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Pathology

Robert R. Cawley, D.O.

Dover, NH 03802

Education & Training

Board Certification

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Radiology Price Estimates

All prices listed below are subject to separate hospital facility fees and professional fees from physicians for their services. Prices will vary.

Discounts:

  • 40% discount for self-pay patients. (Patients with no insurance.) This discount is reflected in fourth column on the charts below. 
  • 20% prompt pay discount with full bill payment in 30 days. This applies to self-pay accounts and self-pay balances after insurance.

X-Ray

Billing Code

WDH Charge

Uninsured Charge

Cervical Spine, 4 or 5 Views

72050

$818

$491

Shoulder, 2 or more Views

73030

$513

$308

Both Shoulders, 2 or more Views

73030

$768

$461

Chest, Front & Side, 2 Views

71020

$508

$305

Wrist, 3 or more Views

73110

$490

$294

Both Wrists, 3 or more Views

73110

$734

$440

Hand, 3 or more Views

73130

$508

$305

Both Hands, 3 or more Views

73130

$760

$456

Hip, One Side, 1 View

73501

$504

$302

Hip, One Side, 2-3 Views

73502

$528

$317

Both Hips, 2 Views

73521

$622

$373

Both Hips, 3-4 Views

73522

$622

$373

Both Hips, 5 or more Views

73523

$1,113

$668

Ankle, 3 or more Views

73610

$496

$298

Both Ankles, 3 or more Views

73610

$649

$389

Foot, 3 or more Views

73630

$496

$298

Both Feet, 3 or more Views

73630

$744

$446

 

MRI

Billing Code

WDH Charge

No Insurance Charge

Brain w/ contrast

70552

$6,170

$3,702

Brain w/o contrast

70551

$4,974

$2,984

Brain w/wo contrast

70553

$6,343

$3,806

Upper Joint w/ contrast

73222

$3,341

$2,005

Upper Joint w/o contrast 

73221

$3,213

$1,928

Upper Joint w/wo contrast

73223

$3,782

$2,269

Lower Joint w/ contrast

73722

$5,766

$3,460

Lower Joint w/o contrast

73721 

$5,380

$3,228

Lower Joint w/wo contrast

73723

$5,380

$3,228

Lumbar Spine w/ contrast

72149

$6,830

$4,098

Lumbar Spine w/o contrast

72148

$5,007

$3,004

Lumbar Spine w/wo contrast

72158

$6,163

$3,698

Cervical Spine w/ contrast

72142

$7,424

$4,454

Cervical Spine w/o contrast

72141

$4,849

$2,909

Cervical Spine w/wo contrast

72156

$6,865

$4,119

 

CT Scan

Billing Code

WDH Charge

No Insurance
Cost

Abdomen w/ contrast

74160

$3,378

$2,027

Abdomen w/o contrast

74150

$3,858

$2,315

Abdomen w/wo contrast

74170

$5,719

$3,431

Facial/Sinus w/ contrast

70487

$2,567

$1,540

Facial/Sinus w/o contrast

70486

$2,385

$1,431

Facial/Sinus w/wo contrast

70488

$2,710

$1,626

Head/Brain w/contrast

70460

$3,203

$1,922

Head/Brain w/o contrast

70450

$3,195

$1,917

Head/Brain w/wo contrast

70470

$4,356

$2,614

Pelvis w/contrast

72193

$2,989

$1,793

Pelvis w/o contrast

72192

$2,554

$1,532

Pelvis w/wo contrast

72194

$3,030

$1,818

Thorax w/contrast

71260

$3,717

$2,230

Thorax w/o contrast

71250

$3,125

$1,875

Thorax w/wo contrast

71270

$5,033

$3,020

 

Ultrasound

Billing Code

WDH Charge

Uninsuranced
Charge

Abdomen - Complete

76700

$1,439

$863

Head/Neck - Soft Tissue

76536

$948

$569

Vaginal - Transvaginal

76830

$1,066

$640

Kidney - Retroperitoneal

76770

$781

$469

Male Genitalia

76870

$936

$562

Contact Us

For help with pricing information, please call (603) 740-2205.

For help understanding your bill or to make payment arrangements, please call our toll free customer service number at (855) 762-5219.


 

Resource

Price Transparency

The New Hampshire Hospital Association offers additional resources to help you better understand hospital pricing, billing and insurance coverage.

Learn More