Imaging prices at Johnson Memorial Hospital
Stafford Springs, CT · every code in this section with a posted price and a Medicare benchmark.
197 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $232.10 | — | 2.2× |
| Abdomen 2 views (74019) | $296.45 | $539 | 2.4× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$209.55–$314.05 | $381–$571 | varies |
| Bone age studies (77072) | $145.75 | $265 | 1.2× |
| Bone Imaging 3 Phase (78315) | $882.20 | $1,604 | 1.8× |
| Bone Imaging Limited Area (78300) | $708.95 | $1,289 | 1.5× |
| Bone Imaging Whole Body (78306) | $827.20 | $1,504 | 1.7× |
| Chest 1 view (71045) | $13,741.89 | — | 131.7× |
| Chest 2 views (71046) | $230.45 | $419 | 2.2× |
| Chest 3 views (71047) | $234.85 | $427 | 2.3× |
| Chest 4 or more views (71048) | $237.60 | $432 | 1.9× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$197.45–$296.45 | $359–$539 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $1,001.55 | $1,821 | 2.4× |
| CT abdomen and pelvis without contrast (74176) | $719.40 | $1,308 | 2.5× |
| CT abdomen w contrast (74160) | $838.75 | $1,525 | 4.0× |
| CT abdomen w wo contrast (74170) | $967.45 | $1,759 | 4.6× |
| CT abdomen w/o contrast (74150) | $658.35 | $1,197 | 5.3× |
| CT Angio Abdomen and Pelvis (74174) | $1,053.80 | $1,916 | 2.5× |
| CT Angio Chest (71275) | $1,098.90 | $1,998 | 5.2× |
| CT Angio Head (70496) | $1,268.30 | $2,306 | 6.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$1,311.75–$1,967.35 | $2,385–$3,577 | varies |
| CT Angio Neck (70498) | $1,206.70 | $2,194 | 5.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,393.15 | $2,533 | 6.6× |
| CT cervical spine w/ contrast (72126) | $930.05 | $1,691 | 2.2× |
| CT cervical spine w/o contrast (72125) | $741.95 | — | 5.9× |
| CT chest w contrast (71260) | $1,047.20 | $1,904 | 5.0× |
| CT chest w/wo contrast (71270) | $1,147.30 | $2,086 | 5.5× |
| CT head/brain with contrast (70460) | $865.70 | $1,574 | 4.1× |
| CT head/brain without and with contrast (70470) | $948.20 | $1,724 | 4.5× |
| CT iac w contrast (70481) | $946 | $1,720 | 4.5× |
| CT l-spine w&w/o contrast (72133) | $347.05 | $631 | 1.7× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$672.65–$1,009.25 | $1,223–$1,835 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$905.85–$1,359.05 | $1,647–$2,471 | varies |
| CT lumbar spine w contrast (72132) | $930.05 | $1,691 | 2.2× |
| CT lumbar spine w/o contrast (72131) | $741.95 | $1,349 | 5.9× |
| CT maxillofacial w contrast (70487) | $905.85 | $1,647 | 4.3× |
| CT maxillofacial wo contrast (70486) | $669.35 | $1,217 | 5.3× |
| CT neck tissue combo (70492) | $1,080.20 | $1,964 | 5.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,026.30 | $1,866 | 4.9× |
| CT orbits w/o contrast (70480) | $787.05 | — | 6.3× |
| CT pelvis w&w/o contrast (72194) | $1,015.30 | $1,846 | 4.8× |
| CT pelvis w/o contrast (72192) | $673.75 | $1,225 | 5.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,134.10–$1,701.70 | $2,062–$3,094 | varies |
| CT scans face/jaw combo (70488) | $996.60 | $1,812 | 4.7× |
| CT soft tissue neck w contrast (70491) | $996.60 | $1,812 | 4.7× |
| CT soft tissue neck w/o contrast (70490) | $699.60 | $1,272 | 5.6× |
| CT thoracic spine w contrast (72129) | $930.05 | $1,691 | 4.4× |
| CT thoracic spine w/o contrast (72128) | $741.95 | $1,349 | 5.9× |
| CT thorax w/o contrast (71250) | $675.95 | $1,229 | 5.4× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$634.70–$953.15 | $1,154–$1,733 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,624.70–$2,436.50 | $2,954–$4,430 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$865.70–$1,298.55 | $1,574–$2,361 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $996.05 | $1,811 | 4.7× |
| Cta Abdomen (74175) | $955.90 | $1,738 | 4.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,379.85 | $4,327 | 5.7× |
| Dxa Bone Density Axial (77080) | $254.10 | $462 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $156.75 | $285 | 1.5× |
| Esophagram (74220) | $303.60 | $552 | 1.4× |
| Fluoroscopy up to 1 hr (76000) | $306.35 | $557 | 1.1× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$167.75–$251.35 | $305–$457 | varies |
| Forearm 2 views (73090) | $417.45 | — | 4.0× |
| Gastric emptying imaging study (78264) | $820.05 | $1,491 | 1.7× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$167.75–$251.35 | $305–$457 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,093.40 | $1,988 | 1.7× |
| Hepatobiliary System Imaging (78226) | $920.70 | $1,674 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $2,006.95 | $3,649 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $1,345.85 | $2,447 | 2.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$242.55–$573.65 | — | varies |
| Liver & Spleen Imaging Static Only (78215) | $755.15 | $1,373 | 1.6× |
| Lung perfusion differential (78597) | $490.60 | $892 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,057.10 | $1,922 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $1,719.30 | $3,126 | 4.1× |
| MRA head w/o contrast (70544) | $1,080.20 | $1,964 | 3.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,814.45 | $3,299 | 4.3× |
| MRA neck w/o contrast (70547) | $1,330.45 | $2,419 | 4.7× |
| MRI abdomen w/o contrast (74181) | $1,040.05 | $1,891 | 3.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,783.10–$2,674.10 | $3,242–$4,862 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,351.25–$3,527.70 | $4,275–$6,414 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,526.25–$2,289.10 | $2,775–$4,162 | varies |
| MRI cervical spine w/o cont (72141) | $1,157.20 | $2,104 | 4.0× |
| MRI chest wo w contrast (71552) | $1,711.05 | $3,111 | 4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,972.30–$2,959 | $3,586–$5,380 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$1,134.65–$1,702.25 | $2,063–$3,095 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $1,965.70 | $3,574 | 4.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,048.30 | $1,906 | 3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,934.90 | $3,518 | 4.6× |
| MRI pelvis w/o & w contrast (72197) | $1,976.70 | $3,594 | 4.7× |
| MRI pelvis w/o contrast (72195) | $1,080.20 | $1,964 | 3.8× |
| MRI thoracic spine w/o contrast (72146) | $1,157.20 | $2,104 | 4.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$770.55–$1,156.10 | $1,401–$2,102 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,080.20–$1,620.30 | $1,964–$2,946 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,097.15–$3,145.45 | $3,813–$5,719 | varies |
| MRI, abdomen, combo (74183) | $2,031.15 | $3,693 | 4.9× |
| MRI, dorsal spine combo (72157) | $1,965.70 | $3,574 | 4.7× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,272.15–$1,907.95 | $2,313–$3,469 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,843.05–$2,764.30 | $3,351–$5,026 | varies |
| MRI, lumbar spine combo (72158) | $1,965.70 | $3,574 | 4.7× |
| Myocardial Spect Multiple Studies (78452) | $2,886.95 | $5,249 | 1.9× |
| Neck soft tissue (70360) | $162.25 | $295 | 1.6× |
| Nonvascular Shunt X-Ray (75809) | $220 | $400 | 1.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 matching MRF lines |
$220–$330.55 | $400–$601 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,020.80 | $1,856 | 1.6× |
| Pelvis 1 or 2 views (72170) | $172.70 | $314 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $790.90 | $1,438 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $261.80 | $476 | 2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $232.10 | — | 2.2× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$185.35–$278.30 | $337–$506 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$209.55–$314.05 | $381–$571 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $232.10 | $422 | 1.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$185.35–$510.40 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$217.80–$327.25 | $396–$595 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$232.10–$348.15 | $422–$633 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $185.35 | $337 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $203.50 | $370 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$209.55–$512.60 | — | varies |
| Radex Sternum Minimum 2 Views (71120) | $197.45 | $359 | 1.9× |
| Radex Toe Minimum 2 Views (73660) | $185.35 | — | 1.8× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$218.35–$327.80 | $397–$596 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$348.15–$417.45 | — | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $209.55 | $381 | 1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $232.10 | $422 | 1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $210.10 | $382 | 1.7× |
| Radiologic exam colon single contrast study (74270) | $388.85 | $707 | 1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $325.05 | $591 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$252.45–$377.85 | $459–$687 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $198.55 | $361 | 1.6× |
| Radiologic exam swallow function contrast study (74230) | $326.15 | $593 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $459.80 | $836 | 2.2× |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$167.75–$251.35 | $305–$457 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$185.35–$278.30 | $337–$506 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$185.35–$278.30 | — | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$185.35–$278.30 | $337–$506 | varies |
| Ribs bilateral 3 views (71110) | $269.50 | $490 | 2.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $512.05 | $931 | 1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,575.10 | $4,682 | 4.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,017.85 | $5,487 | 1.8× |
| Scapula (73010) range across 3 matching MRF lines |
$197.45–$296.45 | $359–$539 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$51.70–$85.25 | $94–$155 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$133.10–$199.65 | $242–$363 | varies |
| Skull less than 4 views (70250) | $232.10 | $422 | 1.9× |
| Thoracic spine 2 views (72070) | $219.45 | $399 | 1.8× |
| Thoracic spine 3 views (72072) | $220 | $400 | 1.8× |
| Thoracolumbar 2 views (72080) | $173.80 | $316 | 1.7× |
| Thyroid Uptake Measurement (78012) | $824.45 | $1,499 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $746.90 | $1,358 | 1.6× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$980.65–$1,421.20 | — | varies |
| Ultrasound Exam Aaa Screen (76706) | $341.55 | $621 | 2.7× |
| Ultrasound, abdomen limited (76705) | $393.80 | $716 | 3.1× |
| Upper gi w/o kub (74240) | $459.80 | $836 | 2.2× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$214.50–$321.20 | $390–$584 | varies |
| Us chest (76604) | $244.20 | $444 | 1.9× |
| Us complete joint (76881) | $309.65 | $563 | 2.5× |
| Us exam, pelvic, limited (76857) | $250.80 | $456 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $183.70 | $334 | 1.5× |
| Us ob detailed single fetus (76811) | $713.35 | $1,297 | 2.5× |
| Us ob limited 1 or more fetuses (76815) | $206.25 | $375 | 1.6× |
| Us ob transvaginal (76817) | $298.10 | $542 | 2.4× |
| Us pelvic non ob complete (76856) | $574.75 | $1,045 | 4.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $328.90 | $598 | 2.6× |
| Us retroperitoneal complete (76770) | $417.45 | $759 | 3.3× |
| Us retroperitoneal limited (76775) | $341.55 | $621 | 2.7× |
| Us scrotum and contents (76870) | $423.50 | $770 | 3.4× |
| Us thyroid (76536) | $309.65 | $563 | 2.5× |
| Wrist 2 views (73100) | $898.70 | — | 8.6× |
| X-Ray Bend Only L-S Spine (72120) | $217.80 | $396 | 1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$155.10–$232.65 | $282–$423 | varies |
| X-Ray Exam Breast Specimen (76098) | $483.45 | $879 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $176.55 | $321 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $194.15 | $353 | 1.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $217.80 | $396 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $147.95 | $269 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $185.35 | $337 | 1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $206.80 | $376 | 1.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $237.60 | $432 | 1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $287.10 | $522 | 2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $206.80 | $376 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $327.80 | $596 | 2.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $198.55 | $361 | 1.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $285.45 | $519 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $221.10 | $402 | 1.8× |
| X-ray eye for foreign body (70030) range across 6 matching MRF lines |
$232.10–$348.15 | $422–$633 | varies |
| X-ray humerus (73060) | $185.35 | $337 | 1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $143 | $260 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $232.10 | $422 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $232.10 | $422 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $180.40 | $328 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $240.90 | $438 | 1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $172.70 | $314 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $232.10 | $422 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $232.10 | $422 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $261.80 | $476 | 2.1× |
| X-Ray Tmj Unilat (70328) | $173.25 | $315 | 1.7× |
| X-Rays Bone Length Studies (77073) | $232.10 | $422 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $386.10 | $702 | 3.1× |
| Xr c-spine 4 or 5 views (72050) | $256.85 | $467 | 2.0× |
| Xr facial bones less than 3 views (70140) | $209.55 | $381 | 2.0× |
| Xr orbits complete 4 views (70200) | $177.65 | $323 | 1.4× |
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.