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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

$810

$486

Shoulder, 2 or more Views

73030

$507

$305

Both Shoulders, 2 or more Views

73030

$761

$457

Chest, Front & Side, 2 Views

71020

$502

$302

Wrist, 3 or more Views

73110

$485

$291

Both Wrists, 3 or more Views

73110

$727

$437

Hand, 3 or more Views

73130

$502

$302

Both Hands, 3 or more Views

73130

$753

$452

Hip, One Side, 1 View

73501

$499

$300

Hip, One Side, 2-3 Views

73502

$523

$314

Both Hips, 2 Views

73521

$580

$348

Both Hips, 3-4 Views

73522

$580

$348

Both Hips, 5 or more Views

73523

$1,102

$662

Ankle, 3 or more Views

73610

$491

$295

Both Ankles, 3 or more Views

73610

$642

$386

Foot, 3 or more Views

73630

$491

$295

Both Feet, 3 or more Views

73630

$736

$442

 

MRI

Billing Code

WDH Charge

No Insurance Charge

Brain w/ contrast

70552

$5,990

$3,594

Brain w/o contrast

70551

$4,829

$2,898

Brain w/wo contrast

70553

$6,158

$3,695

Upper Joint w/ contrast

73222

$3,243

$1,946

Upper Joint w/o contrast 

73221

$3,119 

$1,872

Upper Joint w/wo contrast

73223

$3,671

$2,203

Lower Joint w/ contrast

73722 $5,598 $3,359

Lower Joint w/o contrast

73721 

$3,926

$2,356 

Lower Joint w/wo contrast

73723

$5,223

$3,134

Lumbar Spine w/ contrast

72149 $6,631 $3,979

Lumbar Spine w/o contrast

72148

$4,861

$2,917

Lumbar Spine w/wo contrast

72158

$5,983

$5,590

Cervical Spine w/ contrast

72142

$7,207

$4,325

Cervical Spine w/o contrast

72141

$4,707

$2,825

Cervical Spine w/wo contrast

72156

$6,665

$3,999 

 

CT Scan

Billing Code

WDH Charge

No Insurance
Cost

Abdomen w/ contrast

74160

$3,601

$2,161

Abdomen w/o contrast

74150

$3,153

$1,892

Abdomen w/wo contrast

74170

$5,338

$3,203

Facial/Sinus w/ contast

70487

$2,396

$1,438

Facial/Sinus w/o contrast

70486

$2,226

$1,336

Facial/Sinus w/wo contrast

70488

$2,530

$1,518

Head/Brain w/contrast

70460

$2,990

$1,794

Head/Brain w/o contrast

70450

$2,982

$1,790

Head/Brain w/wo contrast

70470

$4,066 

$2,440

Pelvis w/contrast

72193

$2,790

$1,674

Pelvis w/o contrast

72192

$2,384

$1,341

Pelvis w/wo contrast

72194

$2,828

$1,697

Thorax w/contrast

71260

$3,469

$2,082

Thorax w/o contrast

71250

$2,917

$1,751

Thorax w/wo contrast

71270

$4,886

$2,932

 

Ultrasound

Billing Code

WDH Charge

Uninsuranced
Charge

Abdomen - Complete

76700

$1,369

$822

Head/Neck - Soft Tissue

76536

$920

$522

Vaginal - Transvaginal

76830

$1,014

$609

Kidney - Retroperitoneal

76770

$743

$446

Male Genitalia

76870

$891

$535

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