Imaging prices at Potomac Valley Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $127 $254 1.5×
Abdomen 2 views (74019) $111.50 $223 1.1×
Acute Gastrointestinal Blood Loss Imaging (78278) $865 $1,730 2.3×
Ankle 2 views (73600) $116.50 $233 1.4×
Bone age studies (77072) $116.50 $233 1.2×
Bone Imaging 3 Phase (78315) $858 $1,716 2.2×
Bone Imaging Limited Area (78300) $383.50 $767 1.0×
Bone Imaging Whole Body (78306) $771 $1,542 2.0×
Bone survey infant (77076) $341 $682 3.4×
Chest 1 view (71045) $123.50 $247 1.5×
Chest 2 views (71046) $166 $332 2.0×
Chest 3 views (71047) $207.50 $415 2.5×
Chest 4 or more views (71048) $199 $398 2.0×
Clavicle complete (73000) $123.50 $247 1.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $120 $240 1.2×
Contrast X-Ray Bladder (74430) $389.50 $779 1.2×
CT abdomen and pelvis without and with contrast (74178) $1,706.50 $3,413 5.1×
CT abdomen and pelvis without contrast (74176) $1,232.50 $2,465 5.4×
CT abdomen w contrast (74160) $720 $1,440 4.3×
CT abdomen w wo contrast (74170) $868 $1,736 5.2×
CT abdomen w/o contrast (74150) $615 $1,230 6.1×
CT Angio Abdomen and Pelvis (74174) $1,104 $2,208 3.3×
CT Angio Chest (71275) $982 $1,964 5.8×
CT Angio Head (70496) $750 $1,500 4.5×
CT angio hrt w/3d image (75574) $334.50 $669 1.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $879 $1,758 5.2×
CT Angio Neck (70498) $750 $1,500 4.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $891.50 $1,783 5.3×
CT cervical spine w/ contrast (72126) $702 $1,404 2.1×
CT cervical spine w/o contrast (72125) $619.50 $1,239 6.2×
CT chest w contrast (71260) $728.50 $1,457 4.3×
CT chest w/wo contrast (71270) $891 $1,782 5.3×
CT head/brain with contrast (70460) $596 $1,192 3.5×
CT head/brain without and with contrast (70470) $725 $1,450 4.3×
CT heart contrast eval cardiac structure&morph (75572) $495.50 $991 1.5×
CT heart no contrast quant eval coronry calcium (75571) $99 $198 1.2×
CT iac w contrast (70481) $609.50 $1,219 3.6×
CT l-spine w&w/o contrast (72133) $860.50 $1,721 5.1×
CT lower ext w/o (73700) $544.50 $1,089 5.4×
CT lower extremity w/contrast material (73701) $630 $1,260 3.7×
CT lumbar spine w contrast (72132) $771.50 $1,543 2.3×
CT lumbar spine w/o contrast (72131) $630 $1,260 6.3×
CT maxillofacial w contrast (70487) $559.50 $1,119 3.3×
CT maxillofacial wo contrast (70486) $526.50 $1,053 5.2×
CT neck tissue combo (70492) $681 $1,362 4.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $630.50 $1,261 3.7×
CT orbits w/o contrast (70480) $546 $1,092 5.4×
CT pelvis w&w/o contrast (72194) $901 $1,802 5.4×
CT pelvis w/o contrast (72192) $616.50 $1,233 6.1×
CT scan of leg combo (73702) $800 $1,600 4.8×
CT scans face/jaw combo (70488) $786.50 $1,573 4.7×
CT soft tissue neck w contrast (70491) $569 $1,138 3.4×
CT soft tissue neck w/o contrast (70490) $546 $1,092 5.4×
CT thoracic spine w contrast (72129) $843 $1,686 5.0×
CT thoracic spine w/o contrast (72128) $630 $1,260 6.3×
CT thorax w/o contrast (71250) $590.50 $1,181 5.9×
CT upper ext wo (73200) $492.50 $985 4.9×
CT upper extremity w/o & w/contrast material (73202) $700 $1,400 4.2×
CT upper extremity with contrast (73201) $571.50 $1,143 1.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,444 $2,888 8.6×
Cta Abdomen (74175) $954 $1,908 5.7×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,315 $2,630 3.9×
CTA pelvis (72191) $992.50 $1,985 5.9×
Dxa Bone Density Axial (77080) $352.50 $705 3.5×
Esophagram (74220) $305.50 $611 1.8×
Fluoroscopy up to 1 hr (76000) $513 $1,026 2.2×
Foot 2 views (73620) $116.50 $233 1.4×
Forearm 2 views (73090) $123.50 $247 1.5×
Gastric emptying imaging study (78264) $602 $1,204 1.6×
Gated Heart Planar Single (78472) $738 $1,476 1.9×
Hand 2 views (73120) $111.50 $223 1.1×
Hepatobil Syst Image W/Drug (78227) $828.50 $1,657 1.6×
Hepatobiliary System Imaging (78226) $602 $1,204 1.6×
Ht Muscle Image Spect Sing (78451) $2,033 $4,066 1.6×
Infant hip ultrasound with hip movement (dynamic) (76885) $401 $802 4.8×
Knee 3 Views (73562) $139.50 $279 1.7×
Lung Ventilat&Perfus Imaging (78582) $524 $1,048 1.0×
Meckels Divert Exam (78290) $552 $1,104 1.4×
Mra Head W/O & W/Contrast Material (70546) $1,595.50 $3,191 4.8×
MRA head w/o contrast (70544) $1,137.50 $2,275 5.0×
MRA neck w contrast (70548) $1,221.50 $2,443 3.6×
Mra Neck W/O &W/Contrast Material (70549) $1,595.50 $3,191 4.8×
MRA neck w/o contrast (70547) $1,137.50 $2,275 5.0×
MRI abdomen w contrast (74182) $1,313 $2,626 3.9×
MRI abdomen w/o contrast (74181) $1,132 $2,264 4.9×
MRI any jt lower extrem w/contrast material (73722) $1,313 $2,626 1.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,727.50 $3,455 5.2×
MRI any jt upper extremity w/contrast matrl (73222) $1,313 $2,626 1.7×
MRI cervical spine w/o cont (72141) $993.50 $1,987 4.3×
MRI chest w/o contrast (71550) $1,636.50 $3,273 7.2×
MRI chest wo w contrast (71552) $2,655.50 $5,311 7.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,780.50 $3,561 5.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,143.50 $2,287 5.0×
MRI lumbar spine w contrast (72149) $1,228 $2,456 3.7×
Mri Neck Spine W/O & W/Dye (72156) $1,524 $3,048 4.6×
MRI orbit face &/neck w/o contrast (70540) $993.50 $1,987 4.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,545.50 $3,091 4.6×
MRI pelvis w/o & w contrast (72197) $1,780.50 $3,561 5.3×
MRI pelvis w/o contrast (72195) $1,058.50 $2,117 4.6×
MRI thoracic spine w/o contrast (72146) $1,143.50 $2,287 5.0×
MRI upper extremity oth than jt w/contr matrl (73219) $1,404 $2,808 4.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,143.50 $2,287 5.0×
Mri Uppr Extremity W/O&W/Dye (73220) $1,780.50 $3,561 5.3×
MRI, abdomen, combo (74183) $1,740.50 $3,481 5.2×
MRI, dorsal spine combo (72157) $1,767 $3,534 5.3×
MRI, joint upper extrem (73221) $1,132 $2,264 4.9×
MRI, joint upper extrem combo (73223) $1,727.50 $3,455 5.2×
MRI, lumbar spine combo (72158) $1,755 $3,510 5.2×
Myocardial Spect Multiple Studies (78452) $2,033 $4,066 1.6×
N-invas est c ffr sw aly CTA (75580) $2,073 $4,146 2.5×
Neck soft tissue (70360) $107.50 $215 1.3×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $91 $182 1.1×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $208.50 $417 2.1×
Parathyroid Planar Imaging (78070) $383.50 $767 1.0×
Pelvis 1 or 2 views (72170) $111 $222 1.1×
PET image w/CT, full body (78816) $2,623.50 $5,247 1.9×
PET imaging CT attenuation skull base mid-thigh (78815) $2,623.50 $5,247 1.9×
Pulmonary Perfusion Imaging Particulate (78580) $609.50 $1,219 1.6×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $891 $1,782 1.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $120.50 $241 1.2×
Radex Ankle Complete Minimum 3 Views (73610) $127 $254 1.5×
Radex Calcaneus Minimum 2 Views (73650) $113 $226 1.4×
Radex elbow complete minimum 3 views (73080) $133 $266 1.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $187 $374 1.9×
Radex fingr minimum 2 views (73140) $99.50 $199 1.2×
Radex foot complete minimum 3 views (73630) $127 $254 1.5×
Radex Hand Minimum 3 Views (73130) $127 $254 1.5×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $210 $420 2.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $107.50 $215 1.3×
Radex Ribs Unilateral 2 Views (71100) $146.50 $293 1.8×
Radex shoulder complete minimum 2 views (73030) $133 $266 1.6×
Radex Sinuses Paransl < 3 Views (70210) $92.50 $185 1.1×
Radex Spine 1 View Specify Level (72020) $84 $168 1.0×
Radex Sternum Minimum 2 Views (71120) $113.50 $227 1.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $187 $374 2.2×
Radex Toe Minimum 2 Views (73660) $92 $184 1.1×
Radex Wrist Complete Minimum 3 Views (73110) $127 $254 1.5×
Radiolog exam mandible compl minimum 4 views (70110) $159 $318 1.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $111.50 $223 1.1×
Radiologic exam colon double contrast study (74280) $604.50 $1,209 3.6×
Radiologic exam colon single contrast study (74270) $439.50 $879 2.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $289 $578 1.7×
Radiologic exam knee complete 4/more views (73564) $156.50 $313 1.6×
Radiologic exam pelvis compl minimum 3 views (72190) $137 $274 1.4×
Radiologic Exam Small Int Single Contrast Study (74250) $330.50 $661 2.0×
Radiologic exam upr gi trc double contrast study (74246) $463.50 $927 2.8×
Radiologic examination femur 1 view (73551) $84 $168 1.0×
Radiologic examination femur minimum 2 views (73552) $139.50 $279 1.7×
Radiologic examination knee 1/2 views (73560) $123.50 $247 1.5×
Radiologic examination tibia & fibula 2 views (73590) $123.50 $247 1.5×
Ribs bilateral 3 views (71110) $104 $208 1.0×
Scapula (73010) $111.50 $223 1.1×
Screening Digital Breast Tomosynthesis Bi (77063) $98 $196 4.2×
Shoulder 1 view (73020) $123.50 $247 1.5×
Skull less than 4 views (70250) $104 $208 1.0×
Sternoclavicular joints (71130) $163.50 $327 2.0×
Thoracic spine 3 views (72072) $166 $332 1.7×
Thoracolumbar 2 views (72080) $119.50 $239 1.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $383.50 $767 1.0×
Ultrasound Breast Limited (76642) $113 $226 1.4×
Ultrasound Exam Aaa Screen (76706) $308 $616 3.1×
Ultrasound, abdomen limited (76705) $442 $884 4.4×
Upper gi w/o kub (74240) $409 $818 2.4×
Us breast unilateral complete (76641) $393.50 $787 3.9×
Us chest (76604) $222 $444 2.2×
Us complete joint (76881) $100.50 $201 1.0×
Us exam, pelvic, limited (76857) $210.50 $421 2.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $299.50–$300 $599–$600 varies
Us ob limited 1 or more fetuses (76815) $333.50 $667 3.3×
Us ob transvaginal (76817) $208.50 $417 2.1×
Us pelvic non ob complete (76856) $413 $826 4.1×
Us retroperitoneal complete (76770) $490.50 $981 4.9×
Us retroperitoneal limited (76775) $289.50 $579 2.9×
Us scrotum and contents (76870) $394 $788 3.9×
Us thyroid (76536) $371 $742 3.7×
Us transrectal (76872) $446.50 $893 4.5×
Wrist 2 views (73100) $116.50 $233 1.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $156.50 $313 1.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $120 $240 1.4×
X-Ray Exam Entire Spi 1 Vw (72081) $103.50 $207 1.2×
X-Ray Exam Entire Spi 2/3 Vw (72082) $172 $344 1.7×
X-Ray Exam Hip Uni 1 View (73501) $88 $176 1.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $154 $308 1.8×
X-Ray Exam Hip Uni 4/> Views (73503) $154 $308 1.5×
X-Ray Exam Hips Bi 2 Views (73521) $151 $302 1.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $133 $266 1.3×
X-Ray Exam Hips Bi 5/> Views (73523) $165 $330 1.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $149.50 $299 1.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $259.50 $519 2.6×
X-Ray Exam Unilat Ribs/Chest (71101) $111.50 $223 1.1×
X-ray eye for foreign body (70030) $112.50 $225 1.3×
X-ray humerus (73060) $131 $262 1.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $120 $240 1.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $159 $318 1.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $144 $288 1.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $146.50 $293 1.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $133 $266 1.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $184 $368 2.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $115.50 $231 1.2×
X-ray thoracic spine 4 vw (72074) $160 $320 1.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $485.50 $971 1.5×
X-Rays Bone Length Studies (77073) $190.50 $381 1.9×
X-Rays Bone Survey Complete (77075) $275.50 $551 2.7×
Xr c-spine 4 or 5 views (72050) $259.50 $519 2.6×
Xr orbits complete 4 views (70200) $139 $278 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.