Imaging prices at Valley Regional Hospital
Claremont, NH · every code in this section with a posted price and a Medicare benchmark.
237 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) | $177.10 | $322 | 1.9× |
| Abdomen 2 views (74019) | $215.05 | $391 | 1.9× |
| Ankle 2 views (73600) | $157.30 | $286 | 1.7× |
| Arthrogram ankle (73615) | $692.45 | $1,259 | 1.9× |
| Arthrogram hip (73525) | $660 | $1,200 | 1.8× |
| Arthrogram Wrist (73115) | $297 | $540 | 0.8× |
| Bone age studies (77072) | $139.15 | $253 | 1.2× |
| Bone Imaging 3 Phase (78315) | $706.20 | $1,284 | 1.7× |
| Bone Imaging Limited Area (78300) | $368.50 | $670 | 0.9× |
| Bone Imaging Multiple Areas (78305) | $541.20 | $984 | 1.3× |
| Bone survey infant (77076) | $310.20 | $564 | 2.8× |
| Chest 1 view (71045) | $146.30 | $266 | 1.6× |
| Chest 2 views (71046) range across 7 matching MRF lines |
$194.70–$308 | $354–$560 | varies |
| Chest 3 views (71047) | $181.50 | $330 | 2.0× |
| Chest 4 or more views (71048) | $181.50 | $330 | 1.6× |
| Clavicle complete (73000) | $202.40 | $368 | 2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $787.05 | $1,431 | 7.1× |
| Contrast X-Ray Bladder (74430) | $194.15 | $353 | 0.5× |
| Contrast X-Ray Of Elbow (73085) | $506 | $920 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $603.35 | $1,097 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) | $3,017.30 | $5,486 | 8.1× |
| CT abdomen and pelvis without contrast (74176) | $2,060.30 | $3,746 | 8.1× |
| CT abdomen w contrast (74160) | $1,602.70 | $2,914 | 8.6× |
| CT abdomen w wo contrast (74170) | $1,735.80 | $3,156 | 9.3× |
| CT abdomen w/o contrast (74150) | $1,007.60 | $1,832 | 9.0× |
| CT Angio Abdomen and Pelvis (74174) | $2,528.90 | $4,598 | 6.8× |
| CT Angio Chest (71275) | $1,883.75 | $3,425 | 10.1× |
| CT Angio Head (70496) | $1,871.10 | $3,402 | 10.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,910.70 | $3,474 | 10.2× |
| CT Angio Neck (70498) | $1,857.90 | $3,378 | 9.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,602.70 | $2,914 | 8.6× |
| CT cervical spine w/ contrast (72126) | $1,518.55 | $2,761 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,052.70 | $1,914 | 9.4× |
| CT cervical spine w/wo cont (72127) | $1,722.05 | $3,131 | 9.2× |
| CT chest w contrast (71260) | $1,507.55 | $2,741 | 8.0× |
| CT chest w/wo contrast (71270) | $1,722.05 | $3,131 | 9.2× |
| CT head/brain with contrast (70460) | $1,007.60 | $1,832 | 5.4× |
| CT head/brain without and with contrast (70470) | $1,258.95 | $2,289 | 6.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,111.55 | $2,021 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $630.30 | $1,146 | 6.8× |
| CT iac w contrast (70481) | $1,007.60 | $1,832 | 5.4× |
| CT l-spine w&w/o contrast (72133) | $1,690.15 | $3,073 | 9.0× |
| CT lower ext w/o (73700) range across 5 matching MRF lines |
$253–$987.80 | $460–$1,796 | varies |
| CT lower extremity w/contrast material (73701) | $1,403.05 | $2,551 | 7.5× |
| CT lumbar spine w contrast (72132) | $1,452 | $2,640 | 3.9× |
| CT lumbar spine w/o contrast (72131) | $1,052.70 | $1,914 | 9.4× |
| CT maxillofacial w contrast (70487) | $1,007.60 | $1,832 | 5.4× |
| CT maxillofacial wo contrast (70486) | $876.70 | $1,594 | 7.9× |
| CT neck tissue combo (70492) | $1,258.95 | $2,289 | 6.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,258.95 | $2,289 | 6.7× |
| CT orbits w/o contrast (70480) | $839.85 | $1,527 | 7.5× |
| CT pelvis w&w/o contrast (72194) | $1,674.75 | $3,045 | 8.9× |
| CT pelvis w/o contrast (72192) | $987.80 | $1,796 | 8.8× |
| CT scan of leg combo (73702) | $1,596.65 | $2,903 | 8.5× |
| CT scans face/jaw combo (70488) | $1,280.95 | $2,329 | 6.8× |
| CT soft tissue neck w contrast (70491) | $1,187.45 | $2,159 | 6.3× |
| CT soft tissue neck w/o contrast (70490) | $893.20 | $1,624 | 8.0× |
| CT thoracic spine w contrast (72129) | $1,474 | $2,680 | 7.9× |
| CT thoracic spine w/o contrast (72128) | $1,052.70 | $1,914 | 9.4× |
| CT thorax w/o contrast (71250) | $1,052.70 | $1,914 | 9.4× |
| CT upper ext wo (73200) | $1,012.55 | $1,841 | 9.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,958.55 | $3,561 | 10.5× |
| CT upper extremity with contrast (73201) | $1,478.95 | $2,689 | 4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,383.70 | $4,334 | 12.7× |
| Cta Abdomen (74175) | $1,862.85 | $3,387 | 9.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,800.05 | $5,091 | 7.5× |
| CTA pelvis (72191) | $1,560.90 | $2,838 | 8.3× |
| Dxa Bone Density Axial (77080) | $282.70 | $514 | 2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $142.45 | $259 | 1.5× |
| Echo exam uterus (76831) | $385.55 | $701 | 1.5× |
| Esophagram (74220) | $519.75 | $945 | 2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $341 | $620 | 3.1× |
| Fluoroscopy up to 1 hr (76000) | $348.70 | $634 | 1.4× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$165.55–$331.10 | $301–$602 | varies |
| Forearm 2 views (73090) | $181.50 | $330 | 2.0× |
| Gated Heart Planar Single (78472) | $816.20 | $1,484 | 1.9× |
| Hand 2 views (73120) | $194.70 | $354 | 1.7× |
| Ht Musc Image Planar Mult (78454) | $452.10 | $822 | 0.3× |
| Hysterosalpingogram (74740) range across 6 matching MRF lines |
$96.25–$477.40 | $175–$868 | varies |
| Joint Survey Single View (77077) | $190.30 | $346 | 1.7× |
| K Flow/Funct Image W/O Drug (78707) | $660 | $1,200 | 1.1× |
| Kidney Imaging Morphol (78700) | $451.55 | $821 | 1.1× |
| Knee 3 Views (73562) | $262.35 | $477 | 2.8× |
| Lung Perf&Ventilat Diferentl (78598) | $620.95 | $1,129 | 1.1× |
| Lung perfusion differential (78597) | $506.55 | $921 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,993.20 | $3,624 | 7.8× |
| Mammary ductogram or galactogram multiple (77054) | $488.40 | $888 | 1.9× |
| Mammary ductogram or galactogram single (77053) | $377.30 | $686 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) | $3,889.60 | $7,072 | 10.4× |
| MRA head w/o contrast (70544) | $1,993.20 | $3,624 | 7.8× |
| MRA head with contrast (70545) | $2,922.70 | $5,314 | 7.8× |
| MRA neck w contrast (70548) | $2,511.30 | $4,566 | 6.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,889.60 | $7,072 | 10.4× |
| MRA neck w/o contrast (70547) | $1,993.20 | $3,624 | 7.8× |
| MRI abdomen w contrast (74182) | $2,289.65 | $4,163 | 6.1× |
| MRI abdomen w/o contrast (74181) | $2,019.05 | $3,671 | 7.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,408.45 | $4,379 | 2.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,281.30 | $5,966 | 8.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,351.80 | $4,276 | 2.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,483.25 | $4,515 | 9.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,971.20 | $3,584 | 7.7× |
| MRI cervical spine w contrast (72142) | $2,390.30 | $4,346 | 6.4× |
| MRI cervical spine w/o cont (72141) | $1,993.20 | $3,624 | 7.8× |
| MRI chest w/o contrast (71550) | $1,971.20 | $3,584 | 7.7× |
| MRI chest with contrast (71551) | $2,360.60 | $4,292 | 2.8× |
| MRI chest wo w contrast (71552) | $3,397.35 | $6,177 | 9.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,922.70 | $5,314 | 7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,573.35 | $6,497 | 9.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,959.10 | $3,562 | 7.7× |
| MRI lumbar spine w contrast (72149) | $2,086.70 | $3,794 | 5.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,073.40 | $5,588 | 8.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,959.10 | $3,562 | 7.7× |
| MRI orbit face neck w contrast (70542) | $2,351.80 | $4,276 | 6.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$3,479.30–$3,551.35 | $6,326–$6,457 | varies |
| MRI pelvis w contrast (72196) | $2,360.60 | $4,292 | 6.3× |
| MRI pelvis w/o & w contrast (72197) | $3,547.50 | $6,450 | 9.5× |
| MRI pelvis w/o contrast (72195) | $1,971.20 | $3,584 | 7.7× |
| MRI thoracic spine w/o contrast (72146) | $2,024.55 | $3,681 | 7.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,922.70 | $5,314 | 7.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,969 | $3,580 | 7.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,547.50 | $6,450 | 9.5× |
| MRI, abdomen, combo (74183) | $3,556.85 | $6,467 | 9.5× |
| MRI, dorsal spine combo (72157) | $2,955.15 | $5,373 | 7.9× |
| MRI, dorsal spine contrast (72147) | $2,390.30 | $4,346 | 6.4× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$1,897.50–$3,793.90 | $3,450–$6,898 | varies |
| MRI, joint upper extrem combo (73223) | $2,862.20 | $5,204 | 7.7× |
| MRI, lumbar spine combo (72158) range across 4 matching MRF lines |
$3,131.70–$3,200.45 | $5,694–$5,819 | varies |
| Myelogram cervical (72240) | $845.35 | $1,537 | 1.0× |
| Myelogram Lumbar (72265) | $726 | $1,320 | 0.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $537.35 | $977 | 0.4× |
| Myocardial Spect Multiple Studies (78452) | $1,112.65 | $2,023 | 0.8× |
| Neck soft tissue (70360) | $190.30 | $346 | 2.0× |
| Pelvis 1 or 2 views (72170) | $173.80 | $316 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $288.20 | $524 | 2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $258.50 | $470 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $232.10 | $422 | 2.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $177.10 | $322 | 1.9× |
| Radex elbow complete minimum 3 views (73080) | $200.20 | $364 | 2.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $252.45 | $459 | 2.3× |
| Radex fingr minimum 2 views (73140) | $204.05 | $371 | 2.2× |
| Radex foot complete minimum 3 views (73630) | $215.05 | $391 | 2.3× |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$232.10–$462.55 | $422–$841 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $118.80 | $216 | 1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $244.20 | $444 | 2.6× |
| Radex Ribs Unilateral 2 Views (71100) | $215.05 | $391 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) | $209.55 | $381 | 2.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $140.25 | $255 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $129.80 | $236 | 1.4× |
| Radex Sternum Minimum 2 Views (71120) | $174.35 | $317 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $301.95 | $549 | 3.2× |
| Radex Toe Minimum 2 Views (73660) | $190.30 | $346 | 2.0× |
| Radex upper extremity infant minimum 2 views (73092) | $125.40 | $228 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $256.30 | $466 | 2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $262.35 | $477 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $697.95 | $1,269 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $713.35 | $1,297 | 3.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $665.50 | $1,210 | 3.6× |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$288.20–$576.95 | $524–$1,049 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $175.45 | $319 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $476.30 | $866 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $323.95 | $589 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $471.35 | $857 | 2.5× |
| Radiologic examination femur 1 view (73551) | $174.35 | $317 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) | $224.95 | $409 | 2.4× |
| Radiologic examination knee 1/2 views (73560) | $222.20 | $404 | 2.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $310.20 | $564 | 2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $242.55 | $441 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $199.65 | $363 | 2.1× |
| Ribs bilateral 3 views (71110) | $250.80 | $456 | 2.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $503.25 | $915 | 1.2× |
| Scapula (73010) | $185.35 | $337 | 1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $79.20 | $144 | 3.4× |
| Shoulder 1 view (73020) | $135.30 | $246 | 1.5× |
| Shoulder Arthrography (73040) | $657.25 | $1,195 | 1.8× |
| Sialogram (70390) | $272.80 | $496 | 1.1× |
| Skull less than 4 views (70250) | $210.10 | $382 | 1.9× |
| Sternoclavicular joints (71130) | $223.30 | $406 | 2.4× |
| Thoracic spine 2 views (72070) | $204.05 | $371 | 1.8× |
| Thoracic spine 3 views (72072) | $237.60 | $432 | 2.1× |
| Thoracolumbar 2 views (72080) | $206.25 | $375 | 2.2× |
| Ultrasound Breast Limited (76642) | $358.05 | $651 | 3.9× |
| Ultrasound Exam Aaa Screen (76706) | $289.30 | $526 | 2.6× |
| Ultrasound, abdomen limited (76705) | $495 | $900 | 4.4× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $602.25 | $1,095 | 1.4× |
| Upper gi w/o kub (74240) | $428.45 | $779 | 2.3× |
| Urethrocystogram voiding (74455) | $589.05 | $1,071 | 2.3× |
| Us breast unilateral complete (76641) | $187 | $340 | 1.7× |
| Us chest (76604) | $233.75 | $425 | 2.1× |
| Us complete joint (76881) | $306.35 | $557 | 2.7× |
| Us exam, pelvic, limited (76857) | $300.30 | $546 | 2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $292.60 | $532 | 2.6× |
| Us ob detailed single fetus (76811) | $670.45 | $1,219 | 2.6× |
| Us ob limited 1 or more fetuses (76815) | $306.90 | $558 | 2.7× |
| Us ob transvaginal (76817) | $528.55 | $961 | 4.7× |
| Us pelvic non ob complete (76856) | $443.85 | $807 | 4.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $375.65 | $683 | 3.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $443.85 | $807 | 4.0× |
| Us retroperitoneal complete (76770) | $600.05 | $1,091 | 5.4× |
| Us retroperitoneal limited (76775) | $322.30 | $586 | 2.9× |
| Us scrotum and contents (76870) | $561.55 | $1,021 | 5.0× |
| Us thyroid (76536) | $506 | $920 | 4.5× |
| Venography extremity unilateral rs&i (75820) | $717.20 | $1,304 | 0.4× |
| Wrist 2 views (73100) | $160.60 | $292 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $271.15 | $493 | 2.9× |
| X-ray antegrade pyelogram tube (74425) | $354.75 | $645 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $177.10 | $322 | 1.9× |
| X-Ray Exam Breast Specimen (76098) range across 6 matching MRF lines |
$77–$154 | $140–$280 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $229.35 | $417 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $416.90 | $758 | 3.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $196.90 | $358 | 2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $276.65 | $503 | 3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $287.65 | $523 | 2.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $253.55 | $461 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $328.90 | $598 | 2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $392.15 | $713 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $237.60 | $432 | 2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $342.65 | $623 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $244.20 | $444 | 2.2× |
| X-ray eye for foreign body (70030) | $187.55 | $341 | 2.0× |
| X-ray humerus (73060) | $202.40 | $368 | 2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $165.55 | $301 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $220.55 | $401 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $237.60 | $432 | 2.1× |
| X-ray nose-rectum child f.b. (76010) | $151.80 | $276 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $280.50 | $510 | 2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $210.10 | $382 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $108.90 | $198 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $199.65 | $363 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $224.95 | $409 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $252.45 | $459 | 2.3× |
| X-ray thoracic spine 4 vw (72074) | $254.65 | $463 | 2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $672.10 | $1,222 | 1.8× |
| X-Rays Bone Length Studies (77073) range across 5 matching MRF lines |
$198–$380.60 | $360–$692 | varies |
| X-Rays Bone Survey Complete (77075) | $461.45 | $839 | 4.1× |
| Xr c-spine 4 or 5 views (72050) | $326.15 | $593 | 2.9× |
| Xr facial bones less than 3 views (70140) | $171.60 | $312 | 1.8× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$198.55–$252.45 | $361–$459 | varies |
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.