Imaging prices at UMass Memorial Health–Harrington Hospital

Southbridge, MA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $9,836 $9,836 5.9×
Abdomen 2 views (74019) $322 $322 2.6×
Acute gi blood loss imaging (78278) $1,338 $1,338 2.8×
Ankle 2 views (73600) $415 $415 4.0×
Arthrogram ankle (73615) $2,092 $2,092 5.0×
Arthrogram elbow (73085) $1,191 $1,191 2.8×
Arthrogram hip (73525) $1,303 $1,303 3.1×
Arthrogram knee (73580) $540 $540 1.3×
Arthrogram shoulder (73040) $1,265 $1,265 3.0×
Arthrogram wrist (73115) $515 $515 1.2×
Basic dosimetry (77300) $621 $621 3.9×
Bone &/Joint Imaging Limited Area (78300) $961 $961 2.0×
Bone &/joint imaging whole body (78306) $1,468 $1,468 3.1×
Bone age studies (77072) $407 $407 3.2×
Bone Imaging 3 Phase (78315) $1,591 $1,591 3.3×
Bone survey complete (77075) $1,355 $1,355 10.8×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $1,269 $1,269 2.6×
Brain Imaging Vascular Flow Only (78610) $1,582.40 $1,582.40 2.4×
Cervical spine 2 or 3 views (72040) $493 $493 4.7×
Chest 1 view (71045) $13,583.17 $13,583.17 130.2×
Chest xray 3 views (71047) $407 $407 3.9×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $529 $529 2.5×
Clavicle complete (73000) $444 $444 4.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,687 $1,687 13.5×
Continuing medical physics consltj pr wk (77336) $1,041 $1,041 6.5×
CT abdomen and pelvis without and with contrast (74178) $4,717 $4,717 11.3×
CT abdomen and pelvis without contrast (74176) $3,478 $3,478 12.2×
CT abdomen w contrast (74160) $3,332 $3,332 15.9×
CT abdomen w wo contrast (74170) $4,717 $4,717 22.4×
CT abdomen w/o contrast (74150) $2,781 $2,781 22.2×
CT angio lwr extr w/o&w/dye (73706) $1,783 $1,783 8.5×
CT angiography upper extremity lt (73206) $1,565 $1,565 7.4×
CT c-spine w/contrast (72126) $2,341 $2,341 5.6×
CT c-spine w/o contrast (72125) $2,030 $2,030 16.2×
CT cere prfu aly c+wo CT/CTA (70473) $2,830 $2,830 13.5×
CT cervical spine w&w/o contrast (72127) $2,964 $2,964 14.1×
CT chest w contrast (71260) $6,489.35 $6,489.35 30.9×
CT chest w/wo contrast (71270) $3,147 $3,147 15.0×
CT colonography screening (74263) $1,468 $1,468 5.1×
CT colonography w/dye (74262) $2,143 $2,143 10.2×
CT colonography w/o cntrst (74261) $1,514 $1,514 12.1×
CT head/brain with contrast (70460) $2,408 $2,408 11.5×
CT head/brain without and with contrast (70470) $2,735 $2,735 13.0×
CT heart w/o contrast quant eval coronary calcium (75571) $61 $61 0.6×
CT iac w contrast (70481) $2,884 $2,884 13.7×
CT lower ext w/o (73700) $1,883 $1,883 15.0×
CT lower extremity w wo contrast (73702) $2,673 $2,673 12.7×
CT lower extremity w/contrast material (73701) $2,186 $2,186 10.4×
CT lumbar spine w/contrast (72132) $2,079 $2,079 5.0×
CT lumbar spine w/o contrast (72131) $1,740 $1,740 13.9×
CT maxillofacial w contrast (70487) $3,089 $3,089 14.7×
CT maxillofacial w/wo contrast (70488) $4,063 $4,063 19.3×
CT maxillofacial wo contrast (70486) $2,610 $2,610 20.8×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $3,022 $3,022 14.4×
CT orbits w/o contrast (70480) $2,517 $2,517 20.1×
CT pelvis w/o contrast (72192) $2,466 $2,466 19.7×
CT pelvis w/wo contrast (72194) $4,111 $4,111 19.6×
CT soft tissue neck w contrast (70491) $2,113 $2,113 10.1×
CT soft tissue neck w/o & w/contrast material (70492) $2,764 $2,764 13.1×
CT soft tissue neck w/o contrast (70490) $1,605.50 $1,605.50 12.8×
CT thoracic spine w/contrast (72129) $2,094 $2,094 10.0×
CT thoracic spine w/o contrast (72128) $1,752 $1,752 14.0×
CT thorax w/o contrast (71250) $1,687 $1,687 13.5×
CT upper ext wo (73200) $2,006 $2,006 16.0×
CT upper extremity with contrast (73201) $2,451 $2,451 5.9×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $2,848 $2,848 13.5×
Cta Abdomen (74175) $4,717 $4,717 22.4×
CTA abdomen pelvis (74174) $4,876.35 $4,876.35 11.7×
CTA chest (71275) $3,359.28 $3,359.28 16.0×
Cta Head (70496) $2,830 $2,830 13.5×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,830 $2,830 6.8×
Cta Neck (70498) $2,830 $2,830 13.5×
Cta Pelvis (72191) $2,848 $2,848 13.5×
Cystography minimum 3 views rs&i (74430) $1,061 $1,061 2.5×
Dxa bone density study 1/> sites axial skel (77080) $1,036 $1,036 8.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $1,036 $1,036 9.9×
Dxa bone density study axial skeleton (77085) $1,334 $1,334 10.6×
Esophagus (74220) $717 $717 3.4×
Facial bones min 3 views (70150) $578 $578 4.6×
Fluoroscopy up to 1 hr (76000) $750 $750 2.6×
Foot 2 views (73620) $490 $490 4.7×
Forearm 2 views (73090) $1,237 $1,237 11.9×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $1,220 $1,220 2.5×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $1,578 $1,578 2.4×
Hand 2 views (73120) $417 $417 3.3×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,779 $1,779 2.7×
Hepatobiliary syst imaging including gallbladder (78226) $1,841 $1,841 3.8×
Kidney imaging morphology (78700) $1,777 $1,777 3.7×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,596 $1,596 2.5×
Kidney img morphology vascular flow 1 w/rx (78708) $1,596 $1,596 2.5×
Knee 3 views (73562) $1,142 $1,142 11.0×
Lung perf&ventilat diferentl (78598) $1,802 $1,802 2.8×
Lung perfusion differential (78597) $1,152 $1,152 2.4×
Lymphoscintigraphy (78195) $29,178.88 $29,178.88 44.8×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $2,539 $2,539 2.7×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $2,442 $2,442 5.8×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $3,373 $3,373 8.1×
Mlc imrt design & construction per imrt plan (77338) $4,946 $4,946 11.0×
Mr safety determination physician/other qhp (76016) $663 $663 6.4×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $143 $143 4.1×
Mr safety implt electronics prepj supvj phys/qhp (76018) $1,078 $1,078 9.5×
Mr safety implt pos&/immoblj (76019) $222 $222 3.1×
MRA head w & w/o contrast (70546) $5,257 $5,257 12.6×
MRA head w/o contrast (70544) $3,818 $3,818 13.4×
Mra Neck W/O &W/Contrast Material (70549) $5,257 $5,257 12.6×
MRA neck w/o contrast (70547) $3,675 $3,675 12.9×
MRI abdomen w contrast (74182) $3,321 $3,321 7.9×
MRI abdomen w/o & w/contrast material (74183) $4,006 $4,006 9.6×
MRI abdomen w/o contrast (74181) $3,100 $3,100 10.8×
MRI any jt lower extrem w/contrast material (73722) $4,231 $4,231 4.5×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,405 $4,405 10.5×
MRI breast w/o contrast bilateral (77047) $6,255 $6,255 21.9×
MRI c-spine with contrast (72142) $4,526 $4,526 10.8×
MRI cervical spine w/o contrast (72141) $3,889 $3,889 13.6×
MRI chest w/o & w/contrast material (71552) $3,211 $3,211 7.7×
MRI chest w/o contrast (71550) $2,360 $2,360 8.3×
MRI chest with contrast (71551) $2,327 $2,327 2.5×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,877 $3,877 9.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $5,352 $5,352 12.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,889 $3,889 13.6×
MRI orbit face &/neck w/o contrast (70540) $3,675 $3,675 12.9×
MRI orbit face neck w contrast (70542) $3,877 $3,877 9.3×
MRI orbit/face/neck w&w/o cont (70543) $5,257 $5,257 12.6×
MRI pelvis w/o & w/contrast material (72197) $5,352 $5,352 12.8×
MRI pelvis w/o contrast (72195) $3,744 $3,744 13.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $5,352 $5,352 12.8×
MRI spinal canal lumbar w/contrast material (72149) $4,064 $4,064 9.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $5,352 $5,352 12.8×
MRI spinal canal thoracic w/contrast matrl (72147) $2,535 $2,535 6.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,211 $3,211 7.7×
MRI temporomandibular joint (70336) $3,568 $3,568 12.5×
MRI thoracic spine w/o contrast (72146) $2,335 $2,335 8.2×
MRI up ext w/o contrast (73218) $2,247 $2,247 7.9×
MRI upper ext joint w/o contrast (73221) $3,100 $3,100 10.8×
MRI, joint upper extrem combo (73223) $3,211 $3,211 7.7×
Myocardial Spect Multiple Studies (78452) $5,371 $5,371 3.5×
Myocardial spect single study at rest or stress (78451) $4,560 $4,560 2.9×
Neck soft tissue (70360) $400 $400 3.8×
Nm cardiac blood pool multiple (78473) $1,281 $1,281 2.7×
Nm gastric emptying study (78264) $1,545 $1,545 3.2×
Ntsty modul radthx pln dose-vol histos (77301) $5,847 $5,847 3.5×
Osseous survey limited (77074) $750 $750 6.0×
Parathyrd planar w/spect&CT (78072) $3,293 $3,293 5.1×
Parathyroid Planar Imaging (78070) $1,695 $1,695 3.5×
Pelvis 1 or 2 views (72170) $453 $453 3.6×
Pulmonary Perfusion Imaging Particulate (78580) $1,420 $1,420 3.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,802 $1,802 2.8×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $1,561 $1,561 1.4×
Radex Ankle Compl Minimum 3 Views (73610) $550 $550 5.3×
Radex Calcaneus Minimum 2 Views (73650) $406 $406 3.9×
Radex Elbw Compl Minimum 3 Views (73080) $644 $644 6.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $495 $495 4.7×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $746 $746 6.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $998 $998 8.0×
Radex fingr minimum 2 views (73140) $407 $407 3.9×
Radex Foot Compl Minimum 3 Views (73630) $532 $532 5.1×
Radex Hand Minimum 3 Views (73130) $520 $520 5.0×
Radex Hip Unilateral With Pelvis 1 View (73501) $57,140.39 $57,140.39 547.9×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $727 $727 5.8×
Radex Hips Bilateral With Pelvis 2 Views (73521) $602 $602 4.8×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $998 $998 8.0×
Radex Humerus Minimum 2 Views (73060) $325 $325 3.1×
Radex Kne 1/2 Views (73560) $51,556.50 $51,556.50 494.4×
Radex Kne Compl 4/More Views (73564) $644 $644 5.1×
Radex Mndbl Compl Minimum 4 Views (70110) $528 $528 4.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $452 $452 4.3×
Radex Pelvis Compl Minimum 3 Views (72190) $343 $343 2.7×
Radex Sho Compl Minimum 2 Views (73030) $910 $910 8.7×
Radex Sinuses Paransl < 3 Views (70210) $513 $513 4.9×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $730 $730 5.8×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $583 $583 5.6×
Radex Toe Minimum 2 Views (73660) $306 $306 2.9×
Radex Wrst Compl Minimum 3 Views (73110) $1,012 $1,012 9.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,142 $1,142 9.1×
Radiation treatment delivery level 1 (77402) $5,470 $5,470 44.7×
Radiation treatment delivery level 2 (77407) $6,860 $6,860 14.8×
Radiation treatment delivery level 3 (77412) $6,927 $6,927 10.5×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $273 $273 2.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $506 $506 4.0×
Radiologic exam chest 2 views (71046) $10,261.33 $10,261.33 98.4×
Radiologic exam colon single contrast study (74270) $822 $822 3.9×
Radiologic Exam Esophagus Double Contrast Study (74221) $657 $657 3.1×
Radiologic exam upr gi trc double contrast study (74246) $1,605 $1,605 7.6×
Radiologic exam upr gi trc single contrast study (74240) $815 $815 3.9×
Radiologic examination femur 1 view (73551) $400 $400 3.8×
Radiologic examination tibia & fibula 2 views (73590) $959.50 $959.50 9.2×
Radiological examination surgical specimen (76098) $26,138.47 $26,138.47 39.9×
Ribs bilateral 3 views (71110) $690 $690 5.5×
Rp loclzj tum spect 1 area single day imaging (78803) $2,471 $2,471 3.8×
Sacroiliac Joints < 3 Views (72200) $363 $363 2.9×
Scapula (73010) $657 $657 5.2×
Screening Digital Breast Tomosynthesis Bi (77063) $182 $182 7.8×
Shoulder 1 view (73020) $66,300.38 $66,300.38 635.7×
Small bowel series (74250) $826 $826 3.9×
Special treatment procedure (77470) $2,533 $2,533 3.8×
Spine thoracic 3 views (72072) $981 $981 7.8×
Tbs technical calculation only (77091) $289 $289 2.8×
Telethx isodose pln cplx w/basic dosimetry (77307) $6,939 $6,939 15.5×
Ther rad simulaj-aided field setting complex (77290) $2,350 $2,350 5.2×
Ther rad simulaj-aided field setting simple (77280) $674 $674 4.2×
Thoracolumbar 2 views (72080) $432.88 $432.88 4.2×
Thyroid imaging w/blood flow (78013) $837 $837 1.7×
Thyroid uptake measurement (78012) $1,141 $1,141 2.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,299 $1,299 2.7×
Tmj unilateral (70328) $504 $504 4.8×
Treatment device complex (77334) $1,466 $1,466 3.3×
Treatment devices simple (77332) $754 $754 4.7×
Ultrasound breast complete (76641) $1,084 $1,084 8.7×
Ultrasound Exam Aaa Screen (76706) $1,379 $1,379 11.0×
Ultrasound, abdomen limited (76705) $1,568 $1,568 12.5×
Urethrocystogram voiding (74455) $742 $742 2.6×
Us breast unilateral limited (76642) $510 $510 4.9×
Us chest (76604) $857 $857 6.8×
Us compl joint r-t w/image documentation (76881) $719 $719 5.7×
Us elastography parenchyma (76981) $351 $351 2.8×
Us encephalogram (76506) $1,587 $1,587 12.7×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,169 $1,169 9.3×
Us ob limited (76815) $780 $780 6.2×
Us ob transvaginal (76817) $636 $636 5.1×
Us pelvic non ob complete (76856) $2,596 $2,596 20.7×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $694 $694 5.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $507 $507 4.0×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $1,058 $1,058 8.4×
Us retroperitoneal complete (76770) $1,379 $1,379 11.0×
Us retroperitoneal limited (76775) $1,327 $1,327 10.6×
Us scrotum and contents (76870) $1,045 $1,045 8.3×
Us soft tissue head/neck (76536) $1,233 $1,233 9.8×
Us, eye b-scan (76512) $1,114 $1,114 8.9×
Wrist 2 views (73100) $485 $485 4.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $456 $456 3.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $443 $443 4.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $509 $509 4.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $717 $717 6.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $811 $811 6.5×
X-ray exam of femur 2/> (73552) $555 $555 5.3×
X-ray eye for foreign body (70030) $407 $407 3.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $548 $548 5.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $345 $345 3.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $314 $314 3.0×
X-ray leg, infant (73592) $318 $318 3.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $628 $628 5.0×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $916 $916 7.3×
X-ray nose-rectum child f.b. (76010) $355 $355 3.4×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $672 $672 5.4×
X-ray retrograde pyelogram (74420) $941 $941 2.3×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $583 $583 5.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $667 $667 5.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $947 $947 7.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $607 $607 4.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $426 $426 4.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $594 $594 5.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $803 $803 6.4×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $544 $544 4.3×
X-Ray Spine One View - Xr Spine (72020) $396 $396 3.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $886 $886 8.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $463 $463 4.4×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $520 $520 4.2×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $1,018 $1,018 8.1×
Xr bone length studies (77073) $649 $649 5.2×
Xr c-spine 4 or 5 views (72050) $616 $616 4.9×
Xr c-spine 6 or more views (72052) $651 $651 5.2×
Xr chest 4+ views (71048) $506 $506 4.0×