Imaging prices at Beth Israel Deaconess Hospital–Plymouth

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

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,721 $5,721 3.4×
Abdomen 1 View (74018) $388 $388 3.7×
Abdomen 2 views (74019) $301 $301 2.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $2,006 $2,006 4.2×
Angiography extremity bilateral rs&i (75716) $4,678 $4,678 1.2×
Angiography extremity unilateral rs&i (75710) $4,780 $4,780 1.3×
Ankle 2 views (73600) $248 $248 2.4×
Artery X-Rays Abdomen (75726) $16,785 $16,785 2.5×
Artery X-Rays Pelvis (75736) $19,834 $19,834 3.0×
Arthrogram hip (73525) $822 $822 2.0×
Arthrogram Wrist (73115) $1,313 $1,313 3.1×
Basic radiation dosimetry calculation (77300) $594 $594 3.7×
Bone age studies (77072) $372 $372 3.0×
Bone Imaging 3 Phase (78315) $2,522 $2,522 5.3×
Bone Imaging Whole Body (78306) $2,881 $2,881 6.0×
Bone survey infant (77076) $383 $383 3.1×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $3,287 $3,287 5.1×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,475 $1,475 3.1×
Cardiac MRI w/w/o contrast w/stress (75563) $2,886 $2,886 3.1×
Chest 1 view (71045) $300 $300 2.9×
Chest 2 views (71046) $261 $261 2.5×
Chest 3 views (71047) $325 $325 3.1×
Chest 4 or more views (71048) $587 $587 4.7×
Clavicle complete (73000) $338 $338 3.2×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,496 $1,496 11.9×
Continuing medical physics consltj pr wk (77336) $585 $585 3.6×
Contrast Exam Abdominl Aorta (75625) $4,780 $4,780 1.3×
Contrast X-Ray Bladder (74430) $1,503 $1,503 3.6×
Contrast X-Ray Of Knee Joint (73580) $567 $567 1.4×
Contrast Xray Throat/Cerv Esopha (74210) $686 $686 3.3×
CT abdomen and pelvis without and with contrast (74178) $2,941 $2,941 7.0×
CT abdomen and pelvis without contrast (74176) $1,431 $1,431 5.0×
CT abdomen w contrast (74160) $2,237 $2,237 10.6×
CT abdomen w wo contrast (74170) $2,610 $2,610 12.4×
CT abdomen w/o contrast (74150) $1,431 $1,431 11.4×
CT Angio Abdomen and Pelvis (74174) $2,829 $2,829 6.8×
CT Angio Chest (71275) $1,954 $1,954 9.3×
CT Angio Head (70496) $1,803 $1,803 8.6×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,815 $2,815 13.4×
CT Angio Neck (70498) $1,861 $1,861 8.9×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,859 $2,859 13.6×
CT cervical spine w/ contrast (72126) $766 $766 1.8×
CT cervical spine w/o contrast (72125) $1,293 $1,293 10.3×
CT cervical spine w/wo cont (72127) $1,643 $1,643 7.8×
CT chest w contrast (71260) $2,143 $2,143 10.2×
CT chest w/wo contrast (71270) $2,524 $2,524 12.0×
CT colonography screening (74263) $4,233 $4,233 14.8×
CT head/brain with contrast (70460) $1,740 $1,740 8.3×
CT head/brain without and with contrast (70470) $2,230 $2,230 10.6×
CT heart contrast eval cardiac structure&morph (75572) $1,108 $1,108 2.7×
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines		 $269–$275 $269–$275 varies
CT iac w contrast (70481) $1,708 $1,708 8.1×
CT l-spine w&w/o contrast (72133) $1,987 $1,987 9.5×
CT lower ext w/o (73700) $332 $332 2.6×
CT lower extremity w/contrast material (73701) $1,165 $1,165 5.5×
CT lumbar spine w contrast (72132) $1,743 $1,743 4.2×
CT lumbar spine w/o contrast (72131) $1,616 $1,616 12.9×
CT maxillofacial w contrast (70487) $1,661 $1,661 7.9×
CT maxillofacial wo contrast (70486) $1,095 $1,095 8.7×
CT neck tissue combo (70492) $1,987 $1,987 9.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $772 $772 3.7×
CT orbits w/o contrast (70480) $1,646 $1,646 13.1×
CT pelvis w&w/o contrast (72194) $2,946 $2,946 14.0×
CT pelvis w/o contrast (72192) $1,616 $1,616 12.9×
CT scan of leg combo (73702) $841 $841 4.0×
CT scans face/jaw combo (70488) $686 $686 3.3×
CT soft tissue neck w contrast (70491) $1,592 $1,592 7.6×
CT soft tissue neck w/o contrast (70490) $1,303 $1,303 10.4×
CT thoracic spine w contrast (72129) $2,113 $2,113 10.1×
CT thoracic spine w/o contrast (72128) $1,616 $1,616 12.9×
CT thorax w/o contrast (71250) $1,496 $1,496 11.9×
CT upper ext wo (73200) $1,865 $1,865 14.9×
CT upper extremity w/o & w/contrast material (73202) $2,940 $2,940 14.0×
CT upper extremity with contrast (73201) $2,276 $2,276 5.4×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,394 $2,394 11.4×
Cta Abdomen (74175) $2,552 $2,552 12.1×
CTA pelvis (72191) $2,243 $2,243 10.7×
Doppler Fetal Mid Cerebral Artery (76821) $891 $891 7.1×
Dxa Bone Density Axial (77080) $486 $486 3.9×
Dxa bone density study (77085) $643 $643 5.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $206 $206 2.0×
Echo Guide For Artery Repair (76936) $934 $934 3.6×
Echograp Trans R Pros Study (76873) $383 $383 3.1×
Esophagram (74220) $430 $430 2.0×
Fetal Biophys Profile W/Nst (76818) $360 $360 2.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $778 $778 6.2×
Fluoroscopy up to 1 hr (76000) $862 $862 3.0×
Foot 2 views (73620) $620 $620 5.9×
Forearm 2 views (73090) $352 $352 3.4×
Gastric emptying imaging study (78264) $1,658 $1,658 3.5×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $2,721 $2,721 5.7×
Gated Heart Planar Single (78472) $1,672 $1,672 3.5×
Gated Heart, Multiple (78473) $1,475 $1,475 3.1×
Hand 2 views (73120) $513 $513 4.1×
Hepatobil Syst Image W/Drug (78227) $1,783 $1,783 2.7×
Hepatobiliary System Imaging (78226) $1,658 $1,658 3.5×
Ht Muscle Image Spect Sing (78451) $8,769 $8,769 5.7×
Hysterosalpingogram (74740) $959 $959 3.4×
Infant hip ultrasound, limited static exam (76886) $263 $263 2.5×
K Flow/Funct Image Multiple (78709) $2,185 $2,185 3.4×
K Flow/Funct Image W/Drug (78708) $2,873 $2,873 4.4×
K Flow/Funct Image W/O Drug (78707) $3,528 $3,528 5.4×
Kidney Imaging Morphol (78700) $1,264 $1,264 2.6×
Knee 3 Views (73562) $272 $272 2.6×
Lung perfusion differential (78597) $2,852 $2,852 6.0×
Lung Ventilat&Perfus Imaging (78582) $1,638 $1,638 2.5×
Lymph System Imaging (78195) $3,287 $3,287 5.1×
Magnetic Image Jaw Joint (70336) $1,385 $1,385 4.8×
Mlc imrt design & construction per imrt plan (77338) $1,619 $1,619 3.6×
Mr safety determination physician/other qhp (76016) $273 $273 2.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $76 $76 2.2×
Mr safety implt electronics prepj supvj phys/qhp (76018) $390 $390 3.4×
Mr safety implt pos&/immoblj (76019) $185 $185 2.6×
Mr safety med physics xm customization plng&mntr (76017) $765 $765 2.7×
Mra Head W/O & W/Contrast Material (70546) $2,738 $2,738 6.5×
MRA head w/o contrast (70544) $1,793 $1,793 6.3×
MRA head with contrast (70545) $2,150 $2,150 5.1×
MRA neck w contrast (70548) $2,315 $2,315 5.5×
Mra Neck W/O &W/Contrast Material (70549) $2,141 $2,141 5.1×
MRA neck w/o contrast (70547) $1,793 $1,793 6.3×
MRI abdomen w contrast (74182) $1,609 $1,609 3.8×
MRI abdomen w/o contrast (74181)
range across 2 matching MRF lines		 $761–$1,162 $761–$1,162 varies
MRI any jt lower extrem w/contrast material (73722) $2,150 $2,150 2.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,627 $2,627 6.3×
MRI any jt upper extremity w/contrast matrl (73222) $2,150 $2,150 2.3×
MRI brain functional w/o physician admnistration (70554) $746 $746 2.6×
MRI Breast W/O Contrast Bilateral (77047) $4,242 $4,242 14.8×
MRI cervical spine w contrast (72142) $1,609 $1,609 3.8×
MRI cervical spine w/o cont (72141) $1,735 $1,735 6.1×
MRI chest w/o contrast (71550) $1,605 $1,605 5.6×
MRI chest with contrast (71551) $2,886 $2,886 3.1×
MRI chest wo w contrast (71552) $2,709 $2,709 6.5×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,150 $2,150 5.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,627 $2,627 6.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,793 $1,793 6.3×
MRI lumbar spine w contrast (72149) $2,996 $2,996 7.2×
Mri Neck Spine W/O & W/Dye (72156) $2,985 $2,985 7.1×
MRI orbit face &/neck w/o contrast (70540) $2,263 $2,263 7.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,441 $4,441 10.6×
MRI pelvis w contrast (72196) $1,555 $1,555 3.7×
MRI pelvis w/o & w contrast (72197) $2,390 $2,390 5.7×
MRI pelvis w/o contrast (72195) $1,554 $1,554 5.4×
MRI thoracic spine w/o contrast (72146) $2,390 $2,390 8.4×
MRI upper extremity oth than jt w/contr matrl (73219) $1,609 $1,609 3.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,793 $1,793 6.3×
Mri Uppr Extremity W/O&W/Dye (73220) $2,572 $2,572 6.2×
MRI, abdomen, combo (74183) $3,806 $3,806 9.1×
MRI, dorsal spine combo (72157) $4,075 $4,075 9.7×
MRI, dorsal spine contrast (72147) $3,833 $3,833 9.2×
MRI, joint upper extrem (73221) $1,793 $1,793 6.3×
MRI, joint upper extrem combo (73223) $2,627 $2,627 6.3×
MRI, lumbar spine combo (72158) $2,985 $2,985 7.1×
Myelogram cervical (72240) $2,378 $2,378 2.5×
Myelogram Lumbar (72265) $2,453 $2,453 2.6×
Myocardial Spect Multiple Studies (78452) $4,176 $4,176 2.7×
N-invas est c ffr sw aly CTA (75580) $3,787 $3,787 3.7×
Neck soft tissue (70360) $290 $290 2.8×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $1,264 $1,264 2.6×
Nonvascular Shunt X-Ray (75809) $348 $348 2.8×
Ntsty modul radthx pln dose-vol histos (77301) $4,784 $4,784 2.9×
Nuclear Rx Oral Admin (79005) $1,855 $1,855 6.6×
Ob us nuchal meas 1 gest (76813) $866 $866 6.9×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $383 $383 3.1×
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) $88 $88 2.5×
Optic foramina (70190) $230 $230 2.2×
Parathyroid imaging w/tomographic spect & CT (78072) $3,287 $3,287 5.1×
Parathyroid planar imaging w/wo subtraction (78071) $2,613 $2,613 5.5×
Pelvis 1 or 2 views (72170) $260 $260 2.1×
Peritoneogram Rs&I (74190) $1,637 $1,637 2.5×
PET image w/CT, full body (78816) $5,738 $5,738 3.3×
PET imaging CT attenuation skull base mid-thigh (78815) $5,738 $5,738 3.3×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $9,774 $9,774 2.6×
Pulmonary Perfusion Imaging Particulate (78580) $2,858 $2,858 6.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $195 $195 1.6×
Radex abscess/fistula/sinus tract rs&i (76080) $1,645 $1,645 2.5×
Radex Ankle Complete Minimum 3 Views (73610) $248 $248 2.4×
Radex Calcaneus Minimum 2 Views (73650) $279 $279 2.7×
Radex elbow complete minimum 3 views (73080) $688 $688 6.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $649 $649 5.2×
Radex fingr minimum 2 views (73140) $208 $208 2.0×
Radex foot complete minimum 3 views (73630) $269 $269 2.6×
Radex Hand Minimum 3 Views (73130) $250 $250 2.4×
Radex lower extremity infant minimum 2 views (73592) $178 $178 1.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $360 $360 2.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $435 $435 4.2×
Radex Ribs Unilateral 2 Views (71100) $440 $440 4.2×
Radex shoulder complete minimum 2 views (73030) $238 $238 2.3×
Radex Sinuses Paransl < 3 Views (70210) $323 $323 3.1×
Radex Spine 1 View Specify Level (72020) $294 $294 2.8×
Radex Sternum Minimum 2 Views (71120) $572 $572 5.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $230 $230 2.2×
Radex Toe Minimum 2 Views (73660) $308 $308 3.0×
Radex upper extremity infant minimum 2 views (73092) $220 $220 1.8×
Radex Wrist Complete Minimum 3 Views (73110) $448 $448 4.3×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $440 $440 3.5×
Radiation treatment delivery level 1 (77402) $390 $390 3.2×
Radiation treatment delivery level 2 (77407) $937 $937 2.0×
Radiation treatment delivery level 3 (77412) $770 $770 1.2×
Radiolog exam mandible compl minimum 4 views (70110) $698 $698 5.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $301 $301 2.4×
Radiologic exam colon double contrast study (74280) $1,377 $1,377 6.6×
Radiologic exam colon single contrast study (74270) $537 $537 2.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $686 $686 3.3×
Radiologic exam knee complete 4/more views (73564) $266 $266 2.1×
Radiologic exam pelvis compl minimum 3 views (72190) $440 $440 3.5×
Radiologic Exam Small Int Single Contrast Study (74250) $473 $473 2.3×
Radiologic exam swallow function contrast study (74230) $334 $334 1.6×
Radiologic exam upr gi trc double contrast study (74246) $509 $509 2.4×
Radiologic examination femur 1 view (73551) $239 $239 2.3×
Radiologic examination femur minimum 2 views (73552) $410 $410 3.9×
Radiologic examination knee 1/2 views (73560) $253 $253 2.4×
Radiologic Examination Osseous Survey Limited (77074) $360 $360 2.9×
Radiologic examination tibia & fibula 2 views (73590) $333 $333 3.2×
Ribs bilateral 3 views (71110) $593 $593 4.7×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $4,305 $4,305 6.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,118 $4,118 6.3×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $8,769 $8,769 5.7×
Scapula (73010) $358 $358 2.9×
Screening Digital Breast Tomosynthesis Bi (77063) $143 $143 6.1×
Shoulder 1 view (73020) $317 $317 3.0×
Shoulder Arthrography (73040) $933 $933 2.2×
Skull less than 4 views (70250) $353 $353 2.8×
Special dosimetry (77331) $486 $486 3.0×
Special Physics Consult (77370) $905 $905 5.6×
Special teletherapy port plan (77321) $1,123 $1,123 2.5×
Special treatment procedure (77470) $3,843 $3,843 5.8×
Stereotactic Body Radiation Delivery (77373) $5,754 $5,754 2.7×
Sternoclavicular joints (71130) $143 $143 1.4×
Telethx isodose pln cplx w/basic dosimetry (77307) $936 $936 2.1×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,519 $1,519 3.4×
Ther rad simulaj-aided field setting simple (77280) $808 $808 5.0×
Thoracic spine 2 views (72070) $353 $353 2.8×
Thoracic spine 3 views (72072) $440 $440 3.5×
Thoracolumbar 2 views (72080) $272 $272 2.6×
Thyroid Met Imaging Body (78018) $3,062 $3,062 4.7×
Thyroid Uptake Measurement (78012) $2,531 $2,531 5.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,898 $2,898 6.0×
Tx Devices Design & Construction Complex (77334) $2,005 $2,005 4.5×
Tx devices design & construction intermediate (77333) $886 $886 5.5×
Tx devices design & construction simple (77332) $629 $629 3.9×
Ultrasound Breast Limited (76642) $531 $531 5.1×
Ultrasound Exam Aaa Screen (76706) $230 $230 1.8×
Ultrasound, abdomen limited (76705) $634 $634 5.1×
Umbilical-artery Doppler (OB) (76820) $891 $891 7.1×
Unlisted magnetic resonance procedure (76498) $313 $313 3.0×
Unlisted us procedure (76999) $275 $275 2.6×
Upper gi w/o kub (74240) $1,196 $1,196 5.7×
Urethrocystography retrograde (74450) $785 $785 2.7×
Us chest (76604) $887 $887 7.1×
Us complete joint (76881) $480 $480 3.8×
Us exam, pelvic, limited (76857) $339 $339 2.7×
Us head (76506) $519 $519 4.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $751 $751 6.0×
Us ob detailed single fetus (76811) $1,085 $1,085 3.8×
Us ob limited 1 or more fetuses (76815) $495 $495 4.0×
Us ob transvaginal (76817) $634 $634 5.1×
Us pelvic non ob complete (76856) $742 $742 5.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $634 $634 5.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $634 $634 5.1×
Us retroperitoneal complete (76770) $634 $634 5.1×
Us retroperitoneal limited (76775) $545 $545 4.3×
Us scrotum and contents (76870) $777 $777 6.2×
Us thyroid (76536) $519 $519 4.1×
Us transrectal (76872) $383 $383 3.1×
Vein X-Ray Chest (75827) $4,823 $4,823 2.6×
Venography caval inferior serialography rs&i (75825) $5,543 $5,543 1.5×
Venography extremity unilateral rs&i (75820) $5,846 $5,846 3.1×
Vertebral fracture assessment via dxa (77086) $272 $272 2.6×
Wrist 2 views (73100) $213 $213 2.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $375 $375 3.6×
X-Ray Aorta Leg Arteries (75630) $4,780 $4,780 1.3×
X-Ray Bend Only L-S Spine (72120) $411 $411 3.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $212 $212 2.0×
X-Ray Exam Breast Specimen (76098) $2,074 $2,074 3.2×
X-Ray Exam Entire Spi 1 Vw (72081) $273 $273 2.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $441 $441 3.5×
X-Ray Exam Entire Spi 4/5 Vw (72083) $440 $440 3.5×
X-Ray Exam Hip Uni 1 View (73501) $257 $257 2.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $224 $224 2.1×
X-Ray Exam Hips Bi 2 Views (73521) $320 $320 2.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $440 $440 3.5×
X-Ray Exam Hips Bi 5/> Views (73523) $440 $440 3.5×
X-Ray Exam L-S Spine Bending (72114) $559 $559 4.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $353 $353 3.4×
X-Ray Exam Neck Spine 6/>Vws (72052) $705 $705 5.6×
X-Ray Exam Unilat Ribs/Chest (71101) $597 $597 4.8×
X-ray eye for foreign body (70030) $401 $401 3.8×
X-ray humerus (73060) $338 $338 3.2×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $239 $239 2.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $309 $309 3.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $353 $353 2.8×
X-ray nose-rectum child f.b. (76010) $678 $678 6.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $540 $540 4.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $447 $447 3.6×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $1,989 $1,989 15.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $296 $296 2.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $729 $729 7.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $537 $537 4.3×
X-Ray Stress View (77071) $248 $248 2.4×
X-ray thoracic spine 4 vw (72074) $411 $411 3.3×
X-Rays Bone Survey Complete (77075) $438 $438 3.5×
Xr c-spine 4 or 5 views (72050) $411 $411 3.3×
Xr facial bones less than 3 views (70140) $452 $452 4.3×
Xr orbits complete 4 views (70200) $328 $328 2.6×

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.