Imaging prices at Bon Secours Southern Virginia Medical Center
Emporia, VA · every code in this section with a posted price and a Medicare benchmark.
168 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) | $422.10 | $1,407 | 5.0× |
| Abdomen 2 views (74019) | $614.40 | $2,048 | 6.0× |
| Ankle 2 views (73600) | $174 | $580 | 2.0× |
| Bone Imaging 3 Phase (78315) | $804 | $2,680 | 2.1× |
| Bone Imaging Limited Area (78300) | $1,402.50 | $4,675 | 3.6× |
| Bone Imaging Whole Body (78306) | $1,692 | $5,640 | 4.3× |
| Bone survey infant (77076) | $335.10 | $1,117 | 3.3× |
| Chest 1 view (71045) | $473.10 | $1,577 | 5.6× |
| Chest 2 views (71046) | $473.10 | $1,577 | 5.6× |
| Clavicle complete (73000) | $832.50 | $2,775 | 9.8× |
| CT abdomen and pelvis without and with contrast (74178) | $6,916.20 | $23,054 | 20.3× |
| CT abdomen and pelvis without contrast (74176) | $4,967.70 | $16,559 | 21.3× |
| CT abdomen w contrast (74160) | $861.90 | $2,873 | 5.0× |
| CT abdomen w wo contrast (74170) | $3,578.40 | $11,928 | 20.9× |
| CT abdomen w/o contrast (74150) | $2,631.60 | $8,772 | 25.8× |
| CT Angio Abdomen and Pelvis (74174) | $8,874.90 | $29,583 | 26.1× |
| CT Angio Chest (71275) | $4,437.30 | $14,791 | 25.9× |
| CT Angio Head (70496) | $4,436.10 | $14,787 | 25.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,453.80 | $4,846 | 8.5× |
| CT Angio Neck (70498) | $4,436.10 | $14,787 | 25.9× |
| CT cervical spine w/o contrast (72125) | $2,016.90 | $6,723 | 19.8× |
| CT cervical spine w/wo cont (72127) | $4,165.80 | $13,886 | 24.3× |
| CT chest w contrast (71260) | $2,930.70 | $9,769 | 17.1× |
| CT chest w/wo contrast (71270) | $5,418.60 | $18,062 | 31.7× |
| CT head/brain without and with contrast (70470) | $3,602.70 | $12,009 | 21.1× |
| CT iac w contrast (70481) | $408 | $1,360 | 2.4× |
| CT l-spine w&w/o contrast (72133) | $517.50 | $1,725 | 3.0× |
| CT lower ext w/o (73700) | $2,165.70 | $7,219 | 21.2× |
| CT lower extremity w/contrast material (73701) | $2,656.20 | $8,854 | 15.5× |
| CT lumbar spine w/o contrast (72131) | $4,352.40 | $14,508 | 42.7× |
| CT maxillofacial w contrast (70487) | $758.10 | $2,527 | 4.4× |
| CT maxillofacial wo contrast (70486) | $1,874.40 | $6,248 | 18.4× |
| CT neck tissue combo (70492) | $5,454.90 | $18,183 | 31.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,016 | $6,720 | 11.8× |
| CT orbits w/o contrast (70480) | $1,582.80 | $5,276 | 15.5× |
| CT pelvis w/o contrast (72192) | $2,336.70 | $7,789 | 22.9× |
| CT scan of leg combo (73702) | $983.10 | $3,277 | 5.7× |
| CT scans face/jaw combo (70488) | $1,388.70 | $4,629 | 8.1× |
| CT soft tissue neck w contrast (70491) | $3,633.90 | $12,113 | 21.2× |
| CT soft tissue neck w/o contrast (70490) | $2,708.10 | $9,027 | 26.6× |
| CT thoracic spine w contrast (72129) | $824.10 | $2,747 | 4.8× |
| CT thoracic spine w/o contrast (72128) | $3,485.40 | $11,618 | 34.2× |
| CT thoracic spine w/wo cont (72130) | $595.50 | $1,985 | 3.5× |
| CT thorax w/o contrast (71250) | $3,984.30 | $13,281 | 39.1× |
| CT upper ext wo (73200) | $2,502 | $8,340 | 24.5× |
| CT upper extremity w/o & w/contrast material (73202) | $495.90 | $1,653 | 2.9× |
| CT upper extremity with contrast (73201) | $2,828.10 | $9,427 | 8.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,826.60 | $9,422 | 16.5× |
| Cta Abdomen (74175) | $4,437.30 | $14,791 | 25.9× |
| CTA pelvis (72191) | $847.50 | $2,825 | 5.0× |
| Esophagram (74220) | $556.50 | $1,855 | 3.3× |
| Fluoroscopy up to 1 hr (76000) | $384.90 | $1,283 | 1.7× |
| Foot 2 views (73620) | $202.50 | $675 | 2.4× |
| Forearm 2 views (73090) | $422.10 | $1,407 | 5.0× |
| Gastric emptying imaging study (78264) | $496.20 | $1,654 | 1.3× |
| Hand 2 views (73120) | $259.50 | $865 | 2.5× |
| Hepatobil Syst Image W/Drug (78227) | $2,567.70 | $8,559 | 4.8× |
| Hepatobiliary System Imaging (78226) | $2,567.70 | $8,559 | 6.6× |
| Ht Muscle Image Spect Sing (78451) | $1,200.30 | $4,001 | 1.0× |
| Knee 3 Views (73562) | $423.30 | $1,411 | 5.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,477.70 | $8,259 | 4.7× |
| Mr safety determination physician/other qhp (76016) | $83.10 | $277 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $23.10 | $77 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $86.70 | $289 | 0.9× |
| Mr safety implt pos&/immoblj (76019) | $56.10 | $187 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $228.30 | $761 | 1.0× |
| MRA head w/o contrast (70544) | $4,781.70 | $15,939 | 20.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,354.20 | $14,514 | 12.8× |
| MRA neck w/o contrast (70547) | $376.50 | $1,255 | 1.6× |
| MRI abdomen w contrast (74182) | $1,434.90 | $4,783 | 4.2× |
| MRI abdomen w/o contrast (74181) | $2,122.50 | $7,075 | 9.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,217.10 | $4,057 | 3.6× |
| MRI cervical spine w/o cont (72141) | $4,669.20 | $15,564 | 20.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $9,555.90 | $31,853 | 28.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,511.40 | $15,038 | 19.4× |
| MRI lumbar spine w contrast (72149) | $778.50 | $2,595 | 2.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $687 | $2,290 | 2.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,997.20 | $23,324 | 20.6× |
| MRI pelvis w/o & w contrast (72197) | $5,499.90 | $18,333 | 16.2× |
| MRI pelvis w/o contrast (72195) | $797.70 | $2,659 | 3.4× |
| MRI thoracic spine w/o contrast (72146) | $5,499.90 | $18,333 | 23.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $5,499.90 | $18,333 | 23.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,361.40 | $4,538 | 4.0× |
| MRI, abdomen, combo (74183) | $4,792.80 | $15,976 | 14.1× |
| MRI, dorsal spine combo (72157) | $880.20 | $2,934 | 2.6× |
| MRI, joint upper extrem (73221) | $5,499.90 | $18,333 | 23.6× |
| MRI, lumbar spine combo (72158) | $4,545.60 | $15,152 | 13.4× |
| Myocardial Spect Multiple Studies (78452) | $3,625.80 | $12,086 | 2.9× |
| Neck soft tissue (70360) | $646.50 | $2,155 | 7.6× |
| Pelvis 1 or 2 views (72170) | $456.90 | $1,523 | 4.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $293.10 | $977 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $553.20 | $1,844 | 5.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $591.30 | $1,971 | 7.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $541.20 | $1,804 | 6.4× |
| Radex elbow complete minimum 3 views (73080) | $687 | $2,290 | 8.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $298.50 | $995 | 2.9× |
| Radex fingr minimum 2 views (73140) | $456.90 | $1,523 | 5.4× |
| Radex foot complete minimum 3 views (73630) | $591.30 | $1,971 | 7.0× |
| Radex Hand Minimum 3 Views (73130) | $591.30 | $1,971 | 7.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $270 | $900 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $614.40 | $2,048 | 7.2× |
| Radex Ribs Unilateral 2 Views (71100) | $424.50 | $1,415 | 5.0× |
| Radex shoulder complete minimum 2 views (73030) | $613.20 | $2,044 | 7.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $264.60 | $882 | 3.1× |
| Radex Spine 1 View Specify Level (72020) | $221.10 | $737 | 2.6× |
| Radex Toe Minimum 2 Views (73660) | $456.90 | $1,523 | 5.4× |
| Radex upper extremity infant minimum 2 views (73092) | $402 | $1,340 | 3.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $562.50 | $1,875 | 6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $111.60 | $372 | 1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $582.90 | $1,943 | 5.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $220.20 | $734 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) | $1,032.30 | $3,441 | 10.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $619.80 | $2,066 | 3.6× |
| Radiologic exam swallow function contrast study (74230) | $318.30 | $1,061 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $730.20 | $2,434 | 4.3× |
| Radiologic examination femur 1 view (73551) | $272.10 | $907 | 3.2× |
| Radiologic examination femur minimum 2 views (73552) | $614.40 | $2,048 | 7.2× |
| Radiologic examination knee 1/2 views (73560) | $464.40 | $1,548 | 5.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $422.10 | $1,407 | 5.0× |
| Ribs bilateral 3 views (71110) | $300 | $1,000 | 2.9× |
| Scapula (73010) | $289.50 | $965 | 2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $67.20 | $224 | 2.9× |
| Shoulder 1 view (73020) | $422.10 | $1,407 | 5.0× |
| Skull less than 4 views (70250) | $285.90 | $953 | 2.8× |
| Thoracic spine 2 views (72070) | $614.40 | $2,048 | 6.0× |
| Thoracic spine 3 views (72072) | $614.40 | $2,048 | 6.0× |
| Thoracolumbar 2 views (72080) | $47.70 | $159 | 0.6× |
| Ultrasound Breast Limited (76642) | $627 | $2,090 | 7.4× |
| Ultrasound Exam Aaa Screen (76706) | $750.30 | $2,501 | 7.4× |
| Ultrasound, abdomen limited (76705) | $1,334.40 | $4,448 | 13.1× |
| Upper gi w/o kub (74240) | $447.30 | $1,491 | 2.6× |
| Us breast unilateral complete (76641) | $627 | $2,090 | 6.1× |
| Us chest (76604) | $313.20 | $1,044 | 3.1× |
| Us exam, pelvic, limited (76857) | $886.50 | $2,955 | 8.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $372.90 | $1,243 | 3.7× |
| Us ob detailed single fetus (76811) | $2,347.50 | $7,825 | 10.1× |
| Us ob limited 1 or more fetuses (76815) | $1,334.40 | $4,448 | 13.1× |
| Us ob transvaginal (76817) | $886.80 | $2,956 | 8.7× |
| Us pelvic non ob complete (76856) | $1,334.40 | $4,448 | 13.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,334.40 | $4,448 | 13.1× |
| Us retroperitoneal complete (76770) | $1,334.40 | $4,448 | 13.1× |
| Us scrotum and contents (76870) | $1,334.40 | $4,448 | 13.1× |
| Us spinal canal and contents (76800) | $482.10 | $1,607 | 4.7× |
| Us thyroid (76536) | $879.60 | $2,932 | 8.6× |
| Wrist 2 views (73100) | $509.70 | $1,699 | 6.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $313.20 | $1,044 | 3.7× |
| X-Ray Bend Only L-S Spine (72120) | $51 | $170 | 0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $438 | $1,460 | 5.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $138.60 | $462 | 1.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $463.50 | $1,545 | 5.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $636.60 | $2,122 | 7.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $266.10 | $887 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $390.30 | $1,301 | 3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $614.40 | $2,048 | 7.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $790.80 | $2,636 | 7.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $928.20 | $3,094 | 9.1× |
| X-ray eye for foreign body (70030) | $289.80 | $966 | 3.4× |
| X-ray humerus (73060) | $832.50 | $2,775 | 9.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $90.60 | $302 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $37.50 | $125 | 0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $614.40 | $2,048 | 6.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,230.30 | $4,101 | 12.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $614.40 | $2,048 | 7.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $790.80 | $2,636 | 9.3× |
| X-Ray Tmj Unilat (70328) | $90.60 | $302 | 1.1× |
| X-Rays Bone Survey Complete (77075) | $586.50 | $1,955 | 5.8× |
| Xr c-spine 4 or 5 views (72050) | $830.40 | $2,768 | 8.1× |
| Xr facial bones less than 3 views (70140) | $625.80 | $2,086 | 7.4× |