Imaging prices at Vandalia Health Mon Stonewall Jackson Memorial Hospital
Weston, WV · every code in this section with a posted price and a Medicare benchmark.
206 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) | $250.24 | $500.47 | 3.0× |
| Abdomen 2 views (74019) | $302.75 | $605.49 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,135.75 | $2,271.50 | 3.0× |
| Ankle 2 views (73600) | $250.24 | $500.47 | 3.0× |
| Bone age studies (77072) | $302.75 | $605.49 | 3.0× |
| Bone Imaging 3 Phase (78315) | $1,135.75 | $2,271.50 | 3.0× |
| Bone Imaging Whole Body (78306) | $1,135.75 | $2,271.50 | 3.0× |
| Chest 1 view (71045) | $250.24 | $500.47 | 3.0× |
| Chest 2 views (71046) | $250.24 | $500.47 | 3.0× |
| Chest 4 or more views (71048) | $302.75 | $605.49 | 3.0× |
| Clavicle complete (73000) | $250.24 | $500.47 | 3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $302.75 | $605.49 | 3.0× |
| Contrast X-Ray Bladder (74430) | $1,059.02 | $2,118.03 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,059.02 | $2,118.03 | 3.2× |
| CT abdomen and pelvis without contrast (74176) | $674.77 | $1,349.53 | 2.9× |
| CT abdomen w contrast (74160) | $505.96 | $1,011.91 | 3.0× |
| CT abdomen w wo contrast (74170) | $505.96 | $1,011.91 | 3.0× |
| CT abdomen w/o contrast (74150) | $302.75 | $605.49 | 3.0× |
| CT Angio Abdomen and Pelvis (74174) | $1,059.02 | $2,118.03 | 3.2× |
| CT Angio Chest (71275) | $505.96 | $1,011.91 | 3.0× |
| CT Angio Head (70496) | $505.96 | $1,011.91 | 3.0× |
| CT angio hrt w/3d image (75574) | $854.05 | $1,708.10 | 2.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $505.96 | $1,011.91 | 3.0× |
| CT Angio Neck (70498) | $505.96 | $1,011.91 | 3.0× |
| CT cervical spine w/o contrast (72125) | $302.75 | $605.49 | 3.0× |
| CT cervical spine w/wo cont (72127) | $505.96 | $1,011.91 | 3.0× |
| CT chest w contrast (71260) | $505.96 | $1,011.91 | 3.0× |
| CT chest w/wo contrast (71270) | $505.96 | $1,011.91 | 3.0× |
| CT head/brain with contrast (70460) | $505.96 | $1,011.91 | 3.0× |
| CT head/brain without and with contrast (70470) | $505.96 | $1,011.91 | 3.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $854.05 | $1,708.10 | 2.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $210.57 | $421.14 | 2.5× |
| CT hrt w/3d image congen (75573) | $854.05 | $1,708.10 | 2.6× |
| CT iac w contrast (70481) | $505.96 | $1,011.91 | 3.0× |
| CT l-spine w&w/o contrast (72133) | $505.96 | $1,011.91 | 3.0× |
| CT lower ext w/o (73700) | $302.75 | $605.49 | 3.0× |
| CT lower extremity w/contrast material (73701) | $505.96 | $1,011.91 | 3.0× |
| CT lumbar spine w contrast (72132) | $1,059.02 | $2,118.03 | 3.2× |
| CT lumbar spine w/o contrast (72131) | $302.75 | $605.49 | 3.0× |
| CT maxillofacial w contrast (70487) | $505.96 | $1,011.91 | 3.0× |
| CT maxillofacial wo contrast (70486) | $302.75 | $605.49 | 3.0× |
| CT neck tissue combo (70492) | $505.96 | $1,011.91 | 3.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $505.96 | $1,011.91 | 3.0× |
| CT orbits w/o contrast (70480) | $302.75 | $605.49 | 3.0× |
| CT pelvis w&w/o contrast (72194) | $505.96 | $1,011.91 | 3.0× |
| CT pelvis w/o contrast (72192) | $302.75 | $605.49 | 3.0× |
| CT scan of leg combo (73702) | $505.96 | $1,011.91 | 3.0× |
| CT scans face/jaw combo (70488) | $505.96 | $1,011.91 | 3.0× |
| CT soft tissue neck w contrast (70491) | $505.96 | $1,011.91 | 3.0× |
| CT soft tissue neck w/o contrast (70490) | $302.75 | $605.49 | 3.0× |
| CT thoracic spine w/o contrast (72128) | $302.75 | $605.49 | 3.0× |
| CT thoracic spine w/wo cont (72130) | $505.96 | $1,011.91 | 3.0× |
| CT thorax w/o contrast (71250) | $302.75 | $605.49 | 3.0× |
| CT upper ext wo (73200) | $302.75 | $605.49 | 3.0× |
| CT upper extremity w/o & w/contrast material (73202) | $505.96 | $1,011.91 | 3.0× |
| CT upper extremity with contrast (73201) | $1,059.02 | $2,118.03 | 3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $505.96 | $1,011.91 | 3.0× |
| Cta Abdomen (74175) | $505.96 | $1,011.91 | 3.0× |
| Dxa Bone Density Axial (77080) | $302.75 | $605.49 | 3.0× |
| Echo exam uterus (76831) | $674.77 | $1,349.53 | 2.9× |
| Esophagram (74220) | $505.96 | $1,011.91 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $302.75 | $605.49 | 3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $302.75 | $605.49 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $674.77 | $1,349.53 | 2.9× |
| Foot 2 views (73620) | $250.24 | $500.47 | 3.0× |
| Forearm 2 views (73090) | $250.24 | $500.47 | 3.0× |
| Gastric emptying imaging study (78264) | $1,135.75 | $2,271.50 | 3.0× |
| Gated Heart Planar Single (78472) | $1,135.75 | $2,271.50 | 3.0× |
| Hand 2 views (73120) | $302.75 | $605.49 | 3.0× |
| Hepatobil Syst Image W/Drug (78227) | $1,488.41 | $2,976.82 | 2.9× |
| Hepatobiliary System Imaging (78226) | $1,135.75 | $2,271.50 | 3.0× |
| Ht Muscle Image Spect Sing (78451) | $3,910.20 | $7,820.40 | 3.1× |
| Hysterosalpingogram (74740) | $674.77 | $1,349.53 | 2.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $250.24 | $500.47 | 3.0× |
| Joint Survey Single View (77077) | $302.75 | $605.49 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $1,488.41 | $2,976.82 | 2.9× |
| Knee 3 Views (73562) | $250.24 | $500.47 | 3.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,135.75 | $2,271.50 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,488.41 | $2,976.82 | 2.9× |
| Magnetic Image Jaw Joint (70336) | $674.77 | $1,349.53 | 2.9× |
| Meckels Divert Exam (78290) | $1,135.75 | $2,271.50 | 3.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,059.02 | $2,118.03 | 3.2× |
| MRA head w/o contrast (70544) | $674.77 | $1,349.53 | 2.9× |
| MRA head with contrast (70545) | $1,059.02 | $2,118.03 | 3.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,059.02 | $2,118.03 | 3.2× |
| MRA neck w/o contrast (70547) | $674.77 | $1,349.53 | 2.9× |
| MRI abdomen w contrast (74182) | $1,059.02 | $2,118.03 | 3.2× |
| MRI abdomen w/o contrast (74181) | $674.77 | $1,349.53 | 2.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$2,069.31–$2,204.85 | $4,138.62–$4,409.70 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,059.02 | $2,118.03 | 3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,204.85 | $4,409.70 | 2.9× |
| MRI cervical spine w contrast (72142) | $1,059.02 | $2,118.03 | 3.2× |
| MRI cervical spine w/o cont (72141) | $674.77 | $1,349.53 | 2.9× |
| MRI chest w/o contrast (71550) | $674.77 | $1,349.53 | 2.9× |
| MRI chest wo w contrast (71552) | $1,059.02 | $2,118.03 | 3.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,059.02 | $2,118.03 | 3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $674.77 | $1,349.53 | 2.9× |
| MRI lumbar spine w contrast (72149) | $1,059.02 | $2,118.03 | 3.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,059.02 | $2,118.03 | 3.2× |
| MRI orbit face &/neck w/o contrast (70540) | $674.77 | $1,349.53 | 2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,059.02 | $2,118.03 | 3.2× |
| MRI pelvis w/o & w contrast (72197) | $1,059.02 | $2,118.03 | 3.2× |
| MRI pelvis w/o contrast (72195) | $674.77 | $1,349.53 | 2.9× |
| MRI thoracic spine w/o contrast (72146) | $674.77 | $1,349.53 | 2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $674.77 | $1,349.53 | 2.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,059.02 | $2,118.03 | 3.2× |
| MRI, abdomen, combo (74183) | $1,059.02 | $2,118.03 | 3.2× |
| MRI, dorsal spine combo (72157) | $1,059.02 | $2,118.03 | 3.2× |
| MRI, dorsal spine contrast (72147) | $1,059.02 | $2,118.03 | 3.2× |
| MRI, joint upper extrem (73221) | $674.77 | $1,349.53 | 2.9× |
| MRI, joint upper extrem combo (73223) | $1,059.02 | $2,118.03 | 3.2× |
| MRI, lumbar spine combo (72158) | $1,059.02 | $2,118.03 | 3.2× |
| Myocardial Spect Multiple Studies (78452) | $3,910.20 | $7,820.40 | 3.1× |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$2,174.63–$2,317.07 | $4,349.25–$4,634.13 | varies |
| Neck soft tissue (70360) | $250.24 | $500.47 | 3.0× |
| Parathyroid Planar Imaging (78070) | $1,135.75 | $2,271.50 | 3.0× |
| Pelvis 1 or 2 views (72170) | $302.75 | $605.49 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,135.75 | $2,271.50 | 3.0× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $2,031.65 | $4,063.30 | 2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $302.75 | $605.49 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,519.16 | $3,038.32 | 2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $250.24 | $500.47 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $250.24 | $500.47 | 3.0× |
| Radex elbow complete minimum 3 views (73080) | $250.24 | $500.47 | 3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $302.75 | $605.49 | 3.0× |
| Radex fingr minimum 2 views (73140) | $250.24 | $500.47 | 3.0× |
| Radex foot complete minimum 3 views (73630) | $250.24 | $500.47 | 3.0× |
| Radex Hand Minimum 3 Views (73130) | $250.24 | $500.47 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $302.75 | $605.49 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $250.24 | $500.47 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $250.24 | $500.47 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) | $250.24 | $500.47 | 3.0× |
| Radex Spine 1 View Specify Level (72020) | $250.24 | $500.47 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $250.24 | $500.47 | 3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $250.24 | $500.47 | 3.0× |
| Radex Toe Minimum 2 Views (73660) | $250.24 | $500.47 | 3.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $250.24 | $500.47 | 3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $302.75 | $605.49 | 3.0× |
| Radiologic exam colon double contrast study (74280) | $505.96 | $1,011.91 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $505.96 | $1,011.91 | 3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $505.96 | $1,011.91 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) | $302.75 | $605.49 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $505.96 | $1,011.91 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $505.96 | $1,011.91 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $505.96 | $1,011.91 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) | $250.24 | $500.47 | 3.0× |
| Radiologic examination knee 1/2 views (73560) | $250.24 | $500.47 | 3.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $302.75 | $605.49 | 3.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $250.24 | $500.47 | 3.0× |
| Ribs bilateral 3 views (71110) | $302.75 | $605.49 | 3.0× |
| Scapula (73010) | $302.75 | $605.49 | 3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $71.30 | $142.60 | 3.0× |
| Shoulder 1 view (73020) | $250.24 | $500.47 | 3.0× |
| Skull less than 4 views (70250) | $302.75 | $605.49 | 3.0× |
| Sternoclavicular joints (71130) | $250.24 | $500.47 | 3.0× |
| Thoracic spine 3 views (72072) | $302.75 | $605.49 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $1,135.75 | $2,271.50 | 3.0× |
| Thyroid Uptake Measurement (78012) | $1,135.75 | $2,271.50 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,135.75 | $2,271.50 | 3.0× |
| Ultrasound Breast Limited (76642) | $250.24 | $500.47 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $302.75 | $605.49 | 3.0× |
| Ultrasound, abdomen limited (76705) | $302.75 | $605.49 | 3.0× |
| Umbilical-artery Doppler (OB) (76820) | $302.75 | $605.49 | 3.0× |
| Upper gi w/o kub (74240) | $505.96 | $1,011.91 | 3.0× |
| Urethrocystogram voiding (74455) | $674.77 | $1,349.53 | 2.9× |
| Us breast unilateral complete (76641) | $302.75 | $605.49 | 3.0× |
| Us chest (76604) | $302.75 | $605.49 | 3.0× |
| Us complete joint (76881) | $302.75 | $605.49 | 3.0× |
| Us exam, pelvic, limited (76857) | $302.75 | $605.49 | 3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $302.75 | $605.49 | 3.0× |
| Us ob limited 1 or more fetuses (76815) | $302.75 | $605.49 | 3.0× |
| Us ob transvaginal (76817) | $302.75 | $605.49 | 3.0× |
| Us pelvic non ob complete (76856) | $302.75 | $605.49 | 3.0× |
| Us retroperitoneal complete (76770) | $302.75 | $605.49 | 3.0× |
| Us retroperitoneal limited (76775) | $302.75 | $605.49 | 3.0× |
| Us scrotum and contents (76870) | $302.75 | $605.49 | 3.0× |
| Us thyroid (76536) | $302.75 | $605.49 | 3.0× |
| Venography extremity unilateral rs&i (75820) | $4,410.20 | $8,820.39 | 2.9× |
| Wrist 2 views (73100) | $250.24 | $500.47 | 3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $250.24 | $500.47 | 3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $250.24 | $500.47 | 3.0× |
| X-Ray Exam Breast Specimen (76098) | $1,519.16 | $3,038.32 | 2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $250.24 | $500.47 | 3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $302.75 | $605.49 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $250.24 | $500.47 | 3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $250.24 | $500.47 | 3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $302.75 | $605.49 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $302.75 | $605.49 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $250.24 | $500.47 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $302.75 | $605.49 | 3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $302.75 | $605.49 | 3.0× |
| X-ray humerus (73060) | $250.24 | $500.47 | 3.0× |
| X-ray IV pyelogram (ivp) (74400) | $505.96 | $1,011.91 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $250.24 | $500.47 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $302.75 | $605.49 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $302.75 | $605.49 | 3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $302.75 | $605.49 | 3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $250.24 | $500.47 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $250.24 | $500.47 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $302.75 | $605.49 | 3.0× |
| X-Ray Tmj Unilat (70328) | $250.24 | $500.47 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,059.02 | $2,118.03 | 3.2× |
| X-Rays Bone Length Studies (77073) | $302.75 | $605.49 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $302.75 | $605.49 | 3.0× |
| Xr c-spine 4 or 5 views (72050) | $302.75 | $605.49 | 3.0× |
| Xr orbits complete 4 views (70200) | $302.75 | $605.49 | 3.0× |
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.