388.71 | $578–$617 | varies |
| Ultrasound Exam Aaa Screen (76706) | $566.37 | $899 | 5.1× |
| Ultrasound, abdomen limited (76705) | $477.54 | $758 | 4.3× |
| Umbilical-artery Doppler (OB) (76820) | $385.56 | $612 | 3.5× |
| Upper gi w/o kub (74240) | $540.54 | $858 | 2.9× |
| Us chest (76604) | $449.82 | $714 | 4.0× |
| Us complete joint (76881) | $593.46 | $942 | 5.3× |
| Us exam, pelvic, limited (76857) | $358.47 | $569 | 3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $299.25 | $475 | 2.7× |
| Us ob detailed single fetus (76811) | $950.04 | $1,508 | 3.7× |
| Us ob limited 1 or more fetuses (76815) | $398.79 | $633 | 3.6× |
| Us ob transvaginal (76817) | $454.86 | $722 | 4.1× |
| Us pelvic non ob complete (76856) | $510.93 | $811 | 4.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $497.07 | $789 | 4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $485.10 | $770 | 4.3× |
| Us retroperitoneal complete (76770) | $515.97 | $819 | 4.6× |
| Us retroperitoneal limited (76775) | $463.05 | $735 | 4.1× |
| Us scrotum and contents (76870) | $463.05 | $735 | 4.1× |
| Us thyroid (76536) | $539.91 | $857 | 4.8× |
| Wrist 2 views (73100) | $254.52 | $404 | 2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $307.44 | $488 | 3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $245.07 | $389 | 2.6× |
| X-Ray Exam Breast Specimen (76098) | $233.10 | $370 | 0.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $339.57 | $539 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $380.52 | $604 | 3.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $251.37 | $399 | 2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $367.92 | $584 | 4.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $377.37 | $599 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) | $549.36 | $872 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $268.38 | $426 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $458.01 | $727 | 4.1× |
| X-ray eye for foreign body (70030) | $238.14 | $378 | 2.6× |
| X-ray humerus (73060) | $251.37 | $399 | 2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $272.16 | $432 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $290.43 | $461 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $390.60 | $620 | 3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $285.39 | $453 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $238.14 | $378 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,926.54 | $3,058 | 5.2× |
| Xr c-spine 4 or 5 views (72050) | $359.10 | $570 | 3.2× |
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.