Imaging prices at Sistersville General Hospital
Sistersville, WV · every code in this section with a posted price and a Medicare benchmark.
200 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) range across 2 matching MRF lines |
$152.44–$223.29 | $254.07–$372.15 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$168.54–$198.61 | $280.90–$331.01 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$63.82–$226.24 | $106.37–$377.07 | varies |
| Arthrogram hip (73525) | $353.48 | $589.14 | 1.1× |
| Bone age studies (77072) | $157.52 | $262.53 | 1.6× |
| Bone survey infant (77076) | $498.80 | $831.34 | 5.0× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$206.45–$216.77 | $344.08–$361.28 | varies |
| Chest 2 views (71046) | $189.46 | $315.76 | 2.3× |
| Chest 3 views (71047) | $207.96 | $346.60 | 2.5× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$159.49–$293.43 | $265.82–$489.05 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$98.59–$204.18 | $164.32–$340.30 | varies |
| Contrast X-Ray Bladder (74430) | $199.10 | $331.84 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $413.20 | $688.66 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,621.69 | $2,702.81 | 4.8× |
| CT abdomen and pelvis without contrast (74176) | $1,621.69 | $2,702.81 | 7.1× |
| CT abdomen w contrast (74160) | $1,621.69 | $2,702.81 | 9.6× |
| CT abdomen w wo contrast (74170) | $1,621.69 | $2,702.81 | 9.6× |
| CT abdomen w/o contrast (74150) | $1,621.69 | $2,702.81 | 16.2× |
| CT Angio Abdomen and Pelvis (74174) | $1,681.76 | $2,802.93 | 5.0× |
| CT Angio Chest (71275) | $1,621.69 | $2,702.81 | 9.6× |
| CT Angio Head (70496) | $1,173.13 | $1,955.22 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,816.30 | $3,027.16 | 10.8× |
| CT Angio Neck (70498) | $1,173.13 | $1,955.22 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,621.69–$1,816.30 | $2,702.81–$3,027.16 | varies |
| CT cervical spine w/ contrast (72126) | $1,286.15 | $2,143.58 | 3.8× |
| CT cervical spine w/o contrast (72125) | $976.57 | $1,627.62 | 9.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,621.69–$1,816.30 | $2,702.81–$3,027.16 | varies |
| CT chest w/wo contrast (71270) | $1,621.69 | $2,702.81 | 9.6× |
| CT head/brain with contrast (70460) | $1,173.13 | $1,955.22 | 7.0× |
| CT head/brain without and with contrast (70470) | $1,173.13 | $1,955.22 | 7.0× |
| CT iac w contrast (70481) | $1,173.13 | $1,955.22 | 7.0× |
| CT l-spine w&w/o contrast (72133) | $1,621.69 | $2,702.81 | 9.6× |
| CT lower ext w/o (73700) | $1,621.69 | $2,702.81 | 16.2× |
| CT lower extremity w/contrast material (73701) | $1,621.69 | $2,702.81 | 9.6× |
| CT lumbar spine w contrast (72132) | $1,621.69 | $2,702.81 | 4.8× |
| CT lumbar spine w/o contrast (72131) | $1,621.69 | $2,702.81 | 16.2× |
| CT maxillofacial w contrast (70487) | $1,173.13 | $1,955.22 | 7.0× |
| CT maxillofacial wo contrast (70486) | $976.57 | $1,627.62 | 9.7× |
| CT neck tissue combo (70492) | $1,173.13 | $1,955.22 | 7.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,173.13 | $1,955.22 | 7.0× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$976.57–$1,173.13 | $1,627.62–$1,955.22 | varies |
| CT pelvis w&w/o contrast (72194) | $1,621.69 | $2,702.81 | 9.6× |
| CT pelvis w/o contrast (72192) | $1,621.69 | $2,702.81 | 16.2× |
| CT scan of leg combo (73702) | $1,621.69 | $2,702.81 | 9.6× |
| CT scans face/jaw combo (70488) | $1,173.13 | $1,955.22 | 7.0× |
| CT soft tissue neck w contrast (70491) | $1,173.13 | $1,955.22 | 7.0× |
| CT soft tissue neck w/o contrast (70490) | $976.57 | $1,627.62 | 9.7× |
| CT thoracic spine w contrast (72129) | $1,621.69 | $2,702.81 | 9.6× |
| CT thoracic spine w/o contrast (72128) | $1,621.69 | $2,702.81 | 16.2× |
| CT thorax w/o contrast (71250) | $1,621.69 | $2,702.81 | 16.2× |
| CT upper ext wo (73200) | $1,621.69 | $2,702.81 | 16.2× |
| CT upper extremity with contrast (73201) | $1,621.69 | $2,702.81 | 4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,816.30 | $3,027.16 | 10.8× |
| Cta Abdomen (74175) | $1,816.30 | $3,027.16 | 10.8× |
| CTA pelvis (72191) | $1,815.40 | $3,025.66 | 10.8× |
| Esophagram (74220) | $283.41 | $472.35 | 1.7× |
| Fluoroscopy up to 1 hr (76000) | $302.81 | $504.68 | 1.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$153.17–$226.24 | $255.29–$377.07 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$115.94–$198.35 | $193.24–$330.58 | varies |
| Hand 2 views (73120) range across 7 matching MRF lines |
$33.74–$278.31 | $56.24–$463.85 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$139.21–$296.37 | $232.01–$493.95 | varies |
| Magnetic Image Jaw Joint (70336) | $1,913.34 | $3,188.90 | 8.4× |
| Medical physics dose eval radiation expos w/rprt (76145) | $941.74 | $1,569.57 | 2.6× |
| MRA head w/o contrast (70544) | $1,787.35 | $2,978.91 | 7.8× |
| MRA head with contrast (70545) | $982.99 | $1,638.32 | 2.9× |
| MRA neck w contrast (70548) | $2,025.47 | $3,375.79 | 6.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,054.28 | $3,423.80 | 6.1× |
| MRA neck w/o contrast (70547) | $1,787.35 | $2,978.91 | 7.8× |
| MRI abdomen w contrast (74182) | $1,935.65 | $3,226.09 | 5.8× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,913.34–$2,336.36 | $3,188.90–$3,893.94 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,124.36 | $3,540.60 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,124.36 | $3,540.60 | 6.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,124.36 | $3,540.60 | 2.8× |
| MRI brain functional w/o physician admnistration (70554) | $2,156.88 | $3,594.80 | 9.4× |
| MRI cervical spine w contrast (72142) | $1,787.35 | $2,978.91 | 5.3× |
| MRI cervical spine w/o cont (72141) | $2,155.37 | $3,592.28 | 9.4× |
| MRI chest w/o contrast (71550) | $1,913.34 | $3,188.90 | 8.4× |
| MRI chest with contrast (71551) | $2,124.36 | $3,540.60 | 2.8× |
| MRI chest wo w contrast (71552) | $2,124.36 | $3,540.60 | 6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,124.36 | $3,540.60 | 6.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,124.36 | $3,540.60 | 6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,913.34 | $3,188.90 | 8.4× |
| MRI lumbar spine w contrast (72149) | $1,913.34 | $3,188.90 | 5.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,155.37 | $3,592.28 | 6.4× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,702.22–$1,787.35 | $2,837.04–$2,978.91 | varies |
| MRI orbit face neck w contrast (70542) | $2,025.47 | $3,375.79 | 6.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,155.37 | $3,592.28 | 6.4× |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$1,134.11–$2,124.36 | $1,890.19–$3,540.60 | varies |
| MRI pelvis w/o & w contrast (72197) | $2,124.36 | $3,540.60 | 6.3× |
| MRI pelvis w/o contrast (72195) | $1,913.34 | $3,188.90 | 8.4× |
| MRI thoracic spine w/o contrast (72146) | $2,124.36 | $3,540.60 | 9.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,124.36 | $3,540.60 | 6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 9 matching MRF lines |
$1,743.38–$1,913.34 | $2,905.63–$3,188.90 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 10 matching MRF lines |
$2,075.48–$2,124.36 | $3,459.14–$3,540.60 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$290.96–$2,124.36 | $484.94–$3,540.60 | varies |
| MRI, dorsal spine combo (72157) | $2,124.36 | $3,540.60 | 6.3× |
| MRI, dorsal spine contrast (72147) | $1,913.34 | $3,188.90 | 5.7× |
| MRI, joint upper extrem (73221) | $1,913.34 | $3,188.90 | 8.4× |
| MRI, joint upper extrem combo (73223) | $2,124.36 | $3,540.60 | 6.3× |
| MRI, lumbar spine combo (72158) | $2,124.36 | $3,540.60 | 6.3× |
| Neck soft tissue (70360) | $200.74 | $334.57 | 2.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $99.17 | $165.29 | 1.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) range across 2 matching MRF lines |
$45.22–$202.69 | $75.36–$337.81 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $18.64 | $31.07 | 0.7× |
| Optic foramina (70190) | $456.36 | $760.60 | 5.5× |
| Pelvis 1 or 2 views (72170) | $223.15 | $371.92 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $329.75 | $549.58 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $433.89 | $723.15 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$223.15–$300.10 | $371.92–$500.17 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$198.35–$371.78 | $330.58–$619.64 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$9.74–$198.35 | $16.23–$330.58 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$245.04–$287.32 | $408.40–$478.87 | varies |
| Radex fingr minimum 2 views (73140) | $157.52 | $262.53 | 1.9× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$9.65–$363.83 | $16.09–$606.38 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$207.10–$300.10 | $345.16–$500.17 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $171.28 | $285.46 | 2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $207.10 | $345.16 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $169.15 | $281.91 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$10.50–$278.42 | $17.50–$464.03 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $202.74 | $337.90 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $184.03 | $306.72 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $258.15 | $430.25 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $319.13 | $531.89 | 3.8× |
| Radex Toe Minimum 2 Views (73660) | $157.52 | $262.53 | 1.9× |
| Radex upper extremity infant minimum 2 views (73092) | $157.52 | $262.53 | 1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$43.58–$343.09 | $72.64–$571.81 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $543.25 | $905.42 | 5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $259.55 | $432.59 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $463.75 | $772.92 | 2.8× |
| Radiologic exam colon single contrast study (74270) | $446.58 | $744.30 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$187.50–$294.62 | $312.50–$491.03 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $312.12 | $520.20 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $334.93 | $558.21 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $265.15 | $441.92 | 1.6× |
| Radiologic examination femur 1 view (73551) | $171.98 | $286.64 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$171.98–$257.96 | $286.64–$429.94 | varies |
| Radiologic examination knee 1/2 views (73560) | $207.10 | $345.16 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$121.27–$362.23 | $202.11–$603.71 | varies |
| Ribs bilateral 3 views (71110) | $327.65 | $546.08 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,501.50 | $4,169.17 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,501.50 | $4,169.17 | 4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,837.67 | $4,729.45 | 2.1× |
| Scapula (73010) | $255.23 | $425.39 | 2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $182.97 | $304.95 | 7.8× |
| Sella turcica (70240) | $145.75 | $242.92 | 1.7× |
| Shoulder 1 view (73020) | $159.57 | $265.95 | 1.9× |
| Shoulder Arthrography (73040) | $304.88 | $508.13 | 0.9× |
| Skull less than 4 views (70250) | $274.45 | $457.42 | 2.7× |
| Sternoclavicular joints (71130) | $239.34 | $398.90 | 2.9× |
| Thoracic spine 2 views (72070) | $258.15 | $430.25 | 2.6× |
| Thoracic spine 3 views (72072) | $258.15 | $430.25 | 2.6× |
| Thoracolumbar 2 views (72080) | $258.15 | $430.25 | 3.1× |
| Ultrasound Breast Limited (76642) | $355.09 | $591.82 | 4.3× |
| Ultrasound Exam Aaa Screen (76706) | $190.89 | $318.15 | 1.9× |
| Ultrasound, abdomen limited (76705) | $604.46 | $1,007.44 | 6.0× |
| Upper gi w/o kub (74240) | $352.11 | $586.85 | 2.1× |
| Us chest (76604) | $381.79 | $636.31 | 3.8× |
| Us complete joint (76881) | $117.82 | $196.37 | 1.2× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$402.37–$429.21 | $670.62–$715.35 | varies |
| Us kidney transplant (76776) | $346.58 | $577.63 | 3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$294.74–$616.61 | $491.24–$1,027.69 | varies |
| Us ob limited 1 or more fetuses (76815) | $243.28 | $405.46 | 2.4× |
| Us ob transvaginal (76817) | $240.85 | $401.42 | 2.4× |
| Us pelvic non ob complete (76856) | $420.24 | $700.40 | 4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $301.09 | $501.81 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $278.22 | $463.70 | 2.8× |
| Us retroperitoneal complete (76770) | $366.23 | $610.38 | 3.7× |
| Us retroperitoneal limited (76775) | $535.92 | $893.20 | 5.3× |
| Us scrotum and contents (76870) | $366.23 | $610.38 | 3.7× |
| Us thyroid (76536) range across 2 matching MRF lines |
$366.23–$496.18 | $610.38–$826.96 | varies |
| Us transrectal (76872) | $168.78 | $281.30 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $299.20 | $498.67 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $148.31 | $247.18 | 0.1× |
| Wrist 2 views (73100) range across 9 matching MRF lines |
$9.27–$226.24 | $15.45–$377.07 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $258.15 | $430.25 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$127.65–$198.35 | $212.75–$330.58 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $284.78 | $474.64 | 2.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $171.98 | $286.64 | 2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$12.46–$171.98 | $20.77–$286.64 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $242.17 | $403.61 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $284.78 | $474.64 | 2.8× |
| X-Ray Exam L-S Spine Bending (72114) | $536.54 | $894.23 | 5.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $221.27 | $368.78 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $402.54 | $670.90 | 4.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $245.04 | $408.40 | 2.4× |
| X-ray eye for foreign body (70030) | $149.22 | $248.70 | 1.8× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$128.72–$256.37 | $214.54–$427.29 | varies |
| X-ray IV pyelogram (ivp) (74400) | $468.04 | $780.07 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $145.75 | $242.92 | 1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $314.88 | $524.80 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $325.25 | $542.08 | 3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $233.36 | $388.93 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $255.23 | $425.39 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $312.12 | $520.20 | 3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $331.07 | $551.79 | 3.3× |
| X-Rays Bone Length Studies (77073) | $299.99 | $499.99 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $218.77 | $364.61 | 2.2× |
| Xr c-spine 4 or 5 views (72050) | $385.04 | $641.74 | 3.8× |
| Xr facial bones less than 3 views (70140) | $235.10 | $391.84 | 2.8× |
| Xr orbits complete 4 views (70200) | $155.32 | $258.87 | 1.5× |
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.