Imaging prices at Saint Mary's Hospital

Waterbury, CT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $306.35 $557 2.4×
Acute gastrointestinal blood loss imaging (78278) $630.30 $1,146 1.3×
Angiography extremity bilateral rs&i (75716) $3,989.70 $7,254 1.1×
Angiography extremity unilateral rs&i (75710) $2,263.80 $4,116 0.6×
Angiography pulmonary bilateral slctv rs&i (75743) $5,429.60 $9,872 1.4×
Angiography visceral slctv/supraslctv rs&i (75726) $4,030.95 $7,329 0.6×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $851.95 $1,549 0.2×
Ankle 2 views (73600) $437.25 4.2×
Aortogram thoracic (75605) $3,681.70 $6,694 0.6×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $5,387.80 $9,796 1.4×
Aortography abdominal serialography rs&i (75625) $3,138.85 $5,707 0.8×
Arthrogram hip (73525) $704.55 $1,281 1.7×
Arthrogram shoulder (73040) $425.15 $773 1.0×
Arthrography knee lt (73580) $922.90 $1,678 2.2×
Bone &/Joint Imaging Multiple Areas (78305) $545.05 $991 1.1×
Bone &/joint imaging whole body (78306) $713.35 $1,297 1.5×
Bone age studies (77072) $190.30 $346 1.5×
Bone Imaging 3 Phase (78315) $862.40 $1,568 1.8×
Bone Marrow Imaging Limited Area (78102) $502.70 $914 1.0×
Bone survey complete (77075) $594.55 $1,081 4.7×
Brain image w/flow 4 + views (78606) $1,087.90 $1,978 1.7×
Brain imaging < 4 static views w vascular flow (78601) $761.20 $1,384 1.6×
Cervical spine 2 or 3 views (72040) $317.90 $578 3.0×
Chest 1 view (71045) $18,005.92 172.6×
Chest 3 views (71047) $238.70 $434 2.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $450.45 $819 2.1×
Clavicle complete (73000) $190.85 $347 1.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $572.55 $1,041 4.6×
CT abdomen and pelvis without and with contrast (74178) $1,696.20 $3,084 4.1×
CT abdomen and pelvis without contrast (74176) $843.70 2.9×
CT abdomen w contrast (74160) $955.35 $1,737 4.5×
CT abdomen w wo contrast (74170) $1,030.70 $1,874 4.9×
CT abdomen w/o contrast (74150) $804.10 $1,462 6.4×
CT angiography upper extremity lt (73206) $1,355.75 $2,465 6.4×
CT c-spine w/o contrast (72125) $910.25 $1,655 7.3×
CT cervical spine w&w/o contrast (72127) $1,291.95 $2,349 6.1×
CT cervical spine with contrast (72126) $1,217.15 $2,213 2.9×
CT chest w/wo contrast (71270) $1,249.05 $2,271 5.9×
CT chest with contrast (71260) $2,525.82 12.0×
CT head/brain with contrast (70460) $1,300.75 $2,365 6.2×
CT head/brain without and with contrast (70470) $1,415.70 $2,574 6.7×
CT iac w contrast (70481) $1,062.60 $1,932 5.1×
CT lower ext w/o (73700) $1,535.60 12.3×
CT lower extremity w wo contrast (73702) $1,492.70 $2,714 7.1×
CT lower extremity with contrast (73701) $1,280.40 $2,328 6.1×
CT lumbar spine w & w/o contrast (72133) $1,085.15 $1,973 5.2×
CT lumbar spine w/o contrast (72131) $1,302.40 $2,368 10.4×
CT lumbar spine with contrast (72132) $1,376.65 $2,503 3.3×
CT maxillofacial w contrast (70487) $1,103.30 $2,006 5.2×
CT maxillofacial w/o contrast (70486) $1,003.75 $1,825 8.0×
CT maxillofacial w/wo contrast (70488) $1,262.80 $2,296 6.0×
CT neck soft tissue w contrast (70491) $1,108.25 $2,015 5.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,098.35 $1,997 5.2×
CT orbits w/o contrast (70480) $948.20 7.6×
CT pelvis w & w/o contrast (72194) $2,002 $3,640 9.5×
CT pelvis w/o contrast (72192) $1,056.55 $1,921 8.4×
CT soft tissue neck w/o & w/contrast material (70492) $1,340.35 $2,437 6.4×
CT soft tissue neck w/o contrast (70490) $927.30 $1,686 7.4×
CT thoracic spine w/contrast (72129) $1,183.05 $2,151 5.6×
CT thoracic spine w/o contrast (72128) $994.95 $1,809 7.9×
CT thorax w/o contrast (71250) $982.30 7.8×
CT upper extremity w/o & w/contrast material (73202) $1,439.35 $2,617 6.8×
CT upper extremity w/o contrast rt (73200) $871.20 $1,584 7.0×
CT upper extremity with contrast (73201) $957 $1,740 2.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,061.50 $1,930 5.0×
Cta Abdomen (74175) $974.60 $1,772 4.6×
CTA abdomen pelvis (74174) $1,387.10 $2,522 3.3×
CTA chest (71275) $1,139.38 5.4×
Cta Head (70496) $3,703.48 17.6×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $3,567.85 $6,487 8.5×
CTA lwr ext w&w/o contrast (73706) $1,271.05 $2,311 6.0×
Cta Neck (70498) $1,837 $3,340 8.7×
Cta Pelvis (72191) $1,865.05 $3,391 8.9×
Cystography minimum 3 views rs&i (74430) $451.55 $821 1.1×
Dxa bone density study 1/> sites axial skel (77080) $215.60 $392 1.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $82.50 $150 0.8×
Echoencephalography real time imaging (76506) $470.25 $855 3.8×
Esophagus (74220) $404.25 $735 1.9×
Fetal biophysical profile non-stress testing (76818) $856.90 $1,558 6.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $209.55 $381 1.7×
Fluoroscopy up to 1 hr (76000) $225.50 $410 0.8×
Foot 2 views (73620) $398.75 3.8×
Forearm 2 views (73090) $250.25 2.4×
Hand 2 views (73120) $233.20 $424 1.9×
Hand 3 views (73130) $571.45 5.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,055.45 $1,919 1.6×
Hepatobiliary syst imaging including gallbladder (78226) $999.90 $1,818 2.1×
Ht muscle image spect sing (78451) $1,862.85 $3,387 1.2×
Humerus Min 2 Views Left (73060) $295.90 2.8×
Hysterosalpingogram (74740) $768.35 $1,397 2.7×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,074.15 $1,953 1.7×
Kidney img morphology vascular flow 1 w/rx (78708) $604.45 $1,099 0.9×
Knee 3 views (73562) $345.12 3.3×
Lung perf&ventilat diferentl (78598) $952.05 $1,731 1.5×
Lung perfusion differential (78597) $790.90 $1,438 1.7×
Lymphoscintigraphy (78195) $1,026.30 $1,866 1.6×
Mammary ductogram or galactogram single (77053) $471.35 $857 1.6×
Meckels Diverticulum (78290) $1,163.80 $2,116 2.4×
MRA head w & w/o contrast (70546) $2,549.80 $4,636 6.1×
MRA head w/o contrast (70544) $3,343.44 11.7×
MRA head with contrast (70545) $2,265.45 $4,119 5.4×
MRA neck w contrast (70548) $2,090.55 $3,801 5.0×
Mra Neck W/O &W/Contrast Material (70549) $2,376 $4,320 5.7×
MRA neck w/o contrast (70547) $1,601.05 $2,911 5.6×
MRI abdomen w contrast (74182) $2,543.75 $4,625 6.1×
MRI abdomen w/o & w/contrast material (74183) $2,678.50 $4,870 6.4×
MRI abdomen w/o contrast (74181) $2,031.15 $3,693 7.1×
MRI any jnt lwr ext with con lt (73722) $2,151.05 $3,911 2.3×
MRI any jt upper extremity w/contrast matrl (73222) $2,222 $4,040 2.4×
MRI breast w/o contrast bilateral (77047) $1,779.25 $3,235 6.2×
MRI c-spine with contrast (72142) $2,257.75 $4,105 5.4×
MRI cervical spine w/o contrast (72141) $1,962.40 $3,568 6.9×
MRI chest w/o & w/contrast material (71552) $2,231.35 $4,057 5.3×
MRI chest w/o contrast (71550) $1,092.30 $1,986 3.8×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $759.55 $1,381 1.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,862.30 6.5×
MRI orbit face &/neck w/o contrast (70540) $1,434.95 $2,609 5.0×
MRI orbit/face/neck w&w/o cont (70543) $2,390.85 $4,347 5.7×
MRI orbit/face/neck w/contrast (70542) $1,845.25 $3,355 4.4×
MRI pelvis w contrast (72196) $2,057.55 $3,741 4.9×
MRI pelvis w/o & w/contrast material (72197) $2,553.65 $4,643 6.1×
MRI pelvis w/o contrast (72195) $2,052.60 $3,732 7.2×
MRI scan of arm joint before and after contrast (73223) $2,379.55 5.7×
MRI scan of leg joint before and after contrast (73723) $2,562.45 $4,659 6.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,506.90 $4,558 6.0×
MRI spinal canal lumbar w/contrast material (72149) $2,264.90 $4,118 5.4×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,526.15 $4,593 6.0×
MRI spinal canal thoracic w/contrast matrl (72147) $2,155.45 $3,919 5.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,476.10 $4,502 5.9×
MRI thoracic spine w/o contrast (72146) $1,886.50 $3,430 6.6×
MRI upper ext joint w/o contrast (73221) $2,010.80 7.0×
MRI upper extrem other than jt w/o & w/contras (73220) $2,503.38 6.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,975.60 $3,592 6.9×
Myocardial Spect Multiple Studies (78452) $2,567.40 $4,668 1.7×
Neck soft tissue (70360) $154 $280 1.5×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $421.30 $766 0.9×
Nm gastric emptying study (78264) $829.40 $1,508 1.7×
Nuclear Rx Oral Admin (79005) $1,010.90 $1,838 3.6×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $396.55 $721 3.2×
Osseous survey infant (77076) $215.05 $391 1.7×
Osseous survey limited (77074) $392.70 $714 3.1×
Parathyroid imaging (78070) $735.35 $1,337 1.5×
Pelvis 1 or 2 views (72170) $596.20 4.8×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,126.85 $3,867 5.1×
Pulmonary Perfusion Imaging Particulate (78580) $575.85 $1,047 1.2×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,030.15 $1,873 1.6×
Radex abscess/fistula/sinus tract rs&i (76080) $392.70 $714 0.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $223.85 $407 2.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $339.90 $618 2.7×
Radex hips bilateral with pelvis 2 views (73521) $486.75 $885 3.9×
Radiation tx delivery 1 mev >= intermediate (77407) $234.30 $426 0.5×
Radiolog exam mandible compl minimum 4 views (70110) $134.20 $244 1.1×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $198.55 1.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $217.25 $395 1.7×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $3,084.86 29.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $444.95 $809 2.1×
Radiologic exam upr gi trc double contrast study (74246) $378.95 $689 1.8×
Radiologic exam upr gi trc single contrast study (74240) $564.85 $1,027 2.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $205.70 $374 2.0×
Radiological examination surgical specimen (76098) $473 $860 0.7×
Ribs bilateral 3 views (71110) $405.35 $737 3.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,799.60 $3,272 3.8×
Rp loclzj tum plnr whole body single day imaging (78802) $1,527.35 $2,777 2.3×
Rp loclzj tum spect 1 area single day imaging (78803) $1,942.05 $3,531 3.0×
Sacroiliac Joints < 3 Views (72200) $251.35 $457 2.0×
Scanogram (77073) $298.10 $542 2.4×
Scapula complete (73010) $307.45 $559 2.5×
Screening digital breast tomosynthesis (77063) $36.30 $66 1.6×
Shuntogram indwelling nonvascular shunt rs&i (75809) $217.25 $395 1.7×
Small bowel series (74250) $612.70 $1,114 2.9×
Spec medical radj physics consltj (77370) $864.60 $1,572 5.4×
Spine thoracic 3 views (72072) $331.65 $603 2.6×
Thoracolumbar 2 views (72080) $248.60 $452 2.4×
Thyroid carcinoma metastases img whole body (78018) $1,555.95 $2,829 2.4×
Thyroid uptake measurement (78012) $360.80 $656 0.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $612.70 $1,114 1.3×
Tmj unilateral (70328) $145.20 $264 1.4×
Treatment device intermediate (77333) $851.40 $1,548 5.3×
Treatment devices simple (77332) $818.95 $1,489 5.1×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,063.70 $1,934 2.2×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $414.15 $753 1.0×
Ultrasound, abdomen limited (76705) $534.32 4.3×
Unlisted fluoroscopic procedure (76496) $173.80 $316 1.7×
Upper Extremity Infant (73092) $237.60 $432 1.9×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $601.70 $1,094 2.9×
Us abdl aorta screen aaa (76706) $573.65 $1,043 4.6×
Us breast unilateral complete (76641) $375.10 $682 3.0×
Us breast unilateral limited (76642) $324.50 $590 3.1×
Us chest (76604) $396 $720 3.2×
Us compl joint r-t w/image documentation (76881) $255.20 2.0×
Us elastography parenchyma (76981) $245.30 $446 2.0×
Us infant hips dynamic (76885) $559.35 $1,017 5.4×
Us kidney transplant (76776) $616.55 $1,121 4.9×
Us ob transvaginal (76817) $612.15 $1,113 4.9×
Us pelvic non ob complete (76856) $805.20 $1,464 6.4×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $519.20 $944 4.1×
Us pregnancy ltd (76815) $405.35 $737 3.2×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $533.50 $970 4.3×
Us retroperitoneal complete (76770) $1,167.92 9.3×
Us retroperitoneal limited (76775) $1,223.75 9.8×
Us scrotum and contents (76870) $646.80 $1,176 5.2×
Us soft tissue head/neck (76536) $834.90 $1,518 6.7×
Us spinal canal and contents (76800) $398.75 $725 3.2×
Us transrectal (76872) $12,880.98 102.8×
Us xtr non-vasc lmtd (76882) $216.70 1.7×
Venogram extremity bilateral (75822) $3,113.55 $5,661 1.6×
Venography caval inferior serialography rs&i (75825) $4,414.30 $8,026 1.2×
Venography caval superior serialography rs&i (75827) $1,524.60 $2,772 0.8×
Venography extremity unilateral rs&i (75820) $1,201.75 $2,185 0.6×
Vertebral fracture assessment via dxa (77086) $178.20 $324 1.7×
Wrist 2 views (73100) $212.85 $387 2.0×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $272.25 $495 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $363.55 $661 3.5×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $491.98 4.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $1,040.32 10.0×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $709.78 6.8×
X-ray exam entire spi 4/5 vw (72083) $407.55 $741 3.3×
X-ray exam hip uni 1 view (73501) $37,123.94 355.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $362.45 3.5×
X-ray exam hip uni 4/> views (73503) $393.80 $716 3.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $510.95 $929 4.1×
X-Ray Exam Hips Bi 5/> Views (73523) $722.15 $1,313 5.8×
X-ray exam of femur 1 (73551) $178.75 $325 1.7×
X-ray eye for foreign body (70030) $253 $460 2.4×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $342.10 $622 2.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $180.95 $329 1.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $284.90 $518 2.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $294.80 $536 2.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $130.35 $237 1.2×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $318.45 $579 2.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $290.40 $528 2.8×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $317.35 $577 3.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $301.40 $548 2.4×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $550.55 $1,001 4.4×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $304.70 $554 2.4×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $215.05 $391 2.1×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $200.75 $365 1.9×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $410.30 $746 3.3×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $328.35 $597 2.6×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $13,202.10 31.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $255.20 $464 2.4×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $365.75 $665 2.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $477.40 $868 3.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $328.35 $597 2.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $321.20 $584 3.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $427.08 4.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $360.80 $656 3.5×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $225.50 $410 2.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $402.60 $732 3.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $279.40 $508 2.2×
X-Ray Spine One View - Xr Spine (72020) $25,484.02 244.3×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $276.10 $502 2.6×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $275 $500 2.6×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $293.70 $534 2.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $328.35 $597 2.6×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $547.25 5.2×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $764.22 7.3×
Xr c-spine 6 or more views (72052) $372.90 $678 3.0×
Xr finger(s) 2+ views (73140) $233.48 2.2×
Xr shoulder 1 view (73020) $210.10 2.0×
Xr spine cervical 4 or 5 views (72050) $348.15 $633 2.8×
Xr tibia/fibula 2 views (73590) $500.22 4.8×
Xr tmj bilateral (70330) $239.80 $436 2.3×
Xray knee 1 or 2 views rt (73560) $218.35 $397 2.1×