HCPCS G0130-TC
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Single energy x-ray study
Low
$22
Average
$67
Median
$79
High
$104
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11 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 2 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 3 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 2 | $103 | $103 | $1 | 1% | — | $102 – $105 |
| 4 | GLENS FALLS HOSPITAL INC Falls, NY facility · fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 5 | Renown Regional Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 6 | Renown South Meadows Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 7 | Renown South Meadows Medical Center Reno, NV facility · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 8 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 2 | $103 | $103 | $1 | 1% | — | $102 – $105 |
| 9 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 2 | $103 | $103 | $1 | 1% | — | $102 – $105 |
| 10 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 2 | $104 | $104 | $1 | 1% | — | $103 – $105 |
| 11 | Saratoga Hospital Saratoga Springs, NY facility · fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
← Payers reporting HCPCS G0130-TC · Snapshot 20261115T194459Z-975ba28a