Imaging prices at Bon Secours St. Francis Hospital

Charleston, SC · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $222.60 $371 2.8×
Abdomen 2 views (74019) $220.80 $368 2.3×
Acute Gastrointestinal Blood Loss Imaging (78278) $964.80 $1,608 2.6×
Ankle 2 views (73600) $293.40 $489 3.6×
Bone Imaging 3 Phase (78315) $1,967.40 $3,279 5.3×
Bone Imaging Whole Body (78306) $1,661.40 $2,769 4.5×
Bone survey infant (77076) $310.80 $518 3.2×
Cardiac MRI w/w/o contrast & further seq (75561) $2,282.40 $3,804 7.0×
Cardiac MRI w/w/o contrast w/stress (75563) $2,598.60 $4,331 3.6×
Chest 1 view (71045) $174 $290 2.1×
Chest 2 views (71046) $315.60 $526 3.9×
Chest 3 views (71047) $414.60 $691 5.1×
Chest 4 or more views (71048) $348.60 $581 3.6×
Clavicle complete (73000) $317.40 $529 3.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $598.80 $998 6.2×
CT abdomen and pelvis without and with contrast (74178) $3,105.60 $5,176 9.6×
CT abdomen and pelvis without contrast (74176) $2,247.60 $3,746 10.1×
CT abdomen w contrast (74160) $1,408.20 $2,347 8.6×
CT abdomen w wo contrast (74170) $1,705.80 $2,843 10.5×
CT abdomen w/o contrast (74150) $1,189.80 $1,983 12.2×
CT Angio Abdomen and Pelvis (74174) $2,544 $4,240 7.8×
CT Angio Chest (71275) $1,599 $2,665 9.8×
CT Angio Head (70496) $1,371 $2,285 8.4×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,047.80 $3,413 12.6×
CT Angio Neck (70498) $1,371 $2,285 8.4×
CT cervical spine w/o contrast (72125) $1,582.20 $2,637 16.3×
CT cervical spine w/wo cont (72127) $2,209.20 $3,682 13.5×
CT chest w contrast (71260) $1,249.20 $2,082 7.7×
CT chest w/wo contrast (71270) $1,573.80 $2,623 9.6×
CT colonography screening (74263) $585.60 $976 2.6×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,995.60 $3,326 12.2×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,314.60 $2,191 13.5×
CT head/brain with contrast (70460) $1,344 $2,240 8.2×
CT head/brain without and with contrast (70470) $1,630.80 $2,718 10.0×
CT heart no contrast quant eval coronry calcium (75571)
range across 3 matching MRF lines		 $99–$957 $99–$957 varies
CT iac w contrast (70481) $1,981.20 $3,302 12.1×
CT lower ext w/o (73700) $1,086 $1,810 11.2×
CT lower extremity w/contrast material (73701) $1,538.40 $2,564 9.4×
CT lumbar spine w/o contrast (72131) $1,715.40 $2,859 17.6×
CT maxillofacial w contrast (70487) $1,357.80 $2,263 8.3×
CT maxillofacial wo contrast (70486) $1,268.40 $2,114 13.0×
CT neck tissue combo (70492) $1,791 $2,985 11.0×
CT orbits w/o contrast (70480) $1,517.40 $2,529 15.6×
CT pelvis w/o contrast (72192) $1,128 $1,880 11.6×
CT scan of leg combo (73702) $2,162.40 $3,604 13.3×
CT scans face/jaw combo (70488) $1,199.40 $1,999 7.4×
CT soft tissue neck w contrast (70491) $1,413 $2,355 8.7×
CT soft tissue neck w/o contrast (70490) $1,180.20 $1,967 12.1×
CT thoracic spine w/o contrast (72128) $1,148.40 $1,914 11.8×
CT thorax w/o contrast (71250) $1,089 $1,815 11.2×
CT upper ext wo (73200) $1,087.20 $1,812 11.2×
CT upper extremity with contrast (73201) $2,680.80 $4,468 8.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,819.80 $3,033 11.2×
Cta Abdomen (74175) $1,548 $2,580 9.5×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $157.80 $263 1.6×
Doppler Echo Fetal Spectral Display Complete (76827) $165.60 $276 1.7×
Dxa Bone Density Axial (77080) $337.80 $563 3.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $90.60 $151 1.1×
Echo exam of fetal heart (76825) $1,113 $1,855 2.2×
Esophagram (74220) $427.80 $713 2.6×
Fetal Biophys Profile W/Nst (76818) $909.60 $1,516 9.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $549.60 $916 5.7×
Fluoroscopy up to 1 hr (76000) $492 $820 2.2×
Foot 2 views (73620) $270 $450 3.3×
Forearm 2 views (73090) $382.80 $638 4.7×
Gastric emptying imaging study (78264) $1,760.40 $2,934 4.7×
Hand 2 views (73120) $230.40 $384 2.4×
Hepatobil Syst Image W/Drug (78227) $2,595.60 $4,326 5.1×
Hepatobiliary System Imaging (78226) $1,819.80 $3,033 4.9×
Hysterosalpingogram (74740) $717.60 $1,196 3.2×
K Flow/Funct Image W/Drug (78708) $3,056.40 $5,094 6.1×
Knee 3 Views (73562) $390.60 $651 4.8×
Lung Ventilat&Perfus Imaging (78582) $1,059.60 $1,766 2.1×
Lymph System Imaging (78195) $1,251.60 $2,086 2.5×
Magnetic Image Jaw Joint (70336) $3,153.60 $5,256 14.2×
Mammary ductogram or galactogram multiple (77054) $602.40 $1,004 2.7×
Mr safety determination physician/other qhp (76016) $211.20 $352 2.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $73.20 $122 2.7×
Mr safety implt electronics prepj supvj phys/qhp (76018) $220.20 $367 2.5×
Mr safety implt pos&/immoblj (76019) $142.80 $238 2.6×
Mr safety med physics xm customization plng&mntr (76017) $580.20 $967 2.6×
Mra Head W/O & W/Contrast Material (70546) $4,975.80 $8,293 15.3×
MRA head w/o contrast (70544) $1,407 $2,345 6.3×
MRA neck w contrast (70548) $2,919 $4,865 9.0×
Mra Neck W/O &W/Contrast Material (70549) $1,478.40 $2,464 4.6×
MRA neck w/o contrast (70547) $3,116.40 $5,194 14.0×
MRI abdomen w/o contrast (74181) $1,913.40 $3,189 8.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,684.40 $4,474 8.3×
MRI Breast W/O Contrast Bilateral (77047) $3,430.20 $5,717 15.5×
MRI cardiac w/o contrast (75557) $2,209.20 $3,682 10.0×
MRI cervical spine w/o cont (72141) $1,696.20 $2,827 7.6×
MRI chest w/o contrast (71550) $3,079.20 $5,132 13.9×
MRI chest wo w contrast (71552) $3,958.80 $6,598 12.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,777.40 $4,629 8.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,192.40 $3,654 9.9×
MRI lumbar spine w contrast (72149) $2,169.60 $3,616 6.7×
Mri Neck Spine W/O & W/Dye (72156) $2,868.60 $4,781 8.8×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,352.60 $3,921 7.3×
MRI pelvis w/o & w contrast (72197) $2,071.80 $3,453 6.4×
MRI pelvis w/o contrast (72195) $1,586.40 $2,644 7.1×
MRI thoracic spine w/o contrast (72146) $1,673.40 $2,789 7.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,515.80 $4,193 11.3×
Mri Uppr Extremity W/O&W/Dye (73220) $3,399 $5,665 10.5×
MRI, abdomen, combo (74183) $2,029.20 $3,382 6.3×
MRI, dorsal spine combo (72157) $2,560.20 $4,267 7.9×
MRI, joint upper extrem (73221) $2,302.20 $3,837 10.4×
MRI, joint upper extrem combo (73223) $3,358.80 $5,598 10.4×
MRI, lumbar spine combo (72158) $2,517.60 $4,196 7.8×
N-invas est c ffr sw aly CTA (75580) $526.20 $877 0.7×
Neck soft tissue (70360) $306.60 $511 3.8×
Nuclear Rx Oral Admin (79005) $1,382.40 $2,304 6.4×
Parathyroid Planar Imaging (78070) $1,195.80 $1,993 3.2×
Parathyroid planar imaging w/wo subtraction (78071) $2,076.60 $3,461 5.6×
Pelvis 1 or 2 views (72170) $180.60 $301 1.9×
Pulmonary Perfusion Imaging Particulate (78580) $847.20 $1,412 2.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $573.60 $956 5.9×
Radex abscess/fistula/sinus tract rs&i (76080) $494.40 $824 1.0×
Radex Ankle Complete Minimum 3 Views (73610) $487.20 $812 6.0×
Radex Calcaneus Minimum 2 Views (73650) $280.20 $467 3.5×
Radex elbow complete minimum 3 views (73080) $444 $740 5.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $470.40 $784 4.8×
Radex fingr minimum 2 views (73140) $274.20 $457 3.4×
Radex foot complete minimum 3 views (73630) $451.80 $753 5.6×
Radex Hand Minimum 3 Views (73130) $361.20 $602 4.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $424.80 $708 5.2×
Radex Ribs Unilateral 2 Views (71100) $292.80 $488 3.6×
Radex shoulder complete minimum 2 views (73030) $423 $705 5.2×
Radex Sternum Minimum 2 Views (71120) $342 $570 4.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $292.20 $487 3.6×
Radex Toe Minimum 2 Views (73660) $270 $450 3.3×
Radex upper extremity infant minimum 2 views (73092) $281.40 $469 2.9×
Radex Wrist Complete Minimum 3 Views (73110) $406.20 $677 5.0×
Radiolog exam mandible compl minimum 4 views (70110) $627 $1,045 6.4×
Radiologic exam colon double contrast study (74280) $1,002 $1,670 6.1×
Radiologic exam colon single contrast study (74270) $902.40 $1,504 5.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $459 $765 2.8×
Radiologic exam knee complete 4/more views (73564) $519 $865 5.3×
Radiologic exam pelvis compl minimum 3 views (72190) $502.20 $837 5.2×
Radiologic Exam Small Int Single Contrast Study (74250) $550.20 $917 3.4×
Radiologic exam swallow function contrast study (74230) $330 $550 2.0×
Radiologic exam upr gi trc double contrast study (74246) $455.40 $759 2.8×
Radiologic examination femur minimum 2 views (73552) $401.40 $669 5.0×
Radiologic examination knee 1/2 views (73560) $267 $445 3.3×
Radiologic Examination Osseous Survey Limited (77074) $508.20 $847 5.2×
Radiologic examination tibia & fibula 2 views (73590) $360 $600 4.4×
Ribs bilateral 3 views (71110) $312 $520 3.2×
Rp loclzj tum plnr 1 area single day imaging (78800) $886.80 $1,478 2.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,052.60 $3,421 1.7×
Scapula (73010) $322.20 $537 3.3×
Screening Digital Breast Tomosynthesis Bi (77063) $47.40 $79 2.0×
Shoulder 1 view (73020) $261.60 $436 3.2×
Skull less than 4 views (70250) $324.60 $541 3.3×
Thoracic spine 2 views (72070) $481.80 $803 5.0×
Thoracic spine 3 views (72072) $577.20 $962 5.9×
Thoracolumbar 2 views (72080) $431.40 $719 5.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $934.80 $1,558 2.5×
Ultrasound Breast Limited (76642) $569.40 $949 7.0×
Ultrasound Exam Aaa Screen (76706) $343.20 $572 3.5×
Ultrasound, abdomen limited (76705) $517.20 $862 5.3×
Umbilical-artery Doppler (OB) (76820) $165.60 $276 1.7×
Upper gi w/o kub (74240) $567 $945 3.5×
Us breast unilateral complete (76641) $435.60 $726 4.5×
Us chest (76604) $381.60 $636 3.9×
Us complete joint (76881) $435 $725 4.5×
Us exam, pelvic, limited (76857) $682.80 $1,138 7.0×
Us head (76506) $600 $1,000 6.2×
Us kidney transplant (76776) $807 $1,345 8.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $418.80 $698 4.3×
Us ob detailed single fetus (76811) $899.40 $1,499 4.1×
Us ob limited 1 or more fetuses (76815) $442.80 $738 4.6×
Us ob transvaginal (76817) $799.20 $1,332 8.2×
Us pelvic non ob complete (76856) $610.20 $1,017 6.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $729 $1,215 7.5×
Us preg uterus real time f/u trnsabdl per fetus (76816) $418.20 $697 4.3×
Us retroperitoneal complete (76770) $770.40 $1,284 7.9×
Us retroperitoneal limited (76775) $668.40 $1,114 6.9×
Us scrotum and contents (76870) $754.80 $1,258 7.8×
Us spinal canal and contents (76800) $670.80 $1,118 6.9×
Us thyroid (76536) $788.40 $1,314 8.1×
Wrist 2 views (73100) $243 $405 3.0×
X-Ray Bend Only L-S Spine (72120) $619.80 $1,033 6.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $246.60 $411 3.0×
X-Ray Exam Breast Specimen (76098) $826.80 $1,378 1.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $513.60 $856 5.3×
X-Ray Exam Entire Spi 4/5 Vw (72083) $255 $425 2.6×
X-Ray Exam Hip Uni 1 View (73501) $199.80 $333 2.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $313.80 $523 3.9×
X-Ray Exam Hip Uni 4/> Views (73503) $330.60 $551 3.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $460.20 $767 4.7×
X-Ray Exam Hips Bi 5/> Views (73523) $460.20 $767 4.7×
X-Ray Exam L-S Spine Bending (72114) $966.60 $1,611 9.9×
X-Ray Exam Neck Spine 2-3 Vw (72040) $393 $655 4.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $621 $1,035 6.4×
X-Ray Exam Unilat Ribs/Chest (71101) $531 $885 5.5×
X-ray humerus (73060) $368.40 $614 4.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $261 $435 3.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $459 $765 4.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $565.20 $942 5.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $429.60 $716 4.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $397.20 $662 4.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $526.20 $877 6.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $670.20 $1,117 6.9×
X-Rays Bone Survey Complete (77075) $665.40 $1,109 6.8×
Xr c-spine 4 or 5 views (72050) $651 $1,085 6.7×

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.