Imaging prices at Bon Secours Memorial Regional Medical Center

Mechanicsville, VA · every code in this section with a posted price and a Medicare benchmark.

251 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) $6,811.20 $11,352 4.9×
Abdomen 1 View (74018) $620.40 $1,034 7.1×
Abdomen 2 views (74019) $307.80 $513 2.9×
Acute Gastrointestinal Blood Loss Imaging (78278) $946.20 $1,577 2.4×
Angio pulmonary bilat (75743) $2,241 $3,735 0.7×
Angiography extremity bilateral rs&i (75716) $2,847.60 $4,746 0.9×
Angiography extremity unilateral rs&i (75710) $2,646 $4,410 0.8×
Ankle 2 views (73600) $578.40 $964 6.6×
Aortography thoracic serialography rs&i (75605) $10,710 $17,850 1.9×
Artery X-Rays Abdomen (75726) $4,183.20 $6,972 0.7×
Artery X-Rays Pelvis (75736) $3,779.40 $6,299 0.7×
Arthrogram hip (73525) $1,489.20 $2,482 4.3×
Basic radiation dosimetry calculation (77300) $657.60 $1,096 4.9×
Bone age studies (77072) $737.40 $1,229 7.0×
Bone Imaging 3 Phase (78315) $3,498 $5,830 8.7×
Bone Imaging Limited Area (78300) $1,590.60 $2,651 4.0×
Bone Imaging Whole Body (78306) $2,323.20 $3,872 5.8×
Brain Image W/Flow < 4 Views (78601) $867 $1,445 2.2×
Cardiac MRI w/w/o contrast & further seq (75561) $3,384.60 $5,641 9.7×
Cat Scan Follow-Up Study (76380) $1,146.60 $1,911 13.1×
Chest 1 view (71045) $243.60 $406 2.8×
Chest 2 views (71046) $485.40 $809 5.6×
Chest 3 views (71047) $533.40 $889 6.1×
Chest 4 or more views (71048) $606 $1,010 5.8×
Clavicle complete (73000) $775.20 $1,292 8.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $313.20 $522 3.0×
Continuing medical physics consltj pr wk (77336) $777.60 $1,296 5.8×
Contrast Exam Abdominl Aorta (75625) $3,765 $6,275 1.2×
Contrast X-Ray Bladder (74430) $839.40 $1,399 2.4×
CT abdomen and pelvis without and with contrast (74178) $3,493.80 $5,823 10.0×
CT abdomen and pelvis without contrast (74176) $2,201.40 $3,669 9.2×
CT abdomen w contrast (74160) $2,604 $4,340 14.8×
CT abdomen w wo contrast (74170) $2,323.20 $3,872 13.2×
CT abdomen w/o contrast (74150) $1,969.20 $3,282 18.8×
CT Angio Abdomen and Pelvis (74174) $3,399 $5,665 9.7×
CT Angio Chest (71275) $2,503.80 $4,173 14.2×
CT Angio Head (70496) $2,505.60 $4,176 14.2×
CT angio hrt w/3d image (75574) $2,494.80 $4,158 7.1×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,907.60 $4,846 16.5×
CT Angio Neck (70498) $4,071 $6,785 23.1×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,230.60 $2,051 7.0×
CT cervical spine w/ contrast (72126) $2,887.80 $4,813 8.3×
CT cervical spine w/o contrast (72125) $1,830.60 $3,051 17.5×
CT chest w contrast (71260) $1,986.60 $3,311 11.3×
CT head/brain with contrast (70460) $2,964 $4,940 16.8×
CT head/brain without and with contrast (70470) $2,741.40 $4,569 15.6×
CT heart contrast eval cardiac structure&morph (75572) $2,335.20 $3,892 6.7×
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines		 $115–$129 $115–$129 varies
CT hrt w/3d image congen (75573) $1,512 $2,520 4.3×
CT iac w contrast (70481) $2,647.80 $4,413 15.0×
CT lower ext w/o (73700) $1,528.20 $2,547 14.6×
CT lower extremity w/contrast material (73701) $2,887.80 $4,813 16.4×
CT lumbar spine w contrast (72132) $2,975.40 $4,959 8.5×
CT lumbar spine w/o contrast (72131) $1,447.80 $2,413 13.8×
CT maxillofacial w contrast (70487) $2,730.60 $4,551 15.5×
CT maxillofacial wo contrast (70486) $1,481.40 $2,469 14.1×
CT neck tissue combo (70492) $3,436.80 $5,728 19.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,436.80 $5,728 19.5×
CT orbits w/o contrast (70480) $3,354 $5,590 32.0×
CT pelvis w&w/o contrast (72194) $3,156.60 $5,261 17.9×
CT pelvis w/o contrast (72192) $1,810.20 $3,017 17.3×
CT scan of leg combo (73702) $2,674.80 $4,458 15.2×
CT scans face/jaw combo (70488) $3,021.60 $5,036 17.2×
CT soft tissue neck w contrast (70491) $2,194.80 $3,658 12.5×
CT soft tissue neck w/o contrast (70490) $1,852.20 $3,087 17.7×
CT thoracic spine w contrast (72129) $2,857.20 $4,762 16.2×
CT thoracic spine w/o contrast (72128) $1,689 $2,815 16.1×
CT thorax w/o contrast (71250) $1,629.60 $2,716 15.5×
CT upper ext wo (73200) $1,824.60 $3,041 17.4×
CT upper extremity with contrast (73201) $3,019.80 $5,033 8.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,298.20 $5,497 18.7×
Cta Abdomen (74175) $2,182.80 $3,638 12.4×
CTA pelvis (72191) $3,031.80 $5,053 17.2×
Dxa Bone Density Axial (77080) $898.20 $1,497 8.6×
Esophagram (74220) $1,231.80 $2,053 7.0×
Fluoroscopy up to 1 hr (76000) $1,035 $1,725 4.3×
Follow-Up Angiography (75898) $6,207.60 $10,346 2.0×
Foot 2 views (73620) $385.80 $643 4.4×
Forearm 2 views (73090) $496.20 $827 5.7×
Gastric emptying imaging study (78264) $3,115.20 $5,192 7.8×
Gated Heart Planar Single (78472) $1,875.60 $3,126 4.7×
Hand 2 views (73120) $481.20 $802 4.6×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,884.40 $6,474 1.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $1,461 $2,435 0.5×
Hepatobil Syst Image W/Drug (78227) $3,641.40 $6,069 6.7×
Hepatobiliary System Imaging (78226) $3,612 $6,020 9.0×
Ht Muscle Image Spect Sing (78451) $2,286 $3,810 1.8×
Hysterosalpingogram (74740) $991.20 $1,652 4.1×
K Flow/Funct Image W/Drug (78708) $2,209.80 $3,683 4.1×
K Flow/Funct Image W/O Drug (78707) $1,967.40 $3,279 3.6×
Knee 3 Views (73562) $645 $1,075 7.4×
Liver imaging static only (78201) $1,007.40 $1,679 1.8×
Lung Ventilat&Perfus Imaging (78582) $588 $980 1.1×
Lymph System Imaging (78195) $2,111.40 $3,519 3.9×
Meckels Divert Exam (78290) $1,206.60 $2,011 3.0×
Mr safety determination physician/other qhp (76016) $166.20 $277 1.9×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $46.20 $77 1.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $173.40 $289 1.8×
Mr safety implt pos&/immoblj (76019) $112.20 $187 1.9×
Mr safety med physics xm customization plng&mntr (76017) $456.60 $761 1.9×
Mra Head W/O & W/Contrast Material (70546) $4,180.80 $6,968 11.9×
MRA head w/o contrast (70544) $2,284.80 $3,808 9.5×
MRA neck w contrast (70548) $3,273.60 $5,456 9.4×
MRA neck w/o contrast (70547) $2,695.80 $4,493 11.3×
MRI abdomen w contrast (74182) $3,663 $6,105 10.5×
MRI abdomen w/o contrast (74181) $2,527.20 $4,212 10.6×
MRI any jt lower extrem w/contrast material (73722) $3,628.80 $6,048 4.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,688.40 $7,814 13.4×
MRI any jt upper extremity w/contrast matrl (73222) $3,543.60 $5,906 4.5×
MRI cardiac w/o contrast (75557) $2,728.20 $4,547 11.4×
MRI cervical spine w contrast (72142) $3,459 $5,765 9.9×
MRI cervical spine w/o cont (72141) $2,087.40 $3,479 8.7×
MRI chest w/o contrast (71550) $2,728.20 $4,547 11.4×
MRI chest wo w contrast (71552) $4,661.40 $7,769 13.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,426.20 $7,377 12.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,424 $4,040 10.1×
MRI lumbar spine w contrast (72149) $1,557 $2,595 4.4×
Mri Neck Spine W/O & W/Dye (72156) $3,340.20 $5,567 9.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,426.20 $7,377 12.6×
MRI pelvis w contrast (72196) $3,568.80 $5,948 10.2×
MRI pelvis w/o & w contrast (72197) $3,834.60 $6,391 11.0×
MRI pelvis w/o contrast (72195) $2,658 $4,430 11.1×
MRI thoracic spine w/o contrast (72146) $2,289.60 $3,816 9.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,928.60 $4,881 12.2×
Mri Uppr Extremity W/O&W/Dye (73220) $4,292.40 $7,154 12.3×
MRI, abdomen, combo (74183) $3,352.80 $5,588 9.6×
MRI, dorsal spine combo (72157) $3,525 $5,875 10.1×
MRI, dorsal spine contrast (72147) $1,852.20 $3,087 5.3×
MRI, joint upper extrem (73221) $2,204.40 $3,674 9.2×
MRI, joint upper extrem combo (73223) $4,426.20 $7,377 12.6×
MRI, lumbar spine combo (72158) $3,340.20 $5,567 9.5×
Myocardial Spect Multiple Studies (78452) $5,660.40 $9,434 4.4×
N-invas est c ffr sw aly CTA (75580) $2,646 $4,410 3.1×
Neck soft tissue (70360) $647.40 $1,079 7.4×
Parathyroid Planar Imaging (78070) $1,595.40 $2,659 4.0×
Parathyroid planar imaging w/wo subtraction (78071) $861 $1,435 2.1×
Pelvis 1 or 2 views (72170) $603.60 $1,006 5.8×
PET imaging CT attenuation skull base mid-thigh (78815) $7,013.40 $11,689 4.9×
Pulmonary Perfusion Imaging Particulate (78580) $1,385.40 $2,309 3.5×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $871.20 $1,452 8.3×
Radex abscess/fistula/sinus tract rs&i (76080) $833.40 $1,389 1.5×
Radex Ankle Complete Minimum 3 Views (73610) $569.40 $949 6.5×
Radex Calcaneus Minimum 2 Views (73650) $543.60 $906 6.2×
Radex elbow complete minimum 3 views (73080) $762.60 $1,271 8.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $664.20 $1,107 6.3×
Radex fingr minimum 2 views (73140) $614.40 $1,024 7.0×
Radex foot complete minimum 3 views (73630) $576 $960 6.6×
Radex Hand Minimum 3 Views (73130) $712.80 $1,188 8.2×
Radex lower extremity infant minimum 2 views (73592) $718.80 $1,198 8.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $511.80 $853 5.9×
Radex Ribs Unilateral 2 Views (71100) $448.80 $748 5.1×
Radex shoulder complete minimum 2 views (73030) $759.60 $1,266 8.7×
Radex Sinuses Paransl < 3 Views (70210) $666 $1,110 7.6×
Radex Spine 1 View Specify Level (72020) $503.40 $839 5.8×
Radex Sternum Minimum 2 Views (71120) $559.80 $933 6.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $790.20 $1,317 9.1×
Radex Toe Minimum 2 Views (73660) $430.80 $718 4.9×
Radex upper extremity infant minimum 2 views (73092) $804 $1,340 7.7×
Radex Wrist Complete Minimum 3 Views (73110) $662.40 $1,104 7.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $523.20 $872 5.0×
Radiation treatment delivery level 3 (77412) $3,543.60 $5,906 6.4×
Radiolog exam mandible compl minimum 4 views (70110) $863.40 $1,439 8.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $722.40 $1,204 6.9×
Radiologic exam colon double contrast study (74280) $2,462.40 $4,104 14.0×
Radiologic exam colon single contrast study (74270) $1,495.80 $2,493 8.5×
Radiologic exam knee complete 4/more views (73564) $1,069.80 $1,783 10.2×
Radiologic exam pelvis compl minimum 3 views (72190) $542.40 $904 5.2×
Radiologic Exam Small Int Single Contrast Study (74250) $1,458 $2,430 8.3×
Radiologic exam swallow function contrast study (74230) $620.40 $1,034 3.5×
Radiologic exam upr gi trc double contrast study (74246) $1,794.60 $2,991 10.2×
Radiologic examination femur 1 view (73551) $640.20 $1,067 7.3×
Radiologic examination femur minimum 2 views (73552) $776.40 $1,294 8.9×
Radiologic examination knee 1/2 views (73560) $445.80 $743 5.1×
Radiologic examination tibia & fibula 2 views (73590) $809.40 $1,349 9.3×
Ribs bilateral 3 views (71110) $585 $975 5.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $286.80 $478 0.7×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $463.80 $773 0.9×
Scapula (73010) $803.40 $1,339 7.7×
Screening Digital Breast Tomosynthesis Bi (77063) $107.40 $179 4.6×
Shoulder 1 view (73020) $508.20 $847 5.8×
Shoulder Arthrography (73040) $1,365.60 $2,276 3.9×
Skull less than 4 views (70250) $642 $1,070 6.1×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,114.20 $1,857 3.0×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,050.20 $3,417 5.5×
Ther rad simulaj-aided field setting simple (77280) $1,052.40 $1,754 7.8×
Thoracic spine 2 views (72070) $924 $1,540 8.8×
Thoracic spine 3 views (72072) $735.60 $1,226 7.0×
Thoracolumbar 2 views (72080) $486.60 $811 5.6×
Thyroid Uptake Measurement (78012) $473.40 $789 1.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,208.80 $5,348 8.0×
Tx Devices Design & Construction Complex (77334) $1,430.40 $2,384 3.8×
Tx devices design & construction simple (77332) $741.60 $1,236 5.5×
Ultrasound Breast Limited (76642) $583.20 $972 6.7×
Ultrasound Elastography Parenchyma (76981) $425.40 $709 4.1×
Ultrasound Exam Aaa Screen (76706) $1,010.40 $1,684 9.6×
Ultrasound, abdomen limited (76705) $868.20 $1,447 8.3×
Upper gi w/o kub (74240) $831.60 $1,386 4.7×
Us breast unilateral complete (76641) $717 $1,195 6.8×
Us chest (76604) $868.80 $1,448 8.3×
Us complete joint (76881) $696 $1,160 6.6×
Us exam, pelvic, limited (76857) $759.60 $1,266 7.2×
Us head (76506) $1,409.40 $2,349 13.4×
Us kidney transplant (76776) $1,762.80 $2,938 16.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $615.60 $1,026 5.9×
Us ob limited 1 or more fetuses (76815) $829.80 $1,383 7.9×
Us ob transvaginal (76817) $1,213.80 $2,023 11.6×
Us pelvic non ob complete (76856) $1,611 $2,685 15.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $890.40 $1,484 8.5×
Us retroperitoneal complete (76770) $1,407.60 $2,346 13.4×
Us retroperitoneal limited (76775) $855.60 $1,426 8.2×
Us scrotum and contents (76870) $1,098 $1,830 10.5×
Us spinal canal and contents (76800) $964.20 $1,607 9.2×
Us thyroid (76536) $945.60 $1,576 9.0×
Vein X-Ray Chest (75827) $4,217.40 $7,029 2.7×
Venography caval inferior serialography rs&i (75825) $3,900 $6,500 1.2×
Venography extremity bilateral rs&i (75822) $2,113.80 $3,523 1.3×
Venography extremity unilateral rs&i (75820) $1,491 $2,485 0.9×
Venography Renal Unilateral (75831) $1,550.40 $2,584 0.5×
Wrist 2 views (73100) $534.60 $891 6.1×
X-ray antegrade pyelogram tube (74425) $945 $1,575 2.7×
X-Ray Aorta Leg Arteries (75630) $4,077.60 $6,796 1.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $345.60 $576 4.0×
X-Ray Exam Entire Spi 1 Vw (72081) $697.20 $1,162 8.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $253.20 $422 2.4×
X-Ray Exam Entire Spi 4/5 Vw (72083) $481.80 $803 4.6×
X-Ray Exam Hip Uni 1 View (73501) $325.20 $542 3.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $487.20 $812 5.6×
X-Ray Exam Hip Uni 4/> Views (73503) $822.60 $1,371 7.8×
X-Ray Exam Hips Bi 2 Views (73521) $1,144.80 $1,908 10.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $1,163.40 $1,939 11.1×
X-Ray Exam Hips Bi 5/> Views (73523) $744 $1,240 7.1×
X-Ray Exam L-S Spine Bending (72114) $758.40 $1,264 7.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $591.60 $986 6.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,012.80 $1,688 9.7×
X-Ray Exam Unilat Ribs/Chest (71101) $924 $1,540 8.8×
X-ray eye for foreign body (70030) $492 $820 5.6×
X-ray humerus (73060) $594.60 $991 6.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $154.80 $258 1.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $75 $125 0.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $868.20 $1,447 8.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $696.60 $1,161 6.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $576.60 $961 5.5×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $568.20 $947 5.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $776.40 $1,294 8.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $995.40 $1,659 11.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $847.20 $1,412 8.1×
X-ray thoracic spine 4 vw (72074) $165.60 $276 1.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,941.60 $3,236 5.5×
X-Rays Bone Survey Complete (77075) $1,092 $1,820 10.4×
Xr c-spine 4 or 5 views (72050) $1,011.60 $1,686 9.6×
Xr facial bones less than 3 views (70140) $200.40 $334 2.3×

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.