Imaging prices at Jefferson Medical Center

Ranson, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $173 $346 1.6×
Ankle 2 views (73600) $173 $346 1.9×
Bone &/joint imaging whole body (78306) $659.50 $1,319 1.6×
Bone age studies (77072) $299.50 $599 2.8×
Bone Imaging 3 Phase (78315) $659.50 $1,319 1.6×
Bone survey complete (77075) $344 $688 3.2×
Bone survey infant (77076) $282.50 $565 2.6×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $844 $1,688 2.0×
Cervical spine 2 or 3 views (72040) $185.50 $371 2.1×
Chest 1 view (71045) $174 $348 1.9×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $366 $732 2.0×
Clavicle complete (73000) $173 $346 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $120 $240 1.1×
CT abdomen and pelvis without and with contrast (74178) $2,012.50 $4,025 5.6×
CT abdomen and pelvis without contrast (74176) $1,500 $3,000 6.1×
CT abdomen w contrast (74160) $851.50 $1,703 4.7×
CT abdomen w wo contrast (74170) $1,021.50 $2,043 5.6×
CT abdomen w/o contrast (74150) $714.50 $1,429 6.6×
CT angio lwr extr w/o&w/dye (73706) $935 $1,870 5.2×
CT angiography upper extremity lt (73206) $991.50 $1,983 5.5×
CT c-spine w/contrast (72126) $919.50 $1,839 2.5×
CT c-spine w/o contrast (72125) $665 $1,330 6.1×
CT cere prfu aly c+wo CT/CTA (70473) $1,315 $2,630 7.2×
CT chest w contrast (71260) $855 $1,710 4.7×
CT chest w/wo contrast (71270) $991.50 $1,983 5.5×
CT head/brain with contrast (70460) $919.50 $1,839 5.1×
CT head/brain without and with contrast (70470) $1,071 $2,142 5.9×
CT iac w contrast (70481) $884.50 $1,769 4.9×
CT lower ext w/o (73700) $628 $1,256 5.8×
CT lower extremity w wo contrast (73702) $935 $1,870 5.2×
CT lower extremity w/contrast material (73701) $850.50 $1,701 4.7×
CT lumbar spine w & w/o contrast (72133) $935 $1,870 5.2×
CT lumbar spine w/contrast (72132) $850.50 $1,701 2.4×
CT lumbar spine w/o contrast (72131) $615.50 $1,231 5.7×
CT maxillofacial w contrast (70487) $919.50 $1,839 5.1×
CT maxillofacial w/wo contrast (70488) $1,071 $2,142 5.9×
CT maxillofacial wo contrast (70486) $665 $1,330 6.1×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,051 $2,102 5.8×
CT orbits w/o contrast (70480) $693.50 $1,387 6.4×
CT pelvis w/o contrast (72192) $725.50 $1,451 6.7×
CT pelvis w/wo contrast (72194) $1,139 $2,278 6.3×
CT scan of arm combo (73202) $935 $1,870 5.2×
CT soft tissue neck w contrast (70491) $919.50 $1,839 5.1×
CT soft tissue neck w/o & w/contrast material (70492) $1,071 $2,142 5.9×
CT soft tissue neck w/o contrast (70490) $692 $1,384 6.4×
CT thoracic spine w/contrast (72129) $850.50 $1,701 4.7×
CT thoracic spine w/o contrast (72128) $758 $1,516 7.0×
CT thorax w/o contrast (71250) $734 $1,468 6.8×
CT upper ext wo (73200) $625 $1,250 5.8×
CT upper extremity with contrast (73201) $850.50 $1,701 2.4×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $982 $1,964 5.4×
Cta Abdomen (74175) $991.50 $1,983 5.5×
CTA abdomen pelvis (74174) $1,949 $3,898 5.4×
CTA chest (71275) $1,250 $2,500 6.9×
Cta Head (70496) $1,071 $2,142 5.9×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,315 $2,630 3.6×
Cta Neck (70498) $1,071 $2,142 5.9×
Diskography lumbar (72295) $1,870.50 $3,741 0.9×
Dxa bone density study 1/> sites axial skel (77080) $325.50 $651 3.0×
Echo exam of eye (76529) $87.50 $175 1.0×
Esophagus (74220) $366 $732 2.0×
Facial bones min 3 views (70150) $176.50 $353 1.6×
Fetal biophysical profile non-stress testing (76818) $193 $386 1.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $415.50 $831 3.8×
Fluoroscopy up to 1 hr (76000) $427.50 $855 1.7×
Foot 2 views (73620) $173 $346 1.9×
Forearm 2 views (73090) $173 $346 1.9×
Hand 2 views (73120) $173 $346 1.6×
Hepatobiliary syst imaging including gallbladder (78226) $851.50 $1,703 2.1×
Kidney img morphology vascular flow 1 w/rx (78708) $881.50 $1,763 1.6×
Knee 3 views (73562) $173 $346 1.9×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,381.50 $2,763 1.7×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $1,854 $3,708 5.1×
MRA head w/o contrast (70544) $1,205.50 $2,411 4.9×
Mra Neck W/O &W/Contrast Material (70549) $1,854.50 $3,709 5.1×
MRI abdomen w/o & w/contrast material (74183) $1,854 $3,708 5.1×
MRI abdomen w/o contrast (74181) $1,205.50 $2,411 4.9×
MRI any jt lower extrem w/contrast material (73722) $1,381.50 $2,763 1.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,854 $3,708 5.1×
MRI cervical spine w/o contrast (72141) $1,205.50 $2,411 4.9×
MRI chest w/o & w/contrast material (71552) $1,836.50 $3,673 5.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,854 $3,708 5.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,205.50 $2,411 4.9×
MRI orbit face &/neck w/o contrast (70540) $1,205.50 $2,411 4.9×
MRI orbit/face/neck w&w/o cont (70543) $1,854 $3,708 5.1×
MRI pelvis w/o & w/contrast material (72197) $1,854 $3,708 5.1×
MRI pelvis w/o contrast (72195) $1,166 $2,332 4.7×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,854.50 $3,709 5.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,854.50 $3,709 5.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,854.50 $3,709 5.1×
MRI thoracic spine w/o contrast (72146) $1,205.50 $2,411 4.9×
MRI up ext w/o contrast (73218) $1,205.50 $2,411 4.9×
MRI upper ext joint w/o contrast (73221) $1,205.50 $2,411 4.9×
MRI, joint upper extrem combo (73223) $1,854 $3,708 5.1×
Myocardial Spect Multiple Studies (78452) $2,988.50 $5,977 2.2×
Myocardial spect single study at rest or stress (78451) $2,056 $4,112 1.5×
Neck soft tissue (70360) $171.50 $343 1.9×
Nm gastric emptying study (78264) $786.50 $1,573 1.9×
Nonvascular shunt X-ray (75809) $99.50 $199 0.9×
Parathyrd planar w/spect&CT (78072) $784.50 $1,569 1.4×
Parathyroid Planar Imaging (78070) $594 $1,188 1.4×
Pelvis 1 or 2 views (72170) $173 $346 1.6×
PET image w/CT, skull-thigh (78815) $1,983 $3,966 1.3×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,639 $3,278 2.9×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $891 $1,782 0.9×
Radex Ankle Compl Minimum 3 Views (73610) $173 $346 1.9×
Radex Calcaneus Minimum 2 Views (73650) $173 $346 1.9×
Radex Elbw Compl Minimum 3 Views (73080) $173 $346 1.9×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $174.50 $349 1.9×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $184 $368 1.7×
Radex fingr minimum 2 views (73140) $173 $346 1.9×
Radex Foot Compl Minimum 3 Views (73630) $173 $346 1.9×
Radex Hand Minimum 3 Views (73130) $173 $346 1.9×
Radex Hip Unilateral With Pelvis 1 View (73501) $172.50 $345 1.9×
Radex Hips Bilateral With Pelvis 2 Views (73521) $183 $366 1.7×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $190 $380 1.8×
Radex Humerus Minimum 2 Views (73060) $176.50 $353 2.0×
Radex Kne 1/2 Views (73560) $173 $346 1.9×
Radex Kne Compl 4/More Views (73564) $173 $346 1.6×
Radex Mndbl Compl Minimum 4 Views (70110) $173 $346 1.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $173 $346 1.9×
Radex Sho Compl Minimum 2 Views (73030) $178 $356 2.0×
Radex Sinuses Paransl < 3 Views (70210) $173 $346 1.9×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $180.50 $361 1.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $171.50 $343 1.9×
Radex Toe Minimum 2 Views (73660) $173 $346 1.9×
Radex Wrst Compl Minimum 3 Views (73110) $173 $346 1.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $200 $400 1.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $173 $346 1.9×
Radiologic exam chest 2 views (71046) $174 $348 1.9×
Radiologic exam colon single contrast study (74270) $411 $822 2.3×
Radiologic Exam Esophagus Double Contrast Study (74221) $349 $698 1.9×
Radiologic exam upr gi trc double contrast study (74246) $276 $552 1.5×
Radiologic exam upr gi trc single contrast study (74240) $366 $732 2.0×
Radiologic examination femur 1 view (73551) $176 $352 2.0×
Radiologic examination tibia & fibula 2 views (73590) $173 $346 1.9×
Radiological examination surgical specimen (76098) $414 $828 0.7×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,018 $6,036 2.0×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $2,661 $5,322 2.0×
Scapula (73010) $171.50 $343 1.6×
Screening Digital Breast Tomosynthesis Bi (77063) $82 $164 3.5×
Shoulder 1 view (73020) $173 $346 1.9×
Small bowel series (74250) $366 $732 2.0×
Spine thoracic 3 views (72072) $187 $374 1.7×
Thoracolumbar 2 views (72080) $187 $374 2.1×
Ultrasound breast complete (76641) $270 $540 2.5×
Ultrasound Exam Aaa Screen (76706) $420 $840 3.9×
Ultrasound, abdomen limited (76705) $440 $880 4.1×
Us breast unilateral limited (76642) $272.50 $545 3.0×
Us chest (76604) $436.50 $873 4.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $325.50 $651 3.0×
Us ob detailed single fetus (76811) $493.50 $987 2.0×
Us ob limited (76815) $259 $518 2.4×
Us ob transvaginal (76817) $283 $566 2.6×
Us pelvic non ob complete (76856) $440.50 $881 4.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $273.50 $547 2.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $465.50 $931 4.3×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $276.50 $553 2.6×
Us retroperitoneal complete (76770) $440.50 $881 4.1×
Us retroperitoneal limited (76775) $436.50 $873 4.0×
Us scrotum and contents (76870) $440.50 $881 4.1×
Us soft tissue head/neck (76536) $440.50 $881 4.1×
Wrist 2 views (73100) $173 $346 1.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $299.50 $599 2.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $163 $326 1.8×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $522 $1,044 2.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $173 $346 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $175.50 $351 1.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $186.50 $373 1.7×
X-ray exam of femur 2/> (73552) $180 $360 2.0×
X-ray eye for foreign body (70030) $179 $358 2.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $173 $346 1.9×
X-ray leg, infant (73592) $282.50 $565 3.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $222.50 $445 2.1×
X-ray nose-rectum child f.b. (76010) $173 $346 1.9×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $173 $346 1.6×
X-ray retrograde pyelogram (74420) $578.50 $1,157 1.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $171.50 $343 1.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $173 $346 1.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $299.50 $599 2.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $173 $346 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $173 $346 1.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $178.50 $357 2.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $299.50 $599 2.8×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $183.50 $367 1.7×
X-Ray Spine One View - Xr Spine (72020) $173 $346 1.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $163 $326 1.8×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $173 $346 1.6×
Xr bone length studies (77073) $173 $346 1.6×
Xr c-spine 4 or 5 views (72050) $299.50 $599 2.8×
Xr c-spine 6 or more views (72052) $299.50 $599 2.8×