Imaging prices at Bon Secours St. Francis Medical Center

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $620.40 $1,034 7.3×
Abdomen 2 views (74019) $307.80 $513 3.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $946.20 $1,577 2.4×
Angio internal mammary (75756) $1,325.40 $2,209 0.4×
Angiography extremity bilateral rs&i (75716) $2,847.60 $4,746 0.9×
Angiography extremity unilateral rs&i (75710) $2,646 $4,410 0.9×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $6,027 $10,045 2.0×
Ankle 2 views (73600) $578.40 $964 6.8×
Artery X-Rays Abdomen (75726) $4,183.20 $6,972 0.8×
Arthrogram hip (73525) $1,489.20 $2,482 4.4×
Bone age studies (77072) $737.40 $1,229 7.2×
Bone Imaging 3 Phase (78315) $3,498 $5,830 9.0×
Bone Imaging Limited Area (78300) $1,590.60 $2,651 4.1×
Bone Imaging Whole Body (78306) $2,323.20 $3,872 6.0×
Bone survey infant (77076) $911.40 $1,519 8.9×
Cardiac MRI w/w/o contrast & further seq (75561) $3,384.60 $5,641 9.9×
Cardiac MRI w/w/o contrast w/stress (75563) $3,968.40 $6,614 5.2×
Chest 1 view (71045) $243.60 $406 2.9×
Chest 2 views (71046) $485.40 $809 5.7×
Chest 3 views (71047) $533.40 $889 6.3×
Clavicle complete (73000) $775.20 $1,292 9.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $313.20 $522 3.1×
Contrast Exam Abdominl Aorta (75625) $3,043.80 $5,073 1.0×
Contrast X-Ray Bladder (74430) $839.40 $1,399 2.5×
Contrast X-Ray Of Elbow (73085) $336.60 $561 1.0×
CT abdomen and pelvis without and with contrast (74178) $3,493.80 $5,823 10.3×
CT abdomen and pelvis without contrast (74176) $2,201.40 $3,669 9.5×
CT abdomen w contrast (74160) $2,604 $4,340 15.2×
CT abdomen w wo contrast (74170) $2,323.20 $3,872 13.6×
CT abdomen w/o contrast (74150) $1,969.20 $3,282 19.3×
CT Angio Abdomen and Pelvis (74174) $3,399 $5,665 10.0×
CT Angio Chest (71275) $2,503.80 $4,173 14.6×
CT Angio Head (70496) $2,505.60 $4,176 14.6×
CT angio hrt w/3d image (75574) $2,494.80 $4,158 7.3×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,907.60 $4,846 17.0×
CT Angio Neck (70498) $4,071 $6,785 23.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,233.60 $2,056 7.2×
CT cervical spine w/ contrast (72126) $2,887.80 $4,813 8.5×
CT cervical spine w/o contrast (72125) $1,830.60 $3,051 17.9×
CT chest w contrast (71260) $1,986.60 $3,311 11.6×
CT chest w/wo contrast (71270) $1,879.80 $3,133 11.0×
CT head/brain with contrast (70460) $2,964 $4,940 17.3×
CT head/brain without and with contrast (70470) $2,741.40 $4,569 16.0×
CT heart no contrast quant eval coronry calcium (75571)
range across 3 matching MRF lines		 $115–$129 $115–$129 varies
CT iac w contrast (70481) $2,647.80 $4,413 15.5×
CT lower ext w/o (73700) $1,528.20 $2,547 15.0×
CT lower extremity w/contrast material (73701) $2,887.80 $4,813 16.9×
CT lumbar spine w contrast (72132) $2,975.40 $4,959 8.7×
CT lumbar spine w/o contrast (72131) $1,447.80 $2,413 14.2×
CT maxillofacial w contrast (70487) $2,730.60 $4,551 16.0×
CT maxillofacial wo contrast (70486) $1,481.40 $2,469 14.5×
CT neck tissue combo (70492) $3,436.80 $5,728 20.1×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,436.80 $5,728 20.1×
CT orbits w/o contrast (70480) $3,354 $5,590 32.9×
CT pelvis w&w/o contrast (72194) $3,165.60 $5,276 18.5×
CT pelvis w/o contrast (72192) $1,810.20 $3,017 17.7×
CT scan of leg combo (73702) $2,674.80 $4,458 15.6×
CT scans face/jaw combo (70488) $3,021.60 $5,036 17.7×
CT soft tissue neck w contrast (70491) $2,194.80 $3,658 12.8×
CT soft tissue neck w/o contrast (70490) $1,852.20 $3,087 18.2×
CT thoracic spine w contrast (72129) $1,648.20 $2,747 9.6×
CT thoracic spine w/o contrast (72128) $1,689 $2,815 16.6×
CT thorax w/o contrast (71250) $1,629.60 $2,716 16.0×
CT upper ext wo (73200) $1,824.60 $3,041 17.9×
CT upper extremity with contrast (73201) $3,019.80 $5,033 8.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $3,298.20 $5,497 19.3×
Cta Abdomen (74175) $2,182.80 $3,638 12.8×
CTA pelvis (72191) $3,031.80 $5,053 17.7×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $223.20 $372 2.2×
Doppler Echo Fetal Spectral Display Complete (76827) $223.20 $372 2.2×
Doppler Fetal Mid Cerebral Artery (76821) $487.80 $813 4.8×
Dxa Bone Density Axial (77080) $898.20 $1,497 8.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $147.60 $246 1.7×
Echo exam of fetal heart (76825) $1,419.60 $2,366 2.7×
Echo exam uterus (76831) $190.80 $318 0.8×
Echo Guide For Artery Repair (76936) $640.80 $1,068 3.0×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $405.60 $676 1.7×
Esophagram (74220) $1,231.80 $2,053 7.2×
Fetal Biophys Profile W/Nst (76818) $1,566 $2,610 15.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,108.80 $1,848 10.9×
Fluoroscopy up to 1 hr (76000) $1,035 $1,725 4.4×
Follow-Up Angiography (75898) $1,295.40 $2,159 0.4×
Foot 2 views (73620) $385.80 $643 4.5×
Forearm 2 views (73090) $496.20 $827 5.8×
Gastric emptying imaging study (78264) $3,115.20 $5,192 8.0×
Gated Heart Planar Single (78472) $367.20 $612 0.9×
Gated Heart, Multiple (78473) $780 $1,300 2.0×
Hand 2 views (73120) $481.20 $802 4.7×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,884.40 $6,474 1.3×
Hepatobil Syst Image W/Drug (78227) $3,641.40 $6,069 6.9×
Hepatobiliary System Imaging (78226) $3,612 $6,020 9.3×
Ht Muscle Image Spect Sing (78451) $4,153.20 $6,922 3.3×
Hysterosalpingogram (74740) $991.20 $1,652 4.3×
Infant hip ultrasound with hip movement (dynamic) (76885) $700.20 $1,167 8.2×
K Flow/Funct Image W/Drug (78708) $2,209.80 $3,683 4.2×
K Flow/Funct Image W/O Drug (78707) $1,967.40 $3,279 3.7×
Knee 3 Views (73562) $645 $1,075 7.6×
Lung Perf&Ventilat Diferentl (78598) $475.20 $792 0.9×
Lung Ventilat&Perfus Imaging (78582) $1,825.20 $3,042 3.4×
Lymph System Imaging (78195) $2,111.40 $3,519 4.0×
Magnetic Image Jaw Joint (70336) $2,728.20 $4,547 11.7×
Meckels Divert Exam (78290) $2,163.60 $3,606 5.5×
Mr safety determination physician/other qhp (76016) $166.20 $277 2.0×
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 1.9×
Mr safety implt pos&/immoblj (76019) $112.20 $187 1.9×
Mr safety med physics xm customization plng&mntr (76017) $456.60 $761 2.0×
Mra Head W/O & W/Contrast Material (70546) $4,180.80 $6,968 12.3×
MRA head w/o contrast (70544) $2,284.80 $3,808 9.8×
MRA head with contrast (70545) $1,003.80 $1,673 2.9×
MRA neck w contrast (70548) $3,273.60 $5,456 9.6×
Mra Neck W/O &W/Contrast Material (70549) $4,678.80 $7,798 13.7×
MRA neck w/o contrast (70547) $2,695.80 $4,493 11.6×
MRI abdomen w contrast (74182) $3,663 $6,105 10.8×
MRI abdomen w/o contrast (74181) $2,527.20 $4,212 10.9×
MRI any jt lower extrem w/contrast material (73722) $3,628.80 $6,048 4.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,688.40 $7,814 13.8×
MRI any jt upper extremity w/contrast matrl (73222) $3,543.60 $5,906 4.6×
MRI Breast W/O Contrast Bilateral (77047) $2,940.60 $4,901 12.6×
MRI cardiac w/o contrast (75557) $2,728.20 $4,547 11.7×
MRI cervical spine w contrast (72142) $3,459 $5,765 10.2×
MRI cervical spine w/o cont (72141) $2,087.40 $3,479 9.0×
MRI chest w/o contrast (71550) $2,728.20 $4,547 11.7×
MRI chest with contrast (71551) $2,707.20 $4,512 3.5×
MRI chest wo w contrast (71552) $4,661.40 $7,769 13.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,426.20 $7,377 13.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,424 $4,040 10.4×
MRI lumbar spine w contrast (72149) $3,280.80 $5,468 9.6×
Mri Neck Spine W/O & W/Dye (72156) $3,340.20 $5,567 9.8×
MRI orbit face &/neck w/o contrast (70540) $2,999.40 $4,999 12.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,426.20 $7,377 13.0×
MRI pelvis w contrast (72196) $1,556.40 $2,594 4.6×
MRI pelvis w/o & w contrast (72197) $3,834.60 $6,391 11.3×
MRI pelvis w/o contrast (72195) $2,658 $4,430 11.4×
MRI thoracic spine w/o contrast (72146) $2,289.60 $3,816 9.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,928.60 $4,881 12.6×
Mri Uppr Extremity W/O&W/Dye (73220) $4,292.40 $7,154 12.6×
MRI, abdomen, combo (74183) $3,352.80 $5,588 9.8×
MRI, dorsal spine combo (72157) $3,525 $5,875 10.4×
MRI, dorsal spine contrast (72147) $1,852.20 $3,087 5.4×
MRI, joint upper extrem (73221) $2,204.40 $3,674 9.5×
MRI, joint upper extrem combo (73223) $4,426.20 $7,377 13.0×
MRI, lumbar spine combo (72158) $3,340.20 $5,567 9.8×
Myocardial Spect Multiple Studies (78452) $5,660.40 $9,434 4.5×
N-invas est c ffr sw aly CTA (75580) $2,646 $4,410 3.2×
Neck soft tissue (70360) $647.40 $1,079 7.6×
Ob us nuchal meas 1 gest (76813) $597 $995 5.9×
Parathyroid Planar Imaging (78070) $1,595.40 $2,659 4.1×
Parathyroid planar imaging w/wo subtraction (78071) $1,809.60 $3,016 4.6×
Pelvis 1 or 2 views (72170) $603.60 $1,006 5.9×
Pet Image W/Ct Lmtd (78814) $7,037.40 $11,729 5.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,385.40 $2,309 3.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $871.20 $1,452 8.5×
Radex abscess/fistula/sinus tract rs&i (76080) $844.80 $1,408 1.6×
Radex Ankle Complete Minimum 3 Views (73610) $569.40 $949 6.7×
Radex Calcaneus Minimum 2 Views (73650) $543.60 $906 6.4×
Radex elbow complete minimum 3 views (73080) $762.60 $1,271 9.0×
Radex Facial Bones Complete Minimum 3 Views (70150) $664.20 $1,107 6.5×
Radex fingr minimum 2 views (73140) $614.40 $1,024 7.2×
Radex foot complete minimum 3 views (73630) $576 $960 6.8×
Radex Hand Minimum 3 Views (73130) $712.80 $1,188 8.4×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $540 $900 5.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $511.80 $853 6.0×
Radex Ribs Unilateral 2 Views (71100) $448.80 $748 5.3×
Radex shoulder complete minimum 2 views (73030) $759.60 $1,266 8.9×
Radex Sinuses Paransl < 3 Views (70210) $666 $1,110 7.8×
Radex Spine 1 View Specify Level (72020) $503.40 $839 5.9×
Radex Sternum Minimum 2 Views (71120) $559.80 $933 6.6×
Radex Toe Minimum 2 Views (73660) $430.80 $718 5.1×
Radex Wrist Complete Minimum 3 Views (73110) $662.40 $1,104 7.8×
Radiolog exam mandible compl minimum 4 views (70110) $612.60 $1,021 6.0×
Radiologic exam colon double contrast study (74280) $2,462.40 $4,104 14.4×
Radiologic exam colon single contrast study (74270) $1,495.80 $2,493 8.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $440.40 $734 2.6×
Radiologic exam knee complete 4/more views (73564) $1,069.80 $1,783 10.5×
Radiologic exam pelvis compl minimum 3 views (72190) $542.40 $904 5.3×
Radiologic Exam Small Int Single Contrast Study (74250) $1,458 $2,430 8.5×
Radiologic exam swallow function contrast study (74230) $620.40 $1,034 3.6×
Radiologic exam upr gi trc double contrast study (74246) $1,794.60 $2,991 10.5×
Radiologic examination femur 1 view (73551) $544.20 $907 6.4×
Radiologic examination femur minimum 2 views (73552) $776.40 $1,294 9.1×
Radiologic examination knee 1/2 views (73560) $445.80 $743 5.3×
Radiologic examination tibia & fibula 2 views (73590) $809.40 $1,349 9.5×
Ribs bilateral 3 views (71110) $585 $975 5.7×
Rp loclzj tum plnr 1 area single day imaging (78800) $286.80 $478 0.7×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $929.40 $1,549 1.8×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,403.60 $4,006 4.5×
Scapula (73010) $803.40 $1,339 7.9×
Screening Digital Breast Tomosynthesis Bi (77063) $107.40 $179 4.6×
Shoulder 1 view (73020) $508.20 $847 6.0×
Shoulder Arthrography (73040) $1,365.60 $2,276 4.0×
Skull less than 4 views (70250) $642 $1,070 6.3×
Sternoclavicular joints (71130) $127.80 $213 1.5×
Thoracic spine 2 views (72070) $924 $1,540 9.1×
Thoracic spine 3 views (72072) $735.60 $1,226 7.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,419 $2,365 3.6×
Ultrasound Breast Limited (76642) $583.20 $972 6.9×
Ultrasound Exam Aaa Screen (76706) $1,010.40 $1,684 9.9×
Ultrasound, abdomen limited (76705) $868.20 $1,447 8.5×
Umbilical-artery Doppler (OB) (76820) $523.80 $873 5.1×
Unlisted magnetic resonance procedure (76498) $779.40 $1,299 9.2×
Upper gi w/o kub (74240) $831.60 $1,386 4.9×
Us breast unilateral complete (76641) $600 $1,000 5.9×
Us chest (76604) $868.80 $1,448 8.5×
Us complete joint (76881) $696 $1,160 6.8×
Us exam, pelvic, limited (76857) $759.60 $1,266 7.4×
Us head (76506) $1,409.40 $2,349 13.8×
Us kidney transplant (76776) $1,134 $1,890 11.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $615.60 $1,026 6.0×
Us ob detailed single fetus (76811) $3,756 $6,260 16.1×
Us ob limited 1 or more fetuses (76815) $829.80 $1,383 8.1×
Us ob transvaginal (76817) $1,213.80 $2,023 11.9×
Us pelvic non ob complete (76856) $1,611 $2,685 15.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $918.60 $1,531 9.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $677.40 $1,129 6.6×
Us retroperitoneal complete (76770) $1,407.60 $2,346 13.8×
Us retroperitoneal limited (76775) $855.60 $1,426 8.4×
Us scrotum and contents (76870) $1,098 $1,830 10.8×
Us spinal canal and contents (76800) $964.20 $1,607 9.5×
Us thyroid (76536) $945.60 $1,576 9.3×
Vein X-Ray Liver W/O Hemodyn (75887) $2,577 $4,295 0.8×
Venography extremity unilateral rs&i (75820) $1,491 $2,485 1.0×
Venography Renal Bilateral (75833) $6,027 $10,045 2.0×
Vertebral fracture assessment via dxa (77086) $333 $555 3.9×
Wrist 2 views (73100) $534.60 $891 6.3×
X-Ray Aorta Leg Arteries (75630) $4,077.60 $6,796 1.3×
X-Ray Bend Only L-S Spine (72120) $102 $170 1.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $345.60 $576 4.1×
X-Ray Exam Hip Uni 1 View (73501) $325.20 $542 3.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $487.20 $812 5.7×
X-Ray Exam Hips Bi 2 Views (73521) $1,144.80 $1,908 11.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $1,163.40 $1,939 11.4×
X-Ray Exam L-S Spine Bending (72114) $758.40 $1,264 7.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $591.60 $986 7.0×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,012.80 $1,688 9.9×
X-Ray Exam Unilat Ribs/Chest (71101) $924 $1,540 9.1×
X-ray eye for foreign body (70030) $492 $820 5.8×
X-ray humerus (73060) $594.60 $991 7.0×
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) $402.60 $671 4.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $868.20 $1,447 8.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $696.60 $1,161 6.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $576.60 $961 5.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $553.80 $923 5.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $776.40 $1,294 9.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $995.40 $1,659 11.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $847.20 $1,412 8.3×
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 5.7×
X-Rays Bone Length Studies (77073) $232.20 $387 2.3×
X-Rays Bone Survey Complete (77075) $1,092 $1,820 10.7×
Xr c-spine 4 or 5 views (72050) $1,011.60 $1,686 9.9×
Xr facial bones less than 3 views (70140) $200.40 $334 2.4×

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.