Imaging prices at LewisGale Hospital Pulaski

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

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

Compare against other hospitals interactively →

ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $23,535 $23,535 17.4×
Abdomen 2 views (74019) $1,497 $1,497 14.7×
Ankle 2 views (73600) $1,587 $1,587 18.7×
Arthrogram elbow (73085) $1,376 $1,376 4.0×
Arthrogram hip (73525) $2,267 $2,267 6.7×
Arthrogram knee (73580) $1,713 $1,713 5.0×
Arthrogram shoulder (73040) $1,708 $1,708 5.0×
Arthrogram wrist (73115) $1,057 $1,057 3.1×
Basic dosimetry (77300) $2,449 $2,449 18.7×
Bone &/Joint Imaging Limited Area (78300) $4,951 $4,951 12.7×
Bone &/joint imaging whole body (78306) $8,796 $8,796 22.6×
Bone age studies (77072) $2,349 $2,349 23.0×
Bone Imaging 3 Phase (78315) $7,021 $7,021 18.0×
Bone survey complete (77075) $3,127 $3,127 30.7×
Bone survey infant (77076) $1,067 $1,067 10.5×
Brachytx isodose complex (77318) $6,897 $6,897 18.9×
Brachytx isodose intermed (77317) $2,559 $2,559 7.0×
Brachytx isodose pln smpl w/dosimetry cal (77316) $1,717 $1,717 4.7×
Brain Imaging Pet Metabolic Evaluation (78608) $19,021 $19,021 13.6×
Cervical spine 2 or 3 views (72040) $2,085 $2,085 24.6×
Chest 1 view (71045) $1,203 $1,203 14.2×
Chest xray 3 views (71047) $1,678 $1,678 19.8×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $2,787 $2,787 16.3×
Clavicle complete (73000) $1,501 $1,501 17.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $186 $186 1.8×
Continuing medical physics consltj pr wk (77336) $3,062 $3,062 23.3×
CT abdomen and pelvis without and with contrast (74178) $19,520 $19,520 57.3×
CT abdomen and pelvis without contrast (74176) $15,070 $15,070 64.7×
CT abdomen w contrast (74160) $11,060 $11,060 64.6×
CT abdomen w wo contrast (74170) $13,012 $13,012 76.0×
CT abdomen w/o contrast (74150) $10,047 $10,047 98.5×
CT angio lwr extr w/o&w/dye (73706) $4,501 $4,501 26.3×
CT angiography upper extremity lt (73206) $4,501 $4,501 26.3×
CT c-spine w/contrast (72126) $9,954 $9,954 29.2×
CT c-spine w/o contrast (72125) $7,125 $7,125 69.9×
CT chest w contrast (71260) $10,914 $10,914 63.8×
CT chest w/wo contrast (71270) $12,107 $12,107 70.7×
CT head/brain with contrast (70460) $9,304 $9,304 54.4×
CT head/brain without and with contrast (70470) $11,678 $11,678 68.2×
CT iac w contrast (70481) $7,076 $7,076 41.3×
CT limited/localized follow up study (76380) $3,522 $3,522 41.5×
CT lower ext w/o (73700) $5,981 $5,981 58.6×
CT lower extremity w wo contrast (73702) $7,914 $7,914 46.2×
CT lower extremity w/contrast material (73701) $7,327 $7,327 42.8×
CT lumbar spine w & w/o contrast (72133) $13,746 $13,746 80.3×
CT lumbar spine w/contrast (72132) $10,036 $10,036 29.5×
CT lumbar spine w/o contrast (72131) $9,606 $9,606 94.2×
CT maxillofacial w contrast (70487) $10,824 $10,824 63.2×
CT maxillofacial w/wo contrast (70488) $11,082 $11,082 64.8×
CT maxillofacial wo contrast (70486) $9,019 $9,019 88.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $7,379 $7,379 43.1×
CT orbits w/o contrast (70480) $5,947 $5,947 58.3×
CT pelvis w/o contrast (72192) $8,864 $8,864 86.9×
CT pelvis w/wo contrast (72194) $12,876 $12,876 75.2×
CT scan of arm combo (73202) $5,860 $5,860 34.2×
CT soft tissue neck w contrast (70491) $9,976 $9,976 58.3×
CT soft tissue neck w/o & w/contrast material (70492) $10,602 $10,602 61.9×
CT soft tissue neck w/o contrast (70490) $9,890 $9,890 97.0×
CT thoracic spine w/contrast (72129) $10,527 $10,527 61.5×
CT thoracic spine w/o contrast (72128) $10,101 $10,101 99.0×
CT thoracic spine w/wo contrast (72130) $10,992 $10,992 64.2×
CT thorax w/o contrast (71250) $9,926 $9,926 97.3×
CT upper ext wo (73200) $4,675 $4,675 45.8×
CT upper extremity with contrast (73201) $5,243 $5,243 15.4×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $6,975 $6,975 40.8×
Cta Abdomen (74175) $6,426 $6,426 37.5×
CTA abdomen pelvis (74174) $12,008 $12,008 35.3×
CTA chest (71275) $6,538 $6,538 38.2×
Cta Head (70496) $6,517 $6,517 38.1×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $12,186 $12,186 35.8×
Cta Neck (70498) $5,669 $5,669 33.1×
Cta Pelvis (72191) $5,585 $5,585 32.6×
Dxa bone density study 1/> sites axial skel (77080) $2,000 $2,000 19.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $364 $364 4.3×
Esophagus (74220) $2,462 $2,462 14.4×
Facial bones min 3 views (70150) $2,612 $2,612 25.6×
Fluoroscopy up to 1 hr (76000) $3,056 $3,056 13.1×
Foot 2 views (73620) $1,587 $1,587 18.7×
Forearm 2 views (73090) $1,754 $1,754 20.7×
Hand 2 views (73120) $1,587 $1,587 15.6×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $4,505 $4,505 6.6×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $4,505 $4,505 6.6×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $4,505 $4,505 6.6×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $6,156 $6,156 11.6×
Hepatobiliary syst imaging including gallbladder (78226) $6,156 $6,156 15.8×
Interstitial radiation source applic complex (77778) $25,602 $25,602 37.7×
Lung ventilation imaging (78579) $4,622 $4,622 11.8×
Lymphoscintigraphy (78195) $2,185 $2,185 4.1×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $8,597 $8,597 11.2×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $11,071 $11,071 32.5×
Mlc imrt design & construction per imrt plan (77338) $3,752 $3,752 10.3×
Mr safety determination physician/other qhp (76016) $218 $218 2.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $25 $25 0.9×
Mr safety implt electronics prepj supvj phys/qhp (76018) $228 $228 2.5×
Mr safety implt pos&/immoblj (76019) $148 $148 2.6×
Mr safety med physics xm customization plng&mntr (76017) $598 $598 2.6×
MRA head w & w/o contrast (70546) $14,491 $14,491 42.6×
MRA head w/o contrast (70544) $7,257 $7,257 31.2×
MRA neck w contrast (70548) $7,257 $7,257 21.3×
Mra Neck W/O &W/Contrast Material (70549) $14,491 $14,491 42.6×
MRI abdomen w contrast (74182) $8,600 $8,600 25.3×
MRI abdomen w/o & w/contrast material (74183) $13,505 $13,505 39.7×
MRI abdomen w/o contrast (74181) $5,553 $5,553 23.9×
MRI any jt lower extrem w/contrast material (73722) $9,675 $9,675 12.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $11,071 $11,071 32.5×
MRI cervical spine w/o contrast (72141) $10,204 $10,204 43.8×
MRI chest w/o & w/contrast material (71552) $9,857 $9,857 29.0×
MRI chest w/o contrast (71550) $7,743 $7,743 33.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $9,189 $9,189 27.0×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $11,071 $11,071 32.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $5,808 $5,808 24.9×
MRI orbit face &/neck w/o contrast (70540) $7,536 $7,536 32.4×
MRI orbit face neck w contrast (70542) $7,452 $7,452 21.9×
MRI orbit/face/neck w&w/o cont (70543) $9,706 $9,706 28.5×
MRI pelvis w/contrast (72196) $7,743 $7,743 22.7×
MRI pelvis w/o & w/contrast material (72197) $13,478 $13,478 39.6×
MRI pelvis w/o contrast (72195) $5,551 $5,551 23.8×
MRI spinal canal cervical w/o & w/contr matrl (72156) $13,226 $13,226 38.9×
MRI spinal canal lumbar w/contrast material (72149) $10,276 $10,276 30.2×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $13,226 $13,226 38.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $13,226 $13,226 38.9×
MRI thoracic spine w/o contrast (72146) $11,071 $11,071 47.6×
MRI up ext w/o contrast (73218) $8,508 $8,508 36.5×
MRI upper ext joint w/o contrast (73221) $8,508 $8,508 36.5×
MRI, joint upper extrem combo (73223) $11,071 $11,071 32.5×
Myelogram Lumbar (72265) $2,648 $2,648 3.5×
Myelogram thoracic (72255) $2,808 $2,808 3.7×
Myocardial Spect Multiple Studies (78452) $12,202 $12,202 9.7×
Myocardial spect single study at rest or stress (78451) $6,156 $6,156 4.9×
Neck soft tissue (70360) $1,313 $1,313 15.5×
Nm gastric emptying study (78264) $5,276 $5,276 13.5×
Nm kidney scan w/flow (78701) $1,963 $1,963 5.0×
Ntsty modul radthx pln dose-vol histos (77301) $32,558 $32,558 24.1×
Nuclear Rx Oral Admin (79005) $1,153.50 $1,153.50 5.1×
Parathyrd planar w/spect&CT (78072) $1,939 $1,939 3.7×
Parathyroid Planar Imaging (78070) $1,497 $1,497 3.8×
Pelvis 1 or 2 views (72170) $1,869 $1,869 18.3×
PET image w/CT, skull-thigh (78815) $22,788 $22,788 16.3×
PET imaging for CT attenuation whole body (78816) $23,612.50 $23,612.50 16.9×
Pulmonary Perfusion Imaging Particulate (78580) $4,622 $4,622 11.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $9,240 $9,240 17.4×
Radex Ankle Compl Minimum 3 Views (73610) $1,710 $1,710 20.1×
Radex Calcaneus Minimum 2 Views (73650) $1,454 $1,454 17.1×
Radex Elbw Compl Minimum 3 Views (73080) $1,889 $1,889 22.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $424 $424 5.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $702 $702 6.9×
Radex fingr minimum 2 views (73140) $1,355 $1,355 16.0×
Radex Foot Compl Minimum 3 Views (73630) $1,710 $1,710 20.1×
Radex Hand Minimum 3 Views (73130) $1,710 $1,710 20.1×
Radex Hip Unilateral With Pelvis 1 View (73501) $2,230 $2,230 26.3×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $2,230 $2,230 21.9×
Radex Hips Bilateral With Pelvis 2 Views (73521) $2,079 $2,079 20.4×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $2,079 $2,079 20.4×
Radex Humerus Minimum 2 Views (73060) $1,419 $1,419 16.7×
Radex Kne 1/2 Views (73560) $1,710 $1,710 20.1×
Radex Kne Compl 4/More Views (73564) $2,240 $2,240 22.0×
Radex Mndbl Compl Minimum 4 Views (70110) $2,244 $2,244 22.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $1,501 $1,501 17.7×
Radex Sho Compl Minimum 2 Views (73030) $1,785 $1,785 21.0×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $2,267 $2,267 22.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $2,121 $2,121 25.0×
Radex Toe Minimum 2 Views (73660) $1,182 $1,182 13.9×
Radex upper extremity infant minimum 2 views (73092) $1,471 $1,471 14.4×
Radex Wrst Compl Minimum 3 Views (73110) $1,905 $1,905 22.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,339 $1,339 13.1×
Radiation Delivery Stereotactic Cranial Linear (77372) $54,841 $54,841 7.6×
Radiation treatment delivery level 1 (77402) $10,319.55 $10,319.55 103.7×
Radiation treatment delivery level 2 (77407) $12,221.75 $12,221.75 32.5×
Radiation treatment delivery level 3 (77412) $12,621.75 $12,621.75 23.4×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $1,189 $1,189 14.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $2,158 $2,158 21.2×
Radiologic exam chest 2 views (71046) $1,710 $1,710 20.1×
Radiologic exam colon single contrast study (74270) $3,826 $3,826 22.4×
Radiologic exam upr gi trc double contrast study (74246) $4,358 $4,358 25.5×
Radiologic exam upr gi trc single contrast study (74240) $3,360 $3,360 19.6×
Radiologic examination femur 1 view (73551) $2,035 $2,035 24.0×
Radiologic examination tibia & fibula 2 views (73590) $2,035 $2,035 24.0×
Radiological examination surgical specimen (76098) $913 $913 1.7×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $1,257 $1,257 3.3×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $1,257 $1,257 3.3×
Ribs bilateral 3 views (71110) $2,267 $2,267 22.2×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,633 $4,633 8.7×
Rp loclzj tum plnr whole body single day imaging (78802) $3,686 $3,686 7.0×
Rp loclzj tum spect 1 area single day imaging (78803) $4,684 $4,684 8.8×
Rp Therapy Intravenous Administration (79101) $1,268 $1,268 5.6×
Scapula (73010) $1,587 $1,587 15.6×
Screening Digital Breast Tomosynthesis Bi (77063) $73 $73 3.1×
Shoulder 1 view (73020) $1,057 $1,057 12.4×
Simulation intermediate (77285) $4,531 $4,531 12.4×
Small bowel series (74250) $2,780 $2,780 16.2×
Spec telethx port pln parts hemibdy tot bdy (77321) $9,932 $9,932 27.2×
Special dosimetry (77331) $1,786 $1,786 13.6×
Special Physics Consult (77370) $3,563 $3,563 27.2×
Special treatment procedure (77470) $11,309 $11,309 21.0×
Spine thoracic 3 views (72072) $2,216 $2,216 21.7×
Stereotactic Body Radiation Delivery (77373) $39,174 $39,174 22.5×
Telethx isodose pln cplx w/basic dosimetry (77307) $16,728 $16,728 45.8×
Ther rad simulaj-aided field setting complex (77290) $10,126 $10,126 27.7×
Ther rad simulaj-aided field setting simple (77280) $4,338 $4,338 33.1×
Thoracolumbar 2 views (72080) $2,216 $2,216 26.1×
Thyroid imaging w/blood flow (78013) $3,564 $3,564 9.1×
Thyroid uptake measurement (78012) $3,850 $3,850 9.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $5,766 $5,766 14.8×
Treatment device complex (77334) $4,714 $4,714 12.9×
Treatment device intermediate (77333) $2,349 $2,349 17.9×
Treatment devices simple (77332) $1,546 $1,546 11.8×
Ultrasound breast complete (76641) $1,279 $1,279 12.5×
Ultrasound Exam Aaa Screen (76706) $2,219 $2,219 21.8×
Ultrasound, abdomen limited (76705) $3,294 $3,294 32.3×
Us breast unilateral limited (76642) $894 $894 10.5×
Us chest (76604) $2,755 $2,755 27.0×
Us compl joint r-t w/image documentation (76881) $1,686 $1,686 16.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,352 $1,352 13.3×
Us ob limited (76815) $1,673 $1,673 16.4×
Us ob transvaginal (76817) $1,709 $1,709 16.8×
Us pelvic non ob complete (76856) $3,777 $3,777 37.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $1,198 $1,198 11.7×
Us retroperitoneal limited (76775) $3,437 $3,437 33.7×
Us scrotum and contents (76870) $2,956 $2,956 29.0×
Us soft tissue head/neck (76536) $3,089 $3,089 30.3×
Wrist 2 views (73100) $1,587 $1,587 18.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $2,840 $2,840 27.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $1,891 $1,891 22.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $4,459 $4,459 26.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $1,454 $1,454 17.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $2,230 $2,230 26.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $2,079 $2,079 20.4×
X-ray exam of femur 2/> (73552) $2,035 $2,035 24.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $1,708 $1,708 20.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $1,251 $1,251 14.7×
X-ray leg, infant (73592) $1,649 $1,649 19.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $2,660 $2,660 26.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $3,124 $3,124 30.6×
X-ray nose-rectum child f.b. (76010) $849 $849 10.0×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $2,230 $2,230 21.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $2,230 $2,230 26.3×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $2,337 $2,337 22.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $3,212 $3,212 31.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $1,710 $1,710 16.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $1,710 $1,710 20.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $2,205 $2,205 26.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $2,253 $2,253 22.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $1,587 $1,587 15.6×
X-Ray Spine One View - Xr Spine (72020) $1,430 $1,430 16.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $1,025 $1,025 12.1×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $1,754 $1,754 20.7×
Xr bone length studies (77073) $1,966 $1,966 19.3×
Xr c-spine 4 or 5 views (72050) $2,755 $2,755 27.0×
Xr c-spine 6 or more views (72052) $3,092 $3,092 30.3×
Xr chest 4+ views (71048) $1,391 $1,391 13.6×