Imaging prices at Ascension Seton Edgar B Davis

Luling, TX · every code in this section with a posted price and a Medicare benchmark.

267 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $241.65 $671.25 2.3×
Acute gastrointestinal blood loss imaging (78278) $534.78 $1,485.50 1.3×
Ankle 2 views (73600) $126.18 $350.50 1.4×
Antegrade urography radiological supvj & interpj (74425) $255.15 $708.75 0.7×
Arthrogram elbow (73085) $566.28 $1,573 1.6×
Arthrogram hip (73525) $566.28 $1,573 1.6×
Arthrogram shoulder (73040) $566.28 $1,573 1.6×
Arthrogram wrist (73115) $566.28 $1,573 1.6×
Arthrography knee lt (73580) $566.28 $1,573 1.6×
Bone age studies (77072) $301.23 $836.75 2.9×
Bone Marrow Imaging Limited Area (78102) $380.25 $1,056.25 0.9×
Bone survey complete (77075) $280.80 $780 2.7×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $312.66 $868.50 0.6×
Cervical spine 2 or 3 views (72040) $202.50 $562.50 2.3×
Chest 1 view (71045) $129.69 $360.25 1.5×
Chest 3 views (71047) $241.38 $670.50 2.8×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $441.40 $1,226.12 2.5×
Clavicle complete (73000) $139.68 $388 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $120.42 $334.50 1.1×
CT abdomen and pelvis without and with contrast (74178) $3,829.95 $10,638.75 10.9×
CT abdomen and pelvis without contrast (74176) $3,059.96 $8,499.88 12.8×
CT abdomen w contrast (74160) $1,660.77 $4,613.25 9.4×
CT abdomen w wo contrast (74170) $1,665.76 $4,627.12 9.5×
CT abdomen w/o contrast (74150) $1,520.37 $4,223.25 14.5×
CT angio hrt w/3d image (75574) $2,278.35 $6,328.75 6.5×
CT angiography upper extremity lt (73206) $782.19 $2,172.75 4.4×
CT c-spine w/o contrast (72125) $1,821.42 $5,059.50 17.3×
CT cervical spine w&w/o contrast (72127) $2,390.22 $6,639.50 13.6×
CT cervical spine with contrast (72126) $2,169.09 $6,025.25 6.2×
CT chest w/wo contrast (71270) $2,083.64 $5,787.88 11.8×
CT chest with contrast (71260) $1,487.34 $4,131.50 8.4×
CT colonography screening (74263) $391.68 $1,088 1.6×
CT colonography w/dye (74262) $574.56 $1,596 3.3×
CT colonography w/o cntrst (74261) $352.35 $978.75 3.4×
CT head/brain with contrast (70460) $1,132.38 $3,145.50 6.4×
CT head/brain without and with contrast (70470) $1,822.95 $5,063.75 10.3×
CT heart no contrast quant eval coronry calcium (75571) $53.01 $147.25 0.6×
CT hrt w/3d image congen (75573) $2,665.71 $7,404.75 7.6×
CT iac w contrast (70481) $1,142.01 $3,172.25 6.5×
CT limited/localized follow up study (76380) $277.29 $770.25 3.2×
CT lower ext w/o (73700) $1,409.58 $3,915.50 13.4×
CT lower extremity w wo contrast (73702) $2,447.28 $6,798 13.9×
CT lower extremity with contrast (73701) $1,958.58 $5,440.50 11.1×
CT lumbar spine w & w/o contrast (72133) $1,714.77 $4,763.25 9.7×
CT lumbar spine w/o contrast (72131) $1,482.21 $4,117.25 14.1×
CT lumbar spine with contrast (72132) $1,658.34 $4,606.50 4.7×
CT maxillofacial w contrast (70487) $1,301.58 $3,615.50 7.4×
CT maxillofacial w/o contrast (70486) $1,072.35 $2,978.75 10.2×
CT maxillofacial w/wo contrast (70488) $1,846.98 $5,130.50 10.5×
CT neck soft tissue w contrast (70491) $1,476.45 $4,101.25 8.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,545.38 $7,070.50 14.4×
CT orbits w/o contrast (70480) $1,039.32 $2,887 9.9×
CT pelvis w & w/o contrast (72194) $2,568.51 $7,134.75 14.6×
CT pelvis w/o contrast (72192) $1,955.25 $5,431.25 18.6×
CT soft tissue neck w/o & w/contrast material (70492) $2,568.51 $7,134.75 14.6×
CT soft tissue neck w/o contrast (70490) $1,443.51 $4,009.75 13.7×
CT thoracic spine w/contrast (72129) $2,254.05 $6,261.25 12.8×
CT thoracic spine w/o contrast (72128) $1,599.75 $4,443.75 15.2×
CT thoracic spine w/wo contrast (72130) $1,865.34 $5,181.50 10.6×
CT thorax w/o contrast (71250) $815.49 $2,265.25 7.8×
CT upper extremity w/o & w/contrast material (73202) $2,083.05 $5,786.25 11.8×
CT upper extremity w/o contrast rt (73200) $1,942.65 $5,396.25 18.5×
CT upper extremity with contrast (73201) $1,312.11 $3,644.75 3.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,548.14 $4,300.38 8.8×
Cta Abdomen (74175) $610.29 $1,695.25 3.5×
CTA abdomen pelvis (74174) $1,260.99 $3,502.75 3.6×
CTA chest (71275) $583.47 $1,620.75 3.3×
Cta Head (70496) $1,822.95 $5,063.75 10.3×
CTA lwr ext w&w/o contrast (73706) $1,109.34 $3,081.50 6.3×
Cta Neck (70498) $1,950.39 $5,417.75 11.1×
Cta Pelvis (72191) $610.29 $1,695.25 3.5×
Cystography minimum 3 views rs&i (74430) $339.93 $944.25 1.0×
Dxa bone density study 1/> sites axial skel (77080) $308.43 $856.75 2.9×
Dxa bone density study axial skeleton (77085) $171.09 $475.25 1.6×
Esophagus (74220) $204.84 $569 1.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $147.15 $408.75 1.4×
Fluoroscopy up to 1 hr (76000) $441.72 $1,227 1.8×
Foot 2 views (73620) $147.42 $409.50 1.7×
Forearm 2 views (73090) $155.70 $432.50 1.8×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) $715.68 $1,988 1.3×
Hand 2 views (73120) $156.42 $434.50 1.5×
Hand 3 views (73130) $160.11 $444.75 1.8×
Humerus Min 2 Views Left (73060) $153.36 $426 1.8×
Hysterosalpingogram (74740) $629.46 $1,748.50 2.6×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $223.29 $620.25 2.1×
Knee 3 views (73562) $168.48 $468 1.9×
Lymphoscintigraphy (78195) $631.98 $1,755.50 1.2×
Mr elastography (76391) $353.70 $982.50 1.5×
Mr safety determination physician/other qhp (76016) $111.60 $310 1.3×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $75.60 $210 1.3×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $30.96 $86 1.1×
Mr safety implt electronics prepj supvj phys/qhp (76018) $115.92 $322 1.2×
Mr safety med physics xm customization plng&mntr (76017) $304.92 $847 1.3×
MRA head w & w/o contrast (70546) $1,631.84 $4,532.88 4.7×
MRA head w/o contrast (70544) $711.22 $1,975.62 3.0×
MRA head with contrast (70545) $891.45 $2,476.25 2.5×
MRA neck w contrast (70548) $504.09 $1,400.25 1.4×
Mra Neck W/O &W/Contrast Material (70549) $640.80 $1,780 1.8×
MRA neck w/o contrast (70547) $573.84 $1,594 2.4×
MRI abdomen w contrast (74182) $1,155.42 $3,209.50 3.3×
MRI abdomen w/o & w/contrast material (74183) $1,357.02 $3,769.50 3.9×
MRI abdomen w/o contrast (74181) $802.44 $2,229 3.3×
MRI any jnt lwr ext with con lt (73722) $1,110.78 $3,085.50 1.4×
MRI any jt upper extremity w/contrast matrl (73222) $830.16 $2,306 1.1×
MRI breast w/o contrast bilateral (77047) $570.33 $1,584.25 2.4×
MRI breast w/o contrast unilat (77046) $786.96 $2,186 3.3×
MRI c-spine with contrast (72142) $1,300.32 $3,612 3.7×
MRI cervical spine w/o contrast (72141) $1,175.13 $3,264.25 4.9×
MRI chest w/o & w/contrast material (71552) $1,698.75 $4,718.75 4.8×
MRI chest w/o contrast (71550) $1,072.53 $2,979.25 4.5×
MRI chest with contrast (71551) $1,175.13 $3,264.25 1.5×
MRI fetal sngl/1st gestation (74712) $443.70 $1,232.50 1.9×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $688.59 $1,912.75 2.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $741.42 $2,059.50 2.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $524.88 $1,458 2.2×
MRI orbit face &/neck w/o contrast (70540) $718.47 $1,995.75 3.0×
MRI orbit/face/neck w&w/o cont (70543) $1,279.98 $3,555.50 3.7×
MRI orbit/face/neck w/contrast (70542) $1,264.50 $3,512.50 3.6×
MRI pelvis w contrast (72196) $1,010.70 $2,807.50 2.9×
MRI pelvis w/o & w/contrast material (72197) $1,212.93 $3,369.25 3.5×
MRI pelvis w/o contrast (72195) $786.96 $2,186 3.3×
MRI scan of arm joint before and after contrast (73223) $1,493.19 $4,147.75 4.3×
MRI scan of leg joint before and after contrast (73723) $1,313.37 $3,648.25 3.7×
MRI spectroscopy (76390) $2,136.51 $5,934.75 24.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,902.24 $5,284 5.4×
MRI spinal canal lumbar w/contrast material (72149) $984.60 $2,735 2.8×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,572.39 $4,367.75 4.5×
MRI spinal canal thoracic w/contrast matrl (72147) $1,472.49 $4,090.25 4.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,154.69 $5,985.25 6.1×
MRI thoracic spine w/o contrast (72146) $902.88 $2,508 3.8×
MRI tmj (70336) $699.75 $1,943.75 2.9×
MRI upper ext joint w/o contrast (73221) $708.03 $1,966.75 3.0×
MRI upper extrem other than jt w/o & w/contras (73220) $1,064.34 $2,956.50 3.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $540.09 $1,500.25 2.3×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $1,310.85 $3,641.25 1.5×
Neck soft tissue (70360) $137.16 $381 1.6×
Nuclear medicine study of stomach to assess emptying small bowel movement (78265) $539.37 $1,498.25 1.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $157.95 $438.75 1.5×
Ophthalmic us dx quantitative a-scan only (76511) $314.82 $874.50 3.0×
Orthopantogram (70355) $104.13 $289.25 1.2×
Osseous survey infant (77076) $657.63 $1,826.75 6.3×
Osseous survey limited (77074) $238.59 $662.75 2.3×
Pelvis 1 or 2 views (72170) $153.81 $427.25 1.5×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $772.02 $2,144.50 2.2×
Radex abscess/fistula/sinus tract rs&i (76080) $405.99 $1,127.75 0.7×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $111.42 $309.50 1.3×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $184.41 $512.25 1.8×
Radex hips bilateral with pelvis 2 views (73521) $184.41 $512.25 1.8×
Radex mastoids compl minimum 3 views pr side (70130) $163.71 $454.75 1.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $328.41 $912.25 3.1×
Radiolog exam mandible compl minimum 4 views (70110) $171.45 $476.25 1.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $159.48 $443 1.8×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $202.72 $563.12 2.3×
Radiologic exam colon single contrast study (74270) $283.86 $788.50 1.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $302.13 $839.25 1.7×
Radiologic exam upr gi trc double contrast study (74246) $302.13 $839.25 1.7×
Radiologic exam upr gi trc single contrast study (74240) $302.13 $839.25 1.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $111.42 $309.50 1.3×
Radiological examination surgical specimen (76098) $265.05 $736.25 0.5×
Ribs bilateral 3 views (71110) $277.74 $771.50 2.6×
Rp loclzj tum plnr whole body single day imaging (78802) $363.78 $1,010.50 0.7×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $1,880.82 $5,224.50 1.4×
Sacroiliac Joints < 3 Views (72200) $154.71 $429.75 1.5×
Salivary gland imaging serial images (78231) $701.73 $1,949.25 1.7×
Scanogram (77073) $190.08 $528 1.8×
Scapula complete (73010) $177.52 $493.12 1.7×
Screening digital breast tomosynthesis (77063) $56.88 $158 2.4×
Sella turcica (70240) $96.30 $267.50 1.1×
Shuntogram indwelling nonvascular shunt rs&i (75809) $342.54 $951.50 3.3×
Small bowel series (74250) $261.54 $726.50 1.5×
Speech evaluation complex (70371) $583.02 $1,619.50 2.4×
Spine thoracic 3 views (72072) $257.40 $715 2.5×
Tbs Technical Calculation Only (77091) $121.05 $336.25 1.4×
Testicular Imaging With Vascular Flow (78761) $333.72 $927 0.8×
Thoracolumbar 2 views (72080) $253.71 $704.75 2.9×
Thyroid uptake measurement (78012) $552.60 $1,535 1.4×
Tmj unilateral (70328) $123.48 $343 1.4×
Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) $121.05 $336.25 1.4×
Ultrasound elastography first target lesion (76982) $189.72 $527 1.8×
Ultrasound, abdomen limited (76705) $195.30 $542.50 1.9×
Unlisted magnetic resonance procedure (76498) $1,007.10 $2,797.50 11.5×
Unlisted Ultrasound Procedure (76999) $178.38 $495.50 2.0×
Upper Extremity Infant (73092) $230.40 $640 2.2×
Urethrocystography retrograde rs&i (74450) $475.92 $1,322 2.0×
Urethrocystography voiding (74455) $482.22 $1,339.50 2.0×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $302.49 $840.25 1.7×
Us abdl aorta screen aaa (76706) $262.66 $729.62 2.5×
Us breast unilateral complete (76641) $160.74 $446.50 1.5×
Us breast unilateral limited (76642) $160.74 $446.50 1.8×
Us chest (76604) $133.78 $371.62 1.3×
Us compl joint r-t w/image documentation (76881) $322.02 $894.50 3.1×
Us elastography parenchyma (76981) $189.72 $527 1.8×
Us guided compression repair (76936) $181.80 $505 0.8×
Us infant hips limited static (76886) $610.56 $1,696 7.0×
Us ob transvaginal (76817) $318.20 $883.88 3.0×
Us pelvic non ob complete (76856) $259.78 $721.62 2.5×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $266 $738.88 2.5×
Us pregnancy ltd (76815) $213.52 $593.12 2.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $155.66 $432.38 1.5×
Us retroperitoneal complete (76770) $332.91 $924.75 3.2×
Us retroperitoneal limited (76775) $271.76 $754.88 2.6×
Us scrotum and contents (76870) $407.25 $1,131.25 3.9×
Us soft tissue head/neck (76536) $277.83 $771.75 2.6×
Us transrectal (76872) $336.33 $934.25 3.2×
Us xtr non-vasc lmtd (76882) $322.02 $894.50 3.1×
Us, eye b-scan (76512) $169.47 $470.75 1.6×
Venogram extremity bilateral (75822) $345.51 $959.75 0.2×
Venography extremity unilateral rs&i (75820) $242.46 $673.50 0.2×
Vertebral fracture assessment via dxa (77086) $114.48 $318 1.3×
Wrist 2 views (73100) $157.23 $436.75 1.8×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $234.81 $652.25 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $191.79 $532.75 2.2×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $167.31 $464.75 1.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $301.59 $837.75 1.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $125.96 $349.88 1.4×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $136.53 $379.25 1.6×
X-ray exam entire spi 4/5 vw (72083) $328.41 $912.25 3.1×
X-ray exam hip uni 1 view (73501) $111.42 $309.50 1.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $111.42 $309.50 1.3×
X-ray exam hip uni 4/> views (73503) $184.41 $512.25 1.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $184.41 $512.25 1.8×
X-Ray Exam Hips Bi 5/> Views (73523) $328.41 $912.25 3.1×
X-ray exam of femur 1 (73551) $111.42 $309.50 1.3×
X-ray eye for foreign body (70030) $75.33 $209.25 0.9×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $244.76 $679.88 2.3×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $134.37 $373.25 1.5×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $158.85 $441.25 1.8×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $139.32 $387 1.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $155.70 $432.50 1.8×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $248.13 $689.25 2.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $196.24 $545.12 2.2×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $148.05 $411.25 1.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $244.44 $679 2.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $468.09 $1,300.25 4.5×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $242.60 $673.88 2.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $140.67 $390.75 1.6×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $112.50 $312.50 1.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $223.74 $621.50 2.1×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $243.72 $677 2.3×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $270.09 $750.25 0.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $198.54 $551.50 2.3×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $234.81 $652.25 2.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $270.81 $752.25 2.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $132.84 $369 1.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $154.71 $429.75 1.8×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $164.02 $455.62 1.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $223.74 $621.50 2.6×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $183.33 $509.25 2.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $296.64 $824 2.8×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $188.82 $524.50 1.8×
X-Ray Spine One View - Xr Spine (72020) $192.96 $536 2.2×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $112.95 $313.75 1.3×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $155.70 $432.50 1.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $186.62 $518.38 1.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $123.48 $343 1.4×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $171.09 $475.25 2.0×
Xr arthrogram ankle (73615) $566.28 $1,573 1.6×
Xr c-spine 6 or more views (72052) $435.42 $1,209.50 4.1×
Xr chest 4+ views (71048) $250.56 $696 2.4×
Xr finger(s) 2+ views (73140) $132.03 $366.75 1.5×
XR Mastoids < 3 Views Bilateral (70120) $123.48 $343 1.2×
Xr optic foramina (70190) $93.78 $260.50 1.1×
Xr shoulder 1 view (73020) $92.07 $255.75 1.1×
Xr spine cervical 4 or 5 views (72050) $278.10 $772.50 2.6×
Xr tibia/fibula 2 views (73590) $166.90 $463.62 1.9×
Xr tmj bilateral (70330) $189.72 $527 2.2×
Xray knee 1 or 2 views rt (73560) $132.84 $369 1.5×