Imaging prices at Exeter Hospital

Exeter, NH · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $8,274 $8,274 5.6×
Abdomen 2 views (74019) $741 $741 6.6×
Acute gi blood loss imaging (78278) $2,645 $2,645 6.2×
Angiography extremity bilateral rs&i (75716) $7,340 $7,340 2.2×
Angiography extremity unilateral rs&i (75710) $6,184 $6,184 1.8×
Angiography pelvic slctv/supraslctv rs&i (75736) $6,667 $6,667 1.1×
Angiography visceral slctv/supraslctv rs&i (75726) $7,079 $7,079 1.2×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $3,543 $3,543 1.1×
Ankle 2 views (73600) $495 $495 5.3×
Aortography abdominal serialography rs&i (75625) $7,771 $7,771 2.3×
Arthrogram shoulder (73040) $1,903 $1,903 5.1×
Basic dosimetry (77300) $828 $828 5.8×
Bone &/Joint Imaging Limited Area (78300) $1,769 $1,769 4.1×
Bone &/joint imaging whole body (78306) $2,975 $2,975 7.0×
Bone age studies (77072) $501 $501 4.5×
Bone Imaging 3 Phase (78315) $3,374 $3,374 7.9×
Bone survey complete (77075) $1,232 $1,232 11.0×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $2,383 $2,383 4.1×
Brain Imaging Pet Metabolic Evaluation (78608) $7,964 $7,964 5.2×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $3,432 $3,432 8.0×
Cardiac shunt detection (78428) $1,767 $1,767 4.1×
Cervical spine 2 or 3 views (72040) $744 $744 8.0×
Chest 1 view (71045) $451 $451 4.9×
Chest xray 3 views (71047) $776 $776 8.4×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $864 $864 4.6×
Cineradiography/videoradiography (76120) $503 $503 4.5×
Clavicle complete (73000) $715 $715 7.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $4,082 $4,082 36.6×
Continuing medical physics consltj pr wk (77336) $1,012 $1,012 7.1×
Contrast Xray Throat/Cerv Esopha (74210) $214 $214 1.1×
CT abdomen and pelvis without and with contrast (74178) $9,190 $9,190 24.7×
CT abdomen and pelvis without contrast (74176) $4,847 $4,847 19.0×
CT abdomen w contrast (74160) $4,082 $4,082 21.8×
CT abdomen w wo contrast (74170) $4,595 $4,595 24.5×
CT abdomen w/o contrast (74150) $3,248 $3,248 29.1×
CT angio lwr extr w/o&w/dye (73706) $3,689 $3,689 19.7×
CT angiography upper extremity lt (73206) $4,634 $4,634 24.7×
CT c-spine w/contrast (72126) $4,175 $4,175 11.2×
CT c-spine w/o contrast (72125) $4,082 $4,082 36.6×
CT cervical spine w&w/o contrast (72127) $4,374 $4,374 23.4×
CT chest w contrast (71260) $4,593 $4,593 24.5×
CT chest w/wo contrast (71270) $4,935 $4,935 26.3×
CT colonography w/o cntrst (74261) $1,712 $1,712 15.3×
CT head/brain with contrast (70460) $3,584 $3,584 19.1×
CT head/brain without and with contrast (70470) $4,107 $4,107 21.9×
CT heart w/o contrast quant eval coronary calcium (75571) $275 $275 3.0×
CT iac w contrast (70481) $3,675 $3,675 19.6×
CT lower ext w/o (73700) $3,252 $3,252 29.1×
CT lower extremity w wo contrast (73702) $4,138.79 $4,138.79 22.1×
CT lower extremity w/contrast material (73701) $3,864 $3,864 20.6×
CT lumbar spine w & w/o contrast (72133) $5,197 $5,197 27.7×
CT lumbar spine w/contrast (72132) $4,593 $4,593 12.3×
CT lumbar spine w/o contrast (72131) $4,082 $4,082 36.6×
CT maxillofacial w contrast (70487) $3,500 $3,500 18.7×
CT maxillofacial w/wo contrast (70488) $3,912 $3,912 20.9×
CT maxillofacial wo contrast (70486) $3,182 $3,182 28.5×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $4,095 $4,095 21.9×
CT orbits w/o contrast (70480) $3,182 $3,182 28.5×
CT pelvis w/o contrast (72192) $3,248 $3,248 29.1×
CT pelvis w/wo contrast (72194) $4,439.32 $4,439.32 23.7×
CT scan of arm combo (73202) $4,558 $4,558 24.3×
CT soft tissue neck w contrast (70491) $4,082 $4,082 21.8×
CT soft tissue neck w/o & w/contrast material (70492) $4,374 $4,374 23.4×
CT soft tissue neck w/o contrast (70490) $3,248 $3,248 29.1×
CT thoracic spine w/contrast (72129) $4,593 $4,593 24.5×
CT thoracic spine w/o contrast (72128) $4,082 $4,082 36.6×
CT thorax w/o contrast (71250) $3,977 $3,977 35.6×
CT upper ext wo (73200) $3,238 $3,238 29.0×
CT upper extremity with contrast (73201) $3,724 $3,724 10.0×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $5,741 $5,741 30.7×
Cta Abdomen (74175) $4,096 $4,096 21.9×
CTA abdomen pelvis (74174) $8,292 $8,292 22.3×
CTA chest (71275) $5,741 $5,741 30.7×
Cta Head (70496) $5,134 $5,134 27.4×
Cta Neck (70498) $5,134 $5,134 27.4×
Cta Pelvis (72191) $3,213 $3,213 17.2×
Cystography minimum 3 views rs&i (74430) $1,013 $1,013 2.7×
Doppler Fetal Mid Cerebral Artery (76821) $760 $760 6.8×
Dxa bone density study 1/> sites axial skel (77080) $733 $733 6.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $521 $521 5.6×
Dxa bone density study axial skeleton (77085) $333 $333 3.0×
Esophagus (74220) $839 $839 4.5×
Facial bones min 3 views (70150) $1,001 $1,001 9.0×
Fetal biophysical profile non-stress testing (76818) $333 $333 3.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $930 $930 8.3×
Fluoroscopy up to 1 hr (76000) $818 $818 3.2×
Foot 2 views (73620) $500 $500 5.4×
Forearm 2 views (73090) $500 $500 5.4×
Hand 2 views (73120) $549 $549 4.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $3,321 $3,321 5.7×
Hepatobiliary syst imaging including gallbladder (78226) $2,665 $2,665 6.2×
Hysterosalpingogram (74740) $1,635 $1,635 6.4×
Kidney imaging morphology (78700) $1,766 $1,766 4.1×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $2,692 $2,692 4.6×
Kidney img morphology vascular flow 1 w/rx (78708) $2,692 $2,692 4.6×
Knee 3 views (73562) $725 $725 7.8×
Lung perf&ventilat diferentl (78598) $2,835 $2,835 4.9×
Lung ventilation imaging (78579) $1,696.14 $1,696.14 4.0×
Lymphoscintigraphy (78195) $2,833 $2,833 4.9×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $4,353 $4,353 5.2×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $5,627 $5,627 15.1×
Mlc imrt design & construction per imrt plan (77338) $2,544 $2,544 6.4×
Mr safety determination physician/other qhp (76016) $273 $273 2.9×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $29 $29 0.9×
Mr safety implt electronics prepj supvj phys/qhp (76018) $288 $288 2.8×
Mr safety med physics xm customization plng&mntr (76017) $758 $758 3.0×
MRA head w/o contrast (70544) $4,565 $4,565 17.9×
Mra Neck W/O &W/Contrast Material (70549) $5,509 $5,509 14.8×
MRA neck w/o contrast (70547) $3,489 $3,489 13.7×
MRI abdomen w/o & w/contrast material (74183) $5,686.12 $5,686.12 15.3×
MRI abdomen w/o contrast (74181) $4,670.69 $4,670.69 18.3×
MRI any jt lower extrem w/contrast material (73722) $4,427 $4,427 5.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $5,672 $5,672 15.2×
MRI breast w/o contrast bilateral (77047) $3,339 $3,339 13.1×
MRI c-spine with contrast (72142) $4,958 $4,958 13.3×
MRI cervical spine w/o contrast (72141) $4,751 $4,751 18.6×
MRI chest w/o & w/contrast material (71552) $6,271 $6,271 16.8×
MRI chest w/o contrast (71550) $4,751 $4,751 18.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $5,770 $5,770 15.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $4,133 $4,133 16.2×
MRI orbit face &/neck w/o contrast (70540) $5,204 $5,204 20.4×
MRI orbit/face/neck w&w/o cont (70543) $6,312 $6,312 16.9×
MRI pelvis w/o & w/contrast material (72197) $5,784 $5,784 15.5×
MRI pelvis w/o contrast (72195) $4,751 $4,751 18.6×
MRI spinal canal cervical w/o & w/contr matrl (72156) $6,277 $6,277 16.9×
MRI spinal canal lumbar w/contrast material (72149) $4,958 $4,958 13.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $6,198 $6,198 16.6×
MRI spinal canal thoracic w/contrast matrl (72147) $4,958 $4,958 13.3×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $6,351 $6,351 17.0×
MRI temporomandibular joint (70336) $4,129 $4,129 16.2×
MRI thoracic spine w/o contrast (72146) $4,751 $4,751 18.6×
MRI up ext w/o contrast (73218) $4,034 $4,034 15.8×
MRI upper ext joint w/o contrast (73221) $4,109 $4,109 16.1×
MRI, joint upper extrem combo (73223) $5,534 $5,534 14.9×
Myocardial Spect Multiple Studies (78452) $7,855 $7,855 5.7×
Myocardial spect single study at rest or stress (78451) $5,813 $5,813 4.2×
N-invas est c ffr sw aly CTA (75580) $3,189 $3,189 3.5×
Neck soft tissue (70360) $471 $471 5.1×
Nm gastric emptying study (78264) $2,975 $2,975 7.0×
Ntsty modul radthx pln dose-vol histos (77301) $8,444 $8,444 5.7×
Nuclear Rx Oral Admin (79005) $2,739 $2,739 11.0×
Ob us nuchal meas 1 gest (76813) $878 $878 7.9×
Osseous survey limited (77074) $333 $333 3.0×
Parathyroid Planar Imaging (78070) $1,930 $1,930 4.5×
Parathyroid planar imaging w/wo subtraction (78071) $2,280 $2,280 5.3×
Pelvis 1 or 2 views (72170) $474 $474 4.2×
PET image w/CT, skull-thigh (78815) $10,070 $10,070 6.6×
PET imaging for CT attenuation whole body (78816) $10,504 $10,504 6.9×
Pulmonary Perfusion Imaging Particulate (78580) $1,873 $1,873 4.4×
Pulmonary Ventilation & Perfusion Imaging (78582) $3,665 $3,665 6.3×
Radex Ankle Compl Minimum 3 Views (73610) $533 $533 5.7×
Radex Calcaneus Minimum 2 Views (73650) $479 $479 5.2×
Radex Elbw Compl Minimum 3 Views (73080) $551 $551 5.9×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $794 $794 8.5×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $826.36 $826.36 7.4×
Radex fingr minimum 2 views (73140) $495 $495 5.3×
Radex Foot Compl Minimum 3 Views (73630) $538 $538 5.8×
Radex Hand Minimum 3 Views (73130) $590 $590 6.3×
Radex Hip Unilateral With Pelvis 1 View (73501) $389 $389 4.2×
Radex Hips Bilateral With Pelvis 2 Views (73521) $792 $792 7.1×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $669 $669 6.0×
Radex Humerus Minimum 2 Views (73060) $533 $533 5.7×
Radex Kne 1/2 Views (73560) $526 $526 5.7×
Radex Kne Compl 4/More Views (73564) $982 $982 8.8×
Radex Mndbl Compl Minimum 4 Views (70110) $760 $760 6.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $602 $602 6.5×
Radex Pelvis Compl Minimum 3 Views (72190) $875 $875 7.8×
Radex Sho Compl Minimum 2 Views (73030) $542 $542 5.8×
Radex Sinuses Paransl < 3 Views (70210) $384 $384 4.1×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $976 $976 8.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $875 $875 9.4×
Radex Toe Minimum 2 Views (73660) $477 $477 5.1×
Radex Wrst Compl Minimum 3 Views (73110) $520 $520 5.6×
Radiation Delivery Stereotactic Cranial Linear (77372) $24,554 $24,554 3.1×
Radiation treatment delivery level 1 (77402) $343 $343 3.1×
Radiation treatment delivery level 2 (77407) $824 $824 2.0×
Radiation treatment delivery level 3 (77412) $1,267 $1,267 2.1×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $470 $470 5.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $333 $333 3.0×
Radiologic exam chest 2 views (71046) $520 $520 5.6×
Radiologic exam colon single contrast study (74270) $1,193 $1,193 6.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $1,043 $1,043 5.6×
Radiologic exam upr gi trc double contrast study (74246) $1,439 $1,439 7.7×
Radiologic exam upr gi trc single contrast study (74240) $1,297 $1,297 6.9×
Radiologic examination femur 1 view (73551) $104 $104 1.1×
Radiologic examination tibia & fibula 2 views (73590) $513 $513 5.5×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $333 $333 3.0×
Radiological examination surgical specimen (76098) $859 $859 1.5×
Ribs bilateral 3 views (71110) $847 $847 7.6×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $2,333 $2,333 5.5×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,415 $4,415 7.6×
Rp loclzj tum plnr whole body single day imaging (78802) $3,665 $3,665 6.3×
Rp loclzj tum spect 1 area single day imaging (78803) $3,576 $3,576 6.2×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,948 $3,948 2.9×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $4,092 $4,092 3.0×
Sacroiliac Joints < 3 Views (72200) $333 $333 3.0×
Scapula (73010) $480 $480 4.3×
Screening Digital Breast Tomosynthesis Bi (77063) $140 $140 6.0×
Shoulder 1 view (73020) $381 $381 4.1×
Small bowel series (74250) $1,032 $1,032 5.5×
Special Physics Consult (77370) $1,349 $1,349 9.4×
Special treatment procedure (77470) $3,670 $3,670 6.2×
Spine thoracic 3 views (72072) $661 $661 5.9×
Stereotactic Body Radiation Delivery (77373) $11,281 $11,281 5.9×
Tbs technical calculation only (77091) $107 $107 1.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,879 $1,879 4.7×
Ther rad simulaj-aided field setting complex (77290) $2,687 $2,687 6.7×
Ther rad simulaj-aided field setting simple (77280) $1,355 $1,355 9.4×
Thoracolumbar 2 views (72080) $715 $715 7.7×
Thyroid carcinoma metastases img whole body (78018) $2,800 $2,800 4.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,728 $1,728 4.0×
Treatment device complex (77334) $1,789 $1,789 4.5×
Treatment device intermediate (77333) $1,210 $1,210 8.4×
Treatment devices simple (77332) $943 $943 6.6×
Ultrasound breast complete (76641) $1,968.98 $1,968.98 17.6×
Ultrasound Exam Aaa Screen (76706) $678 $678 6.1×
Ultrasound, abdomen limited (76705) $1,073 $1,073 9.6×
Umbilical-artery Doppler (OB) (76820) $760 $760 6.8×
Unlisted fluoroscopic procedure (76496) $992 $992 10.7×
Unlisted magnetic resonance procedure (76498) $276 $276 3.0×
Urethrocystogram voiding (74455) $1,114 $1,114 4.4×
Urethrocystography retrograde rs&i (74450) $1,112 $1,112 4.4×
Us breast unilateral limited (76642) $766 $766 8.2×
Us chest (76604) $831 $831 7.4×
Us compl joint r-t w/image documentation (76881) $333 $333 3.0×
Us hips infant static (76886) $513 $513 5.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $609 $609 5.5×
Us ob detailed single fetus (76811) $1,719 $1,719 6.7×
Us ob limited (76815) $999 $999 8.9×
Us ob transvaginal (76817) $1,073 $1,073 9.6×
Us pelvic non ob complete (76856) $1,205 $1,205 10.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $729 $729 6.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $939 $939 8.4×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $893 $893 8.0×
Us retroperitoneal complete (76770) $1,196 $1,196 10.7×
Us retroperitoneal limited (76775) $1,201 $1,201 10.8×
Us scrotum and contents (76870) $1,094 $1,094 9.8×
Us soft tissue head/neck (76536) $1,011 $1,011 9.1×
Us spinal canal and contents (76800) $645 $645 5.8×
Venogram Extremity Unilateral (75820) $2,871 $2,871 1.7×
Venography caval inferior serialography rs&i (75825) $5,374 $5,374 1.6×
Venography venous sinus/jugular cath rs&i (75860) $4,015 $4,015 1.2×
Wrist 2 views (73100) $437 $437 4.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $875 $875 7.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $525 $525 5.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,869 $1,869 10.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $457 $457 4.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $588 $588 6.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $128 $128 1.1×
X-ray exam of femur 2/> (73552) $673 $673 7.2×
X-ray eye for foreign body (70030) $562 $562 6.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $458 $458 4.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $571 $571 6.1×
X-ray leg, infant (73592) $337 $337 3.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $615 $615 5.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $952 $952 8.5×
X-ray nose-rectum child f.b. (76010) $396 $396 4.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $631 $631 5.7×
X-ray retrograde pyelogram (74420) $1,119 $1,119 3.0×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $520 $520 5.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $691 $691 6.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,056 $1,056 9.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $502 $502 4.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $534 $534 5.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $662 $662 7.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $948 $948 8.5×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $579 $579 5.2×
X-Ray Spine One View - Xr Spine (72020) $534 $534 5.7×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $504 $504 5.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $509 $509 5.5×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $128 $128 1.1×
Xr bone length studies (77073) $523 $523 4.7×
Xr c-spine 4 or 5 views (72050) $1,094 $1,094 9.8×
Xr c-spine 6 or more views (72052) $1,143 $1,143 10.2×
Xr chest 4+ views (71048) $722 $722 6.5×