Imaging prices at Carilion Giles Community Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $184.80 $528 1.8×
Acute gi blood loss imaging (78278) $757.40 $2,164 1.9×
Ankle 2 views (73600) $236.25 $675 2.8×
Arthrogram shoulder (73040) $563.15 $1,609 1.7×
Bone &/Joint Imaging Limited Area (78300) $859.25 $2,455 2.2×
Bone &/Joint Imaging Multiple Areas (78305) $938.35 $2,681 2.4×
Bone &/joint imaging whole body (78306) $974.75 $2,785 2.5×
Bone age studies (77072) $170.10 $486 1.7×
Bone Imaging 3 Phase (78315) $1,237.95 $3,537 3.2×
Bone Marrow Imaging Limited Area (78102) $498.40 $1,424 1.3×
Bone survey complete (77075) $482.30 $1,378 4.7×
Bone survey infant (77076) $153.65 $439 1.5×
Bowel imaging (78290) $521.15 $1,489 1.3×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $931.70 $2,662 2.4×
Brain imaging, minimum 4 static views; Non-Facility (78605) $1,236.20 $3,532 2.3×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $693.70 $1,982 1.8×
Cardiac shunt detection (78428) $726.25 $2,075 1.9×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $667.80 $1,908 1.3×
Cervical spine 2 or 3 views (72040) $374.85 $1,071 4.4×
Chest 1 view (71045) $127.40 $364 1.5×
Chest xray 3 views (71047) $145.25 $415 1.7×
Clavicle complete (73000) $287.35 $821 3.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $539.70 $1,542 5.3×
CT abdomen and pelvis without and with contrast (74178) $2,153.90 $6,154 6.3×
CT abdomen and pelvis without contrast (74176) $1,132.25 $3,235 4.9×
CT abdomen w contrast (74160) $1,149.75 $3,285 6.7×
CT abdomen w wo contrast (74170) $1,233.05 $3,523 7.2×
CT abdomen w/o contrast (74150) $795.55 $2,273 7.8×
CT angio lwr extr w/o&w/dye (73706) $1,385.65 $3,959 8.1×
CT angiography upper extremity lt (73206) $1,160.60 $3,316 6.8×
CT c-spine w/contrast (72126) $2,105.95 $6,017 6.2×
CT c-spine w/o contrast (72125) $1,004.15 $2,869 9.8×
CT cere prfu aly c+wo CT/CTA (70473) $1,017.10 $2,906 5.9×
CT cervical spine w&w/o contrast (72127) $1,405.25 $4,015 8.2×
CT chest w contrast (71260) $1,028.65 $2,939 6.0×
CT chest w/wo contrast (71270) $1,373.40 $3,924 8.0×
CT head/brain with contrast (70460) $1,029 $2,940 6.0×
CT head/brain without and with contrast (70470) $1,261.40 $3,604 7.4×
CT iac w contrast (70481) $1,097.25 $3,135 6.4×
CT limited/localized follow up study (76380) $513.10 $1,466 6.0×
CT lower ext w/o (73700) $841.40 $2,404 8.2×
CT lower extremity w wo contrast (73702) $1,332.45 $3,807 7.8×
CT lower extremity w/contrast material (73701) $1,090.60 $3,116 6.4×
CT lumbar spine w & w/o contrast (72133) $1,271.55 $3,633 7.4×
CT lumbar spine w/contrast (72132) $1,205.05 $3,443 3.5×
CT lumbar spine w/o contrast (72131) $1,026.55 $2,933 10.1×
CT maxillofacial w contrast (70487) $1,011.15 $2,889 5.9×
CT maxillofacial w/wo contrast (70488) $1,286.60 $3,676 7.5×
CT maxillofacial wo contrast (70486) $775.60 $2,216 7.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,316 $3,760 7.7×
CT orbits w/o contrast (70480) $952 $2,720 9.3×
CT pelvis w/o contrast (72192) $700.35 $2,001 6.9×
CT pelvis w/wo contrast (72194) $1,221.85 $3,491 7.1×
CT scan of arm combo (73202) $1,088.85 $3,111 6.4×
CT soft tissue neck w contrast (70491) $1,016.40 $2,904 5.9×
CT soft tissue neck w/o & w/contrast material (70492) $1,405.95 $4,017 8.2×
CT soft tissue neck w/o contrast (70490) $527.80 $1,508 5.2×
CT thoracic spine w/contrast (72129) $1,291.15 $3,689 7.5×
CT thoracic spine w/o contrast (72128) $724.85 $2,071 7.1×
CT thoracic spine w/wo contrast (72130) $1,090.95 $3,117 6.4×
CT thorax w/o contrast (71250) $868.70 $2,482 8.5×
CT upper ext wo (73200) $873.60 $2,496 8.6×
CT upper extremity with contrast (73201) $1,301.30 $3,718 3.8×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,125.25 $3,215 6.6×
Cta Abdomen (74175) $1,004.50 $2,870 5.9×
CTA abdomen pelvis (74174) $1,985.55 $5,673 5.8×
CTA chest (71275) $1,095.15 $3,129 6.4×
Cta Head (70496) $1,354.85 $3,871 7.9×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,543.10 $7,266 7.5×
Cta Neck (70498) $1,204.35 $3,441 7.0×
Cta Pelvis (72191) $990.50 $2,830 5.8×
Cystography minimum 3 views rs&i (74430) $443.10 $1,266 1.3×
Doppler Fetal Mid Cerebral Artery (76821) $607.60 $1,736 6.0×
Dxa bone density study 1/> sites axial skel (77080) $351.40 $1,004 3.4×
Dxa bone density study 1/>sites appendiclr skel (77081) $166.25 $475 2.0×
Dxa bone density study axial skeleton (77085) $269.85 $771 2.6×
Esophagus (74220) $301.35 $861 1.8×
Facial bones min 3 views (70150) $210.70 $602 2.1×
Fetal biophysical profile non-stress testing (76818) $621.95 $1,777 6.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $281.05 $803 2.8×
Fluoroscopy up to 1 hr (76000) $421.75 $1,205 1.8×
Foot 2 views (73620) $176.05 $503 2.1×
Forearm 2 views (73090) $204.75 $585 2.4×
Hand 2 views (73120) $324.45 $927 3.2×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,735.65 $4,959 3.3×
Hepatobiliary syst imaging including gallbladder (78226) $748.65 $2,139 1.9×
Hysterosalpingogram (74740) $591.85 $1,691 2.5×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $187.25 $535 1.8×
Kidney imaging morphology (78700) $842.10 $2,406 2.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $992.95 $2,837 1.9×
Kidney img morphology vascular flow 1 w/rx (78708) $667.80 $1,908 1.3×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,353.10 $3,866 2.6×
Knee 3 views (73562) $311.50 $890 3.7×
Liver & spleen imaging static only (78215) $720.30 $2,058 1.8×
Liver imaging static only (78201) $911.75 $2,605 1.7×
Lung perfusion differential (78597) $498.40 $1,424 1.3×
Lung ventilation imaging (78579) $498.40 $1,424 1.3×
Lymphoscintigraphy (78195) $987.70 $2,822 1.9×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $2,031.75 $5,805 2.7×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,885.10 $5,386 5.5×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $2,271.15 $6,489 6.7×
MRA head w & w/o contrast (70546) $1,326.85 $3,791 3.9×
MRA head w/o contrast (70544) $1,156.05 $3,303 5.0×
MRA head with contrast (70545) $938.70 $2,682 2.8×
MRA neck w contrast (70548) $983.15 $2,809 2.9×
Mra Neck W/O &W/Contrast Material (70549) $1,827.70 $5,222 5.4×
MRA neck w/o contrast (70547) $815.15 $2,329 3.5×
MRI abdomen w contrast (74182) $1,265.95 $3,617 3.7×
MRI abdomen w/o & w/contrast material (74183) $1,989.40 $5,684 5.8×
MRI abdomen w/o contrast (74181) $1,137.85 $3,251 4.9×
MRI any jt lower extrem w/contrast material (73722) $1,591.80 $4,548 2.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,424.10 $6,926 7.1×
MRI c-spine with contrast (72142) $1,981.70 $5,662 5.8×
MRI cervical spine w/o contrast (72141) $1,349.95 $3,857 5.8×
MRI chest w/o & w/contrast material (71552) $1,987.65 $5,679 5.8×
MRI chest w/o contrast (71550) $1,455.65 $4,159 6.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,894.20 $5,412 5.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,417.10 $6,906 7.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,623.65 $4,639 7.0×
MRI orbit face &/neck w/o contrast (70540) $1,394.40 $3,984 6.0×
MRI orbit/face/neck w&w/o cont (70543) $2,073.75 $5,925 6.1×
MRI pelvis w/contrast (72196) $1,923.25 $5,495 5.7×
MRI pelvis w/o & w/contrast material (72197) $2,877 $8,220 8.5×
MRI pelvis w/o contrast (72195) $1,744.40 $4,984 7.5×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,256.80 $6,448 6.6×
MRI spinal canal lumbar w/contrast material (72149) $1,169.35 $3,341 3.4×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,249.80 $6,428 6.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,256.45 $6,447 6.6×
MRI temporomandibular joint (70336) $1,004.15 $2,869 4.3×
MRI thoracic spine w/o contrast (72146) $1,228.50 $3,510 5.3×
MRI up ext w/o contrast (73218) $1,744.05 $4,983 7.5×
MRI upper ext joint w/o contrast (73221) $1,689.10 $4,826 7.3×
MRI, joint upper extrem combo (73223) $2,315.25 $6,615 6.8×
Myocardial Spect Multiple Studies (78452) $2,742.60 $7,836 2.2×
Myocardial spect single study at rest or stress (78451) $2,242.80 $6,408 1.8×
Neck soft tissue (70360) $151.55 $433 1.8×
Nm adrenal scan (78075) $2,098.95 $5,997 1.7×
Nm bone marrow multi (78103) $609.35 $1,741 1.6×
Nm bone marrow wb (78104) $709.80 $2,028 1.8×
Nm cardiac blood pool multiple (78473) $1,231.65 $3,519 3.2×
Nm cisternogram (78630) $690.90 $1,974 1.3×
Nm gastric emptying study (78264) $1,370.95 $3,917 3.5×
Nm kidney scan w/flow (78701) $2,226.35 $6,361 5.7×
Nm peritoneal-venous shunt patency (78291) $749.35 $2,141 1.9×
Nuclear Rx Oral Admin (79005) $1,524.25 $4,355 6.7×
Osseous survey limited (77074) $153.65 $439 1.5×
Parathyrd planar w/spect&CT (78072) $856.10 $2,446 1.6×
Parathyroid Planar Imaging (78070) $498.40 $1,424 1.3×
Parathyroid planar imaging w/wo subtraction (78071) $537.60 $1,536 1.4×
Pelvis 1 or 2 views (72170) $187.25 $535 1.8×
Pulmonary Perfusion Imaging Particulate (78580) $508.20 $1,452 1.3×
Pulmonary Ventilation & Perfusion Imaging (78582) $990.50 $2,830 1.9×
Radex abscess/fistula/sinus tract rs&i (76080) $680.40 $1,944 1.3×
Radex Ankle Compl Minimum 3 Views (73610) $310.45 $887 3.7×
Radex Calcaneus Minimum 2 Views (73650) $128.10 $366 1.5×
Radex Elbw Compl Minimum 3 Views (73080) $262.85 $751 3.1×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $122.85 $351 1.4×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $388.15 $1,109 3.8×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $511.35 $1,461 5.0×
Radex fingr minimum 2 views (73140) $237.30 $678 2.8×
Radex Foot Compl Minimum 3 Views (73630) $179.55 $513 2.1×
Radex Hand Minimum 3 Views (73130) $392.35 $1,121 4.6×
Radex Hip Unilateral With Pelvis 1 View (73501) $109.55 $313 1.3×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $299.25 $855 2.9×
Radex Hips Bilateral With Pelvis 2 Views (73521) $165.90 $474 1.6×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $406 $1,160 4.0×
Radex Humerus Minimum 2 Views (73060) $188.30 $538 2.2×
Radex Kne 1/2 Views (73560) $148.40 $424 1.7×
Radex Kne Compl 4/More Views (73564) $341.60 $976 3.3×
Radex Mndbl Compl Minimum 4 Views (70110) $229.25 $655 2.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $285.25 $815 3.4×
Radex Pelvis Compl Minimum 3 Views (72190) $230.65 $659 2.3×
Radex Sho Compl Minimum 2 Views (73030) $323.40 $924 3.8×
Radex Sinuses Paransl < 3 Views (70210) $109.55 $313 1.3×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $355.60 $1,016 3.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $135.45 $387 1.6×
Radex Toe Minimum 2 Views (73660) $138.60 $396 1.6×
Radex upper extremity infant minimum 2 views (73092) $185.85 $531 1.8×
Radex Wrst Compl Minimum 3 Views (73110) $334.25 $955 3.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $536.90 $1,534 5.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $106.40 $304 1.3×
Radiologic exam chest 2 views (71046) $145.25 $415 1.7×
Radiologic exam colon single contrast study (74270) $595.70 $1,702 3.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $283.50 $810 1.7×
Radiologic exam upr gi trc double contrast study (74246) $493.85 $1,411 2.9×
Radiologic exam upr gi trc single contrast study (74240) $486.85 $1,391 2.8×
Radiologic examination femur 1 view (73551) $109.55 $313 1.3×
Radiologic examination tibia & fibula 2 views (73590) $306.60 $876 3.6×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $153.65 $439 1.5×
Radiological examination surgical specimen (76098) $680.40 $1,944 1.3×
Ribs bilateral 3 views (71110) $349.30 $998 3.4×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $603.75 $1,725 1.5×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $855.05 $2,443 2.2×
Rp loclzj tum plnr whole body single day imaging (78802) $1,619.45 $4,627 3.1×
Rp loclzj tum spect 1 area single day imaging (78803) $1,654.45 $4,727 3.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,654.45 $4,727 1.3×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $2,025.80 $5,788 1.5×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $1,654.45 $4,727 1.3×
Sacroiliac Joints < 3 Views (72200) $153.65 $439 1.5×
Scapula (73010) $159.60 $456 1.6×
Screening Digital Breast Tomosynthesis Bi (77063) $29.75 $85 1.3×
Shoulder 1 view (73020) $138.60 $396 1.6×
Small bowel series (74250) $305.55 $873 1.8×
Spine thoracic 3 views (72072) $403.20 $1,152 4.0×
Thoracolumbar 2 views (72080) $313.95 $897 3.7×
Thyroid carcinoma metastases img whole body (78018) $1,428.35 $4,081 2.7×
Thyroid imaging w/blood flow (78013) $498.40 $1,424 1.3×
Thyroid uptake measurement (78012) $498.40 $1,424 1.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $728 $2,080 1.9×
Tmj unilateral (70328) $109.55 $313 1.3×
Ultrasound breast complete (76641) $386.40 $1,104 3.8×
Ultrasound Exam Aaa Screen (76706) $203.35 $581 2.0×
Ultrasound, abdomen limited (76705) $653.80 $1,868 6.4×
Umbilical-artery Doppler (OB) (76820) $330.75 $945 3.2×
Unlisted Diagnostic Radiographic Procedure (76499) $67.90 $194 0.8×
Unlisted gastrointestinal px dx nuclear medicine (78299) $647.15 $1,849 1.7×
Urethrocystogram voiding (74455) $653.80 $1,868 2.8×
Us breast unilateral limited (76642) $271.25 $775 3.2×
Us chest (76604) $406.35 $1,161 4.0×
Us compl joint r-t w/image documentation (76881) $602.35 $1,721 5.9×
Us elastography parenchyma (76981) $220.85 $631 2.2×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $290.50 $830 2.8×
Us ob detailed single fetus (76811) $431.20 $1,232 1.9×
Us ob limited (76815) $283.15 $809 2.8×
Us ob transvaginal (76817) $355.95 $1,017 3.5×
Us pelvic non ob complete (76856) $715.40 $2,044 7.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $298.20 $852 2.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $311.15 $889 3.1×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $249.20 $712 2.4×
Us retroperitoneal complete (76770) $394.80 $1,128 3.9×
Us retroperitoneal limited (76775) $262.50 $750 2.6×
Us scrotum and contents (76870) $603.75 $1,725 5.9×
Us soft tissue head/neck (76536) $556.15 $1,589 5.5×
Us spinal canal and contents (76800) $390.60 $1,116 3.8×
Us, eye b-scan (76512) $219.45 $627 2.2×
Venogram extremity bilateral (75822) $1,926.75 $5,505 1.3×
Vertebral fracture assessment via dxa (77086) $158.90 $454 1.9×
Wrist 2 views (73100) $269.50 $770 3.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $286.30 $818 2.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $306.60 $876 3.6×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $519.40 $1,484 3.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $232.40 $664 2.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $142.10 $406 1.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $362.95 $1,037 3.6×
X-ray exam of femur 2/> (73552) $170.45 $487 2.0×
X-ray eye for foreign body (70030) $141.05 $403 1.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $141.05 $403 1.7×
X-ray IV pyelogram (ivp) (74400) $429.10 $1,226 2.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $156.10 $446 1.8×
X-ray leg, infant (73592) $170.80 $488 2.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $337.75 $965 3.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $558.25 $1,595 5.5×
X-ray nose-rectum child f.b. (76010) $292.25 $835 3.4×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $255.85 $731 2.5×
X-ray retrograde pyelogram (74420) $493.85 $1,411 1.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $161.35 $461 1.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $202.65 $579 2.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $442.75 $1,265 4.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $220.85 $631 2.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $304.85 $871 3.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $263.90 $754 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $430.15 $1,229 4.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $223.30 $638 2.2×
X-Ray Spine One View - Xr Spine (72020) $176.40 $504 2.1×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $275.45 $787 3.2×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $234.15 $669 2.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $324.45 $927 3.2×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $466.90 $1,334 4.6×
Xr bone length studies (77073) $150.85 $431 1.5×
Xr c-spine 4 or 5 views (72050) $519.05 $1,483 5.1×
Xr c-spine 6 or more views (72052) $627.20 $1,792 6.1×
Xr chest 4+ views (71048) $166.95 $477 1.6×