Imaging prices at Wellstar Mountain Lakes Medical Center
Clayton, GA · every code in this section with a posted price and a Medicare benchmark.
181 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) | $102.40 | $256 | 1.3× |
| Abdomen 2 views (74019) | $137.60 | $344 | 1.5× |
| Ankle 2 views (73600) | $104 | $260 | 1.4× |
| Bone age studies (77072) | $152.40 | $381 | 1.7× |
| Chest 1 view (71045) | $104 | $260 | 1.4× |
| Chest 2 views (71046) | $102.40 | $256 | 1.3× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$92.80–$102.40 | $232–$256 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$137.60–$168.80 | $344–$422 | varies |
| Clavicle complete (73000) | $104 | $260 | 1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $185.60 | $464 | 2.0× |
| Contrast X-Ray Bladder (74430) | $465.20 | $1,163 | 1.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $225.60 | $564 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $880 | $2,200 | 2.9× |
| CT abdomen and pelvis without contrast (74176) | $280 | $700 | 1.3× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$439.60–$663.60 | $1,099–$1,659 | varies |
| CT abdomen w wo contrast (74170) range across 8 matching MRF lines |
$1,344–$1,504.40 | $3,360–$3,761 | varies |
| CT abdomen w/o contrast (74150) | $125.60 | $314 | 1.4× |
| CT Angio Abdomen and Pelvis (74174) | $439.60 | $1,099 | 1.4× |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$210–$1,381.60 | $525–$3,454 | varies |
| CT Angio Head (70496) | $210 | $525 | 1.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $210 | $525 | 1.4× |
| CT cervical spine w/ contrast (72126) | $439.60 | $1,099 | 1.4× |
| CT cervical spine w/o contrast (72125) | $439.60 | $1,099 | 4.8× |
| CT chest w contrast (71260) | $483.20 | $1,208 | 3.1× |
| CT chest w/wo contrast (71270) | $490 | $1,225 | 3.2× |
| CT head/brain with contrast (70460) | $439.60 | $1,099 | 2.9× |
| CT head/brain without and with contrast (70470) | $790.80 | $1,977 | 5.1× |
| CT iac w contrast (70481) | $468.40 | $1,171 | 3.0× |
| CT lower ext w/o (73700) | $461.20 | $1,153 | 5.0× |
| CT lower extremity w/contrast material (73701) | $610 | $1,525 | 4.0× |
| CT lumbar spine w contrast (72132) | $439.60 | $1,099 | 1.4× |
| CT lumbar spine w/o contrast (72131) | $125.60 | $314 | 1.4× |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$210–$439.60 | $525–$1,099 | varies |
| CT maxillofacial wo contrast (70486) | $453.20 | $1,133 | 4.9× |
| CT neck tissue combo (70492) | $1,402 | $3,505 | 9.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $477.60 | $1,194 | 3.1× |
| CT orbits w/o contrast (70480) | $477.60 | $1,194 | 5.2× |
| CT pelvis w&w/o contrast (72194) | $1,433.20 | $3,583 | 9.3× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$125.60–$486.80 | $314–$1,217 | varies |
| CT scans face/jaw combo (70488) | $490 | $1,225 | 3.2× |
| CT soft tissue neck w contrast (70491) | $210 | $525 | 1.4× |
| CT soft tissue neck w/o contrast (70490) | $125.60 | $314 | 1.4× |
| CT thoracic spine w contrast (72129) | $210 | $525 | 1.4× |
| CT thoracic spine w/o contrast (72128) | $210 | $525 | 2.3× |
| CT thorax w/o contrast (71250) | $125.60 | $314 | 1.4× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$125.60–$454 | $314–$1,135 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$210–$1,394.80 | $525–$3,487 | varies |
| CT upper extremity with contrast (73201) | $439.60 | $1,099 | 1.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,890.80 | $4,727 | 12.3× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,344–$1,838.40 | $3,360–$4,596 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $420 | $1,050 | 1.4× |
| CTA pelvis (72191) | $210 | $525 | 1.4× |
| Esophagram (74220) | $225.60 | $564 | 1.5× |
| Fetal Biophys Profile W/Nst (76818) | $125.60 | $314 | 1.4× |
| Fluoroscopy up to 1 hr (76000) | $290.80 | $727 | 1.4× |
| Foot 2 views (73620) | $104 | $260 | 1.4× |
| Forearm 2 views (73090) | $104 | $260 | 1.4× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$88–$132 | $220–$330 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$88–$104 | $220–$260 | varies |
| Magnetic Image Jaw Joint (70336) | $373.60 | $934 | 1.8× |
| Mra Head W/O & W/Contrast Material (70546) | $589.49 | $1,473.72 | 1.9× |
| MRA head w/o contrast (70544) | $373.60 | $934 | 1.8× |
| MRA head with contrast (70545) | $589.49 | $1,473.72 | 1.9× |
| MRA neck w contrast (70548) | $250 | $625 | 0.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $589.60 | $1,474 | 1.9× |
| MRA neck w/o contrast (70547) | $373.60 | $934 | 1.8× |
| MRI abdomen w contrast (74182) | $465.20 | $1,163 | 1.5× |
| MRI abdomen w/o contrast (74181) | $373.60 | $934 | 1.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$948.40–$1,185.20 | $2,371–$2,963 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $589.60 | $1,474 | 1.9× |
| MRI cervical spine w contrast (72142) | $680.40 | $1,701 | 2.2× |
| MRI cervical spine w/o cont (72141) | $373.60 | $934 | 1.8× |
| MRI chest w/o contrast (71550) | $586.80 | $1,467 | 2.8× |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$453.20–$903.20 | $1,133–$2,258 | varies |
| MRI chest wo w contrast (71552) | $1,268 | $3,170 | 4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 12 matching MRF lines |
$350–$1,220.80 | $875–$3,052 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$373.60–$586.80 | $934–$1,467 | varies |
| MRI lumbar spine w contrast (72149) | $465.20 | $1,163 | 1.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $589.60 | $1,474 | 1.9× |
| MRI orbit face &/neck w/o contrast (70540) range across 6 matching MRF lines |
$373.60–$586.80 | $934–$1,467 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 7 matching MRF lines |
$315.20–$1,220.80 | $788–$3,052 | varies |
| MRI pelvis w contrast (72196) | $439.60 | $1,099 | 1.4× |
| MRI pelvis w/o & w contrast (72197) | $589.60 | $1,474 | 1.9× |
| MRI pelvis w/o contrast (72195) | $373.60 | $934 | 1.8× |
| MRI thoracic spine w/o contrast (72146) | $373.63 | $934.08 | 1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $373.60 | $934 | 1.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 9 matching MRF lines |
$589.60–$1,266.40 | $1,474–$3,166 | varies |
| MRI, abdomen, combo (74183) | $589.60 | $1,474 | 1.9× |
| MRI, dorsal spine combo (72157) | $589.49 | $1,473.72 | 1.9× |
| MRI, dorsal spine contrast (72147) | $634 | $1,585 | 2.1× |
| MRI, joint upper extrem (73221) | $373.60 | $934 | 1.8× |
| MRI, joint upper extrem combo (73223) | $589.60 | $1,474 | 1.9× |
| MRI, lumbar spine combo (72158) | $589.49 | $1,473.72 | 1.9× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$1,592.80–$1,649.60 | $3,982–$4,124 | varies |
| Neck soft tissue (70360) | $104 | $260 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $67.56 | $168.90 | 0.7× |
| Pelvis 1 or 2 views (72170) | $137.60 | $344 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $137.60 | $344 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$59.60–$104 | $149–$260 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $104 | $260 | 1.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $137.60 | $344 | 1.5× |
| Radex fingr minimum 2 views (73140) | $104 | $260 | 1.4× |
| Radex foot complete minimum 3 views (73630) | $104 | $260 | 1.4× |
| Radex Hand Minimum 3 Views (73130) | $104 | $260 | 1.4× |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$109.60–$164.40 | $274–$411 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 4 matching MRF lines |
$99.60–$149.20 | $249–$373 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $104 | $260 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$84.40–$126.80 | $211–$317 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$88.40–$132.40 | $221–$331 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $104 | $260 | 1.4× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$102.40–$104 | $256–$260 | varies |
| Radex Sternum Minimum 2 Views (71120) | $104 | $260 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $104 | $260 | 1.4× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$43.20–$134.80 | $108–$337 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$56.40–$104 | $141–$260 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $137.60 | $344 | 1.5× |
| Radiologic exam colon single contrast study (74270) | $225.60 | $564 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$98.80–$148.40 | $247–$371 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $225.60 | $564 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $225.60 | $564 | 1.5× |
| Radiologic examination femur 1 view (73551) | $42 | $105 | 0.6× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$83.60–$126.80 | $209–$317 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$60.40–$104 | $151–$260 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $137.60 | $344 | 1.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$56.40–$104 | $141–$260 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$72.40–$125.60 | $181–$314 | varies |
| Shoulder 1 view (73020) | $104 | $260 | 1.4× |
| Skull less than 4 views (70250) | $137.60 | $344 | 1.5× |
| Sternoclavicular joints (71130) | $104 | $260 | 1.4× |
| Thoracic spine 2 views (72070) | $137.60 | $344 | 1.5× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$127.60–$137.60 | $319–$344 | varies |
| Ultrasound Breast Limited (76642) | $104 | $260 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) | $125.60 | $314 | 1.4× |
| Ultrasound, abdomen limited (76705) | $206.80 | $517 | 2.3× |
| Unlisted us procedure (76999) | $191.60 | $479 | 2.5× |
| Urethrocystogram voiding (74455) | $290.80 | $727 | 1.4× |
| Urethrocystography retrograde (74450) | $290.80 | $727 | 1.4× |
| Us breast unilateral complete (76641) | $183.60 | $459 | 2.0× |
| Us chest (76604) | $137.60 | $344 | 1.5× |
| Us complete joint (76881) | $126 | $315 | 1.4× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$137.60–$191.60 | $344–$479 | varies |
| Us ob limited 1 or more fetuses (76815) | $137.60 | $344 | 1.5× |
| Us ob transvaginal (76817) | $125.60 | $314 | 1.4× |
| Us pelvic non ob complete (76856) | $125.60 | $314 | 1.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $137.60 | $344 | 1.5× |
| Us retroperitoneal complete (76770) | $125.60 | $314 | 1.4× |
| Us scrotum and contents (76870) | $125.60 | $314 | 1.4× |
| Us thyroid (76536) | $125.60 | $314 | 1.4× |
| Us transrectal (76872) | $148 | $370 | 1.6× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$48.40–$104 | $121–$260 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $104.40 | $261 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $104 | $260 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $102.40 | $256 | 1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $137.60 | $344 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $109.60 | $274 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$134.80–$137.60 | $337–$344 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$116–$137.60 | $290–$344 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $137.60 | $344 | 1.5× |
| X-Ray Exam L-S Spine Bending (72114) | $137.60 | $344 | 1.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $125.60 | $314 | 1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $137.60 | $344 | 1.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$93.20–$140 | $233–$350 | varies |
| X-ray humerus (73060) | $104 | $260 | 1.4× |
| X-ray IV pyelogram (ivp) (74400) | $225.60 | $564 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $104 | $260 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $104 | $260 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $137.60 | $344 | 1.5× |
| X-ray nose-rectum child f.b. (76010) | $104 | $260 | 1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $152.40 | $381 | 1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $86.80 | $217 | 0.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$70.80–$125.60 | $177–$314 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $104 | $260 | 1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $104 | $260 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $137.60 | $344 | 1.5× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$56.40–$104 | $141–$260 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $465.20 | $1,163 | 1.5× |
| X-Rays Bone Length Studies (77073) | $125.60 | $314 | 1.4× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$137.60–$223.20 | $344–$558 | varies |
| Xr c-spine 4 or 5 views (72050) | $137.60 | $344 | 1.5× |
| Xr facial bones less than 3 views (70140) | $104 | $260 | 1.4× |
| Xr orbits complete 4 views (70200) | $137.60 | $344 | 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.