Imaging prices at Baystate Franklin Medical Center

Greenfield, MA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $524.86 $524.86 4.2×
Acute gi blood loss imaging (78278) $1,347.87 $1,347.87 2.8×
Ankle 2 views (73600) $483.79 $483.79 4.6×
Arthrogram hip (73525) $1,346.80 $1,346.80 3.2×
Arthrogram knee (73580) $2,134 $2,134 5.1×
Arthrogram shoulder (73040) $2,072 $2,072 5.0×
Basic dosimetry (77300) $766.88 $766.88 4.8×
Bone &/Joint Imaging Limited Area (78300) $1,264.08 $1,264.08 2.6×
Bone &/joint imaging whole body (78306) $1,646.40 $1,646.40 3.4×
Bone age studies (77072) $611 $611 4.9×
Bone Imaging 3 Phase (78315) $1,630.66 $1,630.66 3.4×
Bone Marrow Imaging Limited Area (78102) $1,347.87 $1,347.87 2.8×
Bone survey complete (77075) $673 $673 5.4×
Bone survey infant (77076) $611 $611 4.9×
Bowel imaging (78290) $1,372 $1,372 2.9×
Cardiac MRI w/w/o contrast & further seq (75561) $2,958 $2,958 7.1×
Cervical spine 2 or 3 views (72040) $640.99 $640.99 6.1×
Chest 1 view (71045) $267 $267 2.6×
Chest xray 3 views (71047) $343 $343 3.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $870.75 $870.75 4.1×
Clavicle complete (73000) $446.96 $446.96 4.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,163 $1,163 9.3×
Contrast Xray Throat/Cerv Esopha (74210) $623 $623 3.0×
CT abdomen and pelvis without and with contrast (74178) $3,509 $3,509 8.4×
CT abdomen and pelvis without contrast (74176) $2,083 $2,083 7.3×
CT abdomen w contrast (74160) $1,545 $1,545 7.3×
CT abdomen w wo contrast (74170) $1,838 $1,838 8.7×
CT abdomen w/o contrast (74150) $1,255 $1,255 10.0×
CT angio hrt w/3d image (75574) $2,095 $2,095 5.0×
CT angio lwr extr w/o&w/dye (73706) $2,408 $2,408 11.5×
CT angiography upper extremity lt (73206) $1,996 $1,996 9.5×
CT c-spine w/contrast (72126) $1,843 $1,843 4.4×
CT c-spine w/o contrast (72125) $1,165 $1,165 9.3×
CT chest w contrast (71260) $1,475 $1,475 7.0×
CT colonography screening (74263) $3,894 $3,894 13.6×
CT colonography w/o cntrst (74261) $2,436 $2,436 19.4×
CT head/brain with contrast (70460) $1,256 $1,256 6.0×
CT head/brain without and with contrast (70470) $1,382 $1,382 6.6×
CT heart contrast eval cardiac structure&morph (75572) $1,465 $1,465 3.5×
CT heart w/o contrast quant eval coronary calcium (75571) $1,064 $1,064 10.2×
CT iac w contrast (70481) $1,282 $1,282 6.1×
CT limited/localized follow up study (76380) $731 $731 7.0×
CT lower ext w/o (73700) $1,410.52 $1,410.52 11.3×
CT lower extremity w wo contrast (73702) $1,800 $1,800 8.6×
CT lower extremity w/contrast material (73701) $1,957.44 $1,957.44 9.3×
CT lumbar spine w/contrast (72132) $2,150 $2,150 5.1×
CT lumbar spine w/o contrast (72131) $1,382 $1,382 11.0×
CT maxillofacial w contrast (70487) $1,256 $1,256 6.0×
CT maxillofacial w/wo contrast (70488) $1,391 $1,391 6.6×
CT maxillofacial wo contrast (70486) $1,014 $1,014 8.1×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,903 $1,903 9.1×
CT orbits w/o contrast (70480) $1,014 $1,014 8.1×
CT pelvis w/o contrast (72192) $1,346 $1,346 10.7×
CT pelvis w/wo contrast (72194) $2,040 $2,040 9.7×
CT soft tissue neck w contrast (70491) $1,282 $1,282 6.1×
CT soft tissue neck w/o & w/contrast material (70492) $1,678 $1,678 8.0×
CT soft tissue neck w/o contrast (70490) $1,014 $1,014 8.1×
CT thoracic spine w/contrast (72129) $1,546 $1,546 7.4×
CT thoracic spine w/o contrast (72128) $1,407 $1,407 11.2×
CT thoracic spine w/wo contrast (72130) $2,665 $2,665 12.7×
CT thorax w/o contrast (71250) $1,163 $1,163 9.3×
CT upper ext wo (73200) $1,207.50 $1,207.50 9.6×
CT upper extremity with contrast (73201) $2,150 $2,150 5.1×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,895 $1,895 9.0×
Cta Abdomen (74175) $1,701 $1,701 8.1×
CTA abdomen pelvis (74174) $5,483 $5,483 13.1×
CTA chest (71275) $1,752 $1,752 8.3×
Cta Head (70496) $1,508 $1,508 7.2×
Cta Neck (70498) $1,400 $1,400 6.7×
Cta Pelvis (72191) $2,254 $2,254 10.7×
Cystography minimum 3 views rs&i (74430) $1,186 $1,186 2.8×
Doppler Fetal Mid Cerebral Artery (76821) $543 $543 4.3×
Dxa bone density study 1/> sites axial skel (77080) $636 $636 5.1×
Dxa bone density study axial skeleton (77085) $615 $615 4.9×
Esophagus (74220) $808.22 $808.22 3.8×
Facial bones min 3 views (70150) $611 $611 4.9×
Fetal biophysical profile non-stress testing (76818) $978 $978 7.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $932 $932 7.4×
Fluoroscopy up to 1 hr (76000) $930 $930 3.3×
Foot 2 views (73620) $410.87 $410.87 3.9×
Forearm 2 views (73090) $453.15 $453.15 4.3×
Hand 2 views (73120) $672.10 $672.10 5.4×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,981.18 $1,981.18 3.0×
Hysterosalpingogram (74740) $2,176 $2,176 7.6×
Kidney imaging morphology (78700) $1,347.87 $1,347.87 2.8×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,821 $1,821 2.8×
Kidney img morphology vascular flow 1 w/rx (78708) $2,458.35 $2,458.35 3.8×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,821 $1,821 2.8×
Knee 3 views (73562) $455.29 $455.29 4.4×
Liver & spleen imaging static only (78215) $1,372 $1,372 2.9×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,372 $1,372 2.9×
Lung perf&ventilat diferentl (78598) $1,821 $1,821 2.8×
Lung ventilation imaging (78579) $1,372 $1,372 2.9×
Lymphoscintigraphy (78195) $1,576.94 $1,576.94 2.4×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $2,901.18 $2,901.18 3.1×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $3,231.31 $3,231.31 7.7×
Mlc imrt design & construction per imrt plan (77338) $2,835 $2,835 6.3×
MRA head w & w/o contrast (70546) $3,049 $3,049 7.3×
MRA head w/o contrast (70544) $1,995 $1,995 7.0×
MRA head with contrast (70545) $2,838 $2,838 6.8×
MRA neck w contrast (70548) $2,838 $2,838 6.8×
Mra Neck W/O &W/Contrast Material (70549) $3,662 $3,662 8.8×
MRA neck w/o contrast (70547) $2,002 $2,002 7.0×
MRI abdomen w/o & w/contrast material (74183) $3,281 $3,281 7.8×
MRI abdomen w/o contrast (74181) $1,985 $1,985 6.9×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,980 $2,980 7.1×
MRI c-spine with contrast (72142) $2,838 $2,838 6.8×
MRI cardiac w/o contrast (75557) $2,402 $2,402 8.4×
MRI cervical spine w/o contrast (72141) $1,961 $1,961 6.9×
MRI chest w/o & w/contrast material (71552) $4,141 $4,141 9.9×
MRI chest w/o contrast (71550) $2,321 $2,321 8.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,611.63 $2,611.63 6.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,072.51 $3,072.51 7.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,851 $1,851 6.5×
MRI orbit face &/neck w/o contrast (70540) $2,951 $2,951 10.3×
MRI orbit face neck w contrast (70542) $4,136 $4,136 9.9×
MRI orbit/face/neck w&w/o cont (70543) $4,359 $4,359 10.4×
MRI pelvis w/o & w/contrast material (72197) $3,321.11 $3,321.11 7.9×
MRI pelvis w/o contrast (72195) $2,336.97 $2,336.97 8.2×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,325 $3,325 8.0×
MRI spinal canal lumbar w/contrast material (72149) $2,838 $2,838 6.8×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,452 $3,452 8.3×
MRI spinal canal thoracic w/contrast matrl (72147) $2,838 $2,838 6.8×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,325 $3,325 8.0×
MRI temporomandibular joint (70336) $2,369.60 $2,369.60 8.3×
MRI thoracic spine w/o contrast (72146) $1,961 $1,961 6.9×
MRI up ext w/o contrast (73218) $2,442.84 $2,442.84 8.5×
MRI upper ext joint w/o contrast (73221) $2,104.80 $2,104.80 7.4×
MRI, joint upper extrem combo (73223) $2,931 $2,931 7.0×
Myelogram Cervical (72240) $3,492.24 $3,492.24 3.7×
Myelogram Lumbar (72265) $3,492.24 $3,492.24 3.7×
Myelography 2 or more regions (72270) $3,492.24 $3,492.24 3.7×
Myocardial Spect Multiple Studies (78452) $5,050.53 $5,050.53 3.3×
Myocardial spect single study at rest or stress (78451) $4,570 $4,570 2.9×
Neck soft tissue (70360) $457.18 $457.18 4.4×
Nm cardiac blood pool multiple (78473) $1,372 $1,372 2.9×
Ntsty modul radthx pln dose-vol histos (77301) $9,710 $9,710 5.9×
Nuclear Rx Oral Admin (79005) $1,030 $1,030 3.7×
Ob us nuchal meas 1 gest (76813) $692.40 $692.40 5.5×
Osseous survey limited (77074) $611 $611 4.9×
Pelvis 1 or 2 views (72170) $611 $611 4.9×
Pulmonary Perfusion Imaging Particulate (78580) $1,372 $1,372 2.9×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,821 $1,821 2.8×
Radex abscess/fistula/sinus tract rs&i (76080) $2,176 $2,176 3.3×
Radex Ankle Compl Minimum 3 Views (73610) $490.89 $490.89 4.7×
Radex Calcaneus Minimum 2 Views (73650) $427.57 $427.57 4.1×
Radex Elbw Compl Minimum 3 Views (73080) $490.30 $490.30 4.7×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $369 $369 3.5×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $843.77 $843.77 6.7×
Radex fingr minimum 2 views (73140) $424.78 $424.78 4.1×
Radex Foot Compl Minimum 3 Views (73630) $493.45 $493.45 4.7×
Radex Hand Minimum 3 Views (73130) $672.10 $672.10 6.4×
Radex Hip Unilateral With Pelvis 1 View (73501) $369 $369 3.5×
Radex Hips Bilateral With Pelvis 2 Views (73521) $611 $611 4.9×
Radex Humerus Minimum 2 Views (73060) $384 $384 3.7×
Radex Kne 1/2 Views (73560) $401 $401 3.8×
Radex Kne Compl 4/More Views (73564) $744 $744 5.9×
Radex Mndbl Compl Minimum 4 Views (70110) $611 $611 4.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $369 $369 3.5×
Radex Pelvis Compl Minimum 3 Views (72190) $642 $642 5.1×
Radex Sho Compl Minimum 2 Views (73030) $487.12 $487.12 4.7×
Radex Sinuses Paransl < 3 Views (70210) $369 $369 3.5×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $642 $642 5.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $379 $379 3.6×
Radex Toe Minimum 2 Views (73660) $369 $369 3.5×
Radex upper extremity infant minimum 2 views (73092) $381 $381 3.0×
Radex Wrst Compl Minimum 3 Views (73110) $468 $468 4.5×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $357.75 $357.75 3.4×
Radiologic exam chest 2 views (71046) $339 $339 3.3×
Radiologic exam colon single contrast study (74270) $1,166.40 $1,166.40 5.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $643 $643 3.1×
Radiologic exam upr gi trc double contrast study (74246) $677 $677 3.2×
Radiologic exam upr gi trc single contrast study (74240) $913.95 $913.95 4.3×
Radiologic examination femur 1 view (73551) $369 $369 3.5×
Radiologic examination tibia & fibula 2 views (73590) $427 $427 4.1×
Radiologic examination, teeth; complete, full mouth Non-Facility (70320) $1,164 $1,164 4.1×
Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) $1,164 $1,164 4.1×
Radiologic examination, teeth; single view Non-Facility (70300) $416 $416 4.0×
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) $623.17 $623.17 6.0×
Radiological examination surgical specimen (76098) $2,196 $2,196 3.4×
Ribs bilateral 3 views (71110) $611 $611 4.9×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,570 $4,570 7.0×
Rp loclzj tum plnr whole body single day imaging (78802) $2,119.06 $2,119.06 3.3×
Rp loclzj tum spect 1 area single day imaging (78803) $4,570 $4,570 7.0×
Rp Therapy Intravenous Administration (79101) $1,030 $1,030 3.7×
Sacroiliac Joints < 3 Views (72200) $611 $611 4.9×
Saline Infus Sonohysterography W/Color Doppler (76831) $932 $932 3.3×
Scapula (73010) $506.58 $506.58 4.0×
Screening Digital Breast Tomosynthesis Bi (77063) $182.12 $182.12 7.8×
Shoulder 1 view (73020) $442 $442 4.2×
Small bowel series (74250) $623 $623 3.0×
Spine thoracic 3 views (72072) $673 $673 5.4×
Thoracolumbar 2 views (72080) $448 $448 4.3×
Thyroid carcinoma metastases img whole body (78018) $1,372 $1,372 2.1×
Thyroid imaging w/blood flow (78013) $1,347.87 $1,347.87 2.8×
Thyroid uptake measurement (78012) $1,372 $1,372 2.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,372 $1,372 2.9×
Tmj unilateral (70328) $369 $369 3.5×
Ultrasound Exam Aaa Screen (76706) $457 $457 3.6×
Ultrasound, abdomen limited (76705) $918.50 $918.50 7.3×
Umbilical-artery Doppler (OB) (76820) $718.76 $718.76 5.7×
Ureteral reflux study (78740) $1,372 $1,372 2.9×
Urethrocystogram voiding (74455) $2,176 $2,176 7.6×
Urethrocystography retrograde rs&i (74450) $1,186 $1,186 4.1×
Us breast unilateral limited (76642) $559 $559 5.4×
Us chest (76604) $624 $624 5.0×
Us elastography parenchyma (76981) $964 $964 7.7×
Us encephalogram (76506) $591 $591 4.7×
Us infant hips w manipulation (76885) $717 $717 6.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $559 $559 4.5×
Us ob detailed single fetus (76811) $1,026 $1,026 3.6×
Us ob limited (76815) $932 $932 7.4×
Us ob transvaginal (76817) $1,118.40 $1,118.40 8.9×
Us pelvic non ob complete (76856) $953.85 $953.85 7.6×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $590.69 $590.69 4.7×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $932 $932 7.4×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $834.30 $834.30 6.7×
Us retroperitoneal complete (76770) $978 $978 7.8×
Us retroperitoneal limited (76775) $576 $576 4.6×
Us scrotum and contents (76870) $932 $932 7.4×
Us soft tissue head/neck (76536) $932 $932 7.4×
Us spinal canal and contents (76800) $678 $678 5.4×
Us transrectal (76872) $932 $932 7.4×
Us, eye b-scan (76512) $535 $535 4.3×
Us,transplanted kidney, real time/ doppler (76776) $932 $932 7.4×
Wrist 2 views (73100) $407.67 $407.67 3.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $734.75 $734.75 5.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $327.56 $327.56 3.1×
X-ray b.e. reductn intuss (74283) $1,003.11 $1,003.11 4.8×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,186 $1,186 5.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $462.90 $462.90 4.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $388 $388 3.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $642 $642 5.1×
X-ray exam of femur 2/> (73552) $426.50 $426.50 4.1×
X-ray eye for foreign body (70030) $424 $424 4.1×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $369 $369 3.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $369 $369 3.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $369 $369 3.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $611 $611 4.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $673.65 $673.65 5.4×
X-ray nose-rectum child f.b. (76010) $1,186 $1,186 11.4×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $727.90 $727.90 5.8×
X-ray retrograde pyelogram (74420) $2,176 $2,176 5.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $478.77 $478.77 4.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $665.22 $665.22 5.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $841.05 $841.05 6.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $810.07 $810.07 6.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $472.19 $472.19 4.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $460.34 $460.34 4.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $611 $611 4.9×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $549.90 $549.90 4.4×
X-Ray Spine One View - Xr Spine (72020) $369 $369 3.5×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $455.40 $455.40 4.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $414 $414 4.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $659 $659 5.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $727 $727 5.8×
Xr bone length studies (77073) $477.90 $477.90 3.8×
Xr c-spine 4 or 5 views (72050) $643.10 $643.10 5.1×
Xr c-spine 6 or more views (72052) $744.49 $744.49 5.9×
Xr chest 4+ views (71048) $512 $512 4.1×
Xr urogram antegrade (74425) $1,931.65 $1,931.65 4.6×