Imaging prices at Baylor Scott and White Surgical Hospital at Sherma

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $250.20 $417 2.4×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $3,672 $6,120 1.2×
Angiography extremity bilateral rs&i (75716) $4,099.80 $6,833 1.3×
Angiography extremity unilateral rs&i (75710) $4,020.90 $6,701.50 1.3×
Angiography internal mammary rs&i (75756) $4,140 $6,900 1.3×
Angiography pelvic slctv/supraslctv rs&i (75736) $7,090.50 $11,817.50 1.3×
Angiography visceral slctv/supraslctv rs&i (75726) $7,090.50 $11,817.50 1.3×
Ankle 2 views (73600) $266.40 $444 3.0×
Aortogram thoracic (75605) $7,090.50 $11,817.50 1.3×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $4,256.40 $7,094 1.3×
Aortography abdominal serialography rs&i (75625) $4,020.90 $6,701.50 1.3×
Aortography thoracic w/o serialography rs&i (75600) $4,140 $6,900 1.3×
Artery X-Rays Adrenal Gland (75731) $3,672 $6,120 1.2×
Arthrogram elbow (73085) $942 $1,570 2.7×
Arthrogram hip (73525) $1,000.20 $1,667 2.8×
Arthrogram shoulder (73040) $934.80 $1,558 2.7×
Arthrogram wrist (73115) $816.60 $1,361 2.3×
Arthrography knee lt (73580) $1,217.40 $2,029 3.5×
Bone &/Joint Imaging Limited Area (78300) $332.40 $554 0.8×
Bone &/joint imaging whole body (78306) $966.60 $1,611 2.4×
Bone age studies (77072) $233.40 $389 2.2×
Bone survey complete (77075) $382.80 $638 3.6×
Cervical spine 2 or 3 views (72040) $341.40 $569 3.9×
Chest 1 view (71045) $216 $360 2.5×
Chest 3 views (71047) $358.20 $597 4.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $375.60 $626 2.1×
Clavicle complete (73000) $275.40 $459 3.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $409.20 $682 3.9×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $375.60 $626 2.1×
CT abdomen and pelvis without and with contrast (74178) $900 $1,500 2.6×
CT abdomen and pelvis without contrast (74176) $566.40 $944 2.4×
CT abdomen w contrast (74160) $2,601 $4,335 14.7×
CT abdomen w wo contrast (74170) $3,201.60 $5,336 18.1×
CT abdomen w/o contrast (74150) $2,184.60 $3,641 20.7×
CT angio hrt w/3d image (75574) $1,408.80 $2,348 4.0×
CT angiography upper extremity lt (73206) $2,150.40 $3,584 12.2×
CT c-spine w/o contrast (72125) $1,876.80 $3,128 17.8×
CT cervical spine w&w/o contrast (72127) $2,794.20 $4,657 15.8×
CT cervical spine with contrast (72126) $2,268 $3,780 6.4×
CT chest w/wo contrast (71270) $2,960.40 $4,934 16.7×
CT chest with contrast (71260) $2,335.20 $3,892 13.2×
CT colonography screening (74263) $241.20 $402 1.0×
CT colonography w/dye (74262) $609.60 $1,016 3.4×
CT colonography w/o cntrst (74261) $307.80 $513 2.9×
CT head/brain with contrast (70460) $1,709.40 $2,849 9.7×
CT head/brain without and with contrast (70470) $2,184.60 $3,641 12.4×
CT heart contrast eval cardiac structure&morph (75572) $1,418.40 $2,364 4.0×
CT heart no contrast quant eval coronry calcium (75571) $126 $210 1.4×
CT hrt w/3d image congen (75573) $1,408.80 $2,348 4.0×
CT iac w contrast (70481) $1,741.20 $2,902 9.8×
CT lower ext w/o (73700) $1,117.80 $1,863 10.6×
CT lower extremity w wo contrast (73702) $1,641.60 $2,736 9.3×
CT lower extremity with contrast (73701) $1,267.20 $2,112 7.2×
CT lumbar spine w & w/o contrast (72133) $2,668.20 $4,447 15.1×
CT lumbar spine w/o contrast (72131) $1,867.20 $3,112 17.7×
CT lumbar spine with contrast (72132) $2,209.80 $3,683 6.3×
CT maxillofacial w contrast (70487) $1,726.20 $2,877 9.8×
CT maxillofacial w/o contrast (70486) $1,500.60 $2,501 14.2×
CT maxillofacial w/wo contrast (70488) $2,134.20 $3,557 12.1×
CT neck soft tissue w contrast (70491) $1,726.20 $2,877 9.8×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,168.40 $3,614 12.3×
CT orbits w/o contrast (70480) $1,542.60 $2,571 14.6×
CT pelvis w & w/o contrast (72194) $2,368.20 $3,947 13.4×
CT pelvis w/o contrast (72192) $1,658.40 $2,764 15.7×
CT scan for measuring calcium and other minerals in bone (77078) $499.80 $833 5.7×
CT soft tissue neck w/o & w/contrast material (70492) $2,158.80 $3,598 12.2×
CT soft tissue neck w/o contrast (70490) $1,518 $2,530 14.4×
CT thoracic spine w/contrast (72129) $2,251.20 $3,752 12.7×
CT thoracic spine w/o contrast (72128) $1,876.80 $3,128 17.8×
CT thoracic spine w/wo contrast (72130) $2,751 $4,585 15.6×
CT thorax w/o contrast (71250) $2,085 $3,475 19.8×
CT upper extremity w/o & w/contrast material (73202) $1,592.40 $2,654 9.0×
CT upper extremity w/o contrast rt (73200) $1,149.60 $1,916 10.9×
CT upper extremity with contrast (73201) $1,325.40 $2,209 3.8×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,017.80 $3,363 11.4×
Cta Abdomen (74175) $3,918 $6,530 22.2×
CTA abdomen pelvis (74174) $900 $1,500 2.6×
CTA chest (71275) $3,642 $6,070 20.6×
Cta Head (70496) $2,884.20 $4,807 16.3×
CTA lwr ext w&w/o contrast (73706) $2,050.20 $3,417 11.6×
Cta Neck (70498) $2,884.20 $4,807 16.3×
Cta Pelvis (72191) $3,010.20 $5,017 17.0×
Cystography minimum 3 views rs&i (74430) $641.40 $1,069 1.8×
Diskogram cervical (72285) $7,969.80 $13,283 4.0×
Diskography lumbar (72295) $7,969.80 $13,283 4.0×
Dxa bone density study 1/> sites axial skel (77080) $233.40 $389 2.2×
Esophagus (74220) $466.20 $777 2.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $325.80 $543 3.1×
Fluoroscopy up to 1 hr (76000) $382.80 $638 1.6×
Foot 2 views (73620) $258 $430 2.9×
Forearm 2 views (73090) $258 $430 2.9×
Hand 2 views (73120) $275.40 $459 2.6×
Hand 3 views (73130) $275.40 $459 3.1×
Humerus Min 2 Views Left (73060) $307.80 $513 3.5×
Hysterosalpingogram (74740) $809.40 $1,349 3.4×
Knee 3 views (73562) $332.40 $554 3.8×
MRA head w & w/o contrast (70546) $2,101.20 $3,502 6.0×
MRA head w/o contrast (70544) $1,459.20 $2,432 6.1×
MRA head with contrast (70545) $1,617 $2,695 4.6×
MRA neck w contrast (70548) $1,633.80 $2,723 4.6×
Mra Neck W/O &W/Contrast Material (70549) $2,101.20 $3,502 6.0×
MRA neck w/o contrast (70547) $1,434 $2,390 6.0×
MRI abdomen w contrast (74182) $1,703.40 $2,839 4.8×
MRI abdomen w/o & w/contrast material (74183) $1,960.20 $3,267 5.6×
MRI abdomen w/o contrast (74181) $4,560 $7,600 19.0×
MRI any jnt lwr ext with con lt (73722) $1,703.40 $2,839 2.2×
MRI any jt upper extremity w/contrast matrl (73222) $1,703.40 $2,839 2.2×
MRI c-spine with contrast (72142) $1,709.40 $2,849 4.9×
MRI cervical spine w/o contrast (72141) $1,703.40 $2,839 7.1×
MRI chest w/o & w/contrast material (71552) $2,584.20 $4,307 7.3×
MRI chest w/o contrast (71550) $1,703.40 $2,839 7.1×
MRI chest with contrast (71551) $1,858.80 $3,098 2.4×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,703.40 $2,839 4.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,703.40 $2,839 4.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,703.40 $2,839 7.1×
MRI orbit face &/neck w/o contrast (70540) $1,704 $2,840 7.1×
MRI orbit/face/neck w&w/o cont (70543) $2,350.80 $3,918 6.7×
MRI orbit/face/neck w/contrast (70542) $1,876.80 $3,128 5.3×
MRI pelvis w contrast (72196) $1,776 $2,960 5.1×
MRI pelvis w/o & w/contrast material (72197) $2,259.60 $3,766 6.4×
MRI pelvis w/o contrast (72195) $1,703.40 $2,839 7.1×
MRI scan of arm joint before and after contrast (73223) $1,851.60 $3,086 5.3×
MRI scan of leg joint before and after contrast (73723) $1,767 $2,945 5.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,217.60 $3,696 6.3×
MRI spinal canal lumbar w/contrast material (72149) $1,783.80 $2,973 5.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,317.80 $3,863 6.6×
MRI spinal canal thoracic w/contrast matrl (72147) $1,809 $3,015 5.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,335.20 $3,892 6.6×
MRI thoracic spine w/o contrast (72146) $1,703.40 $2,839 7.1×
MRI tmj (70336) $1,175.40 $1,959 4.9×
MRI upper ext joint w/o contrast (73221) $1,703.40 $2,839 7.1×
MRI upper extrem other than jt w/o & w/contras (73220) $1,703.40 $2,839 4.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,703.40 $2,839 7.1×
Myelogram Cervical (72240) $1,476 $2,460 1.9×
Myelogram Lumbar (72265) $1,476 $2,460 1.9×
Myelography 2 or more regions (72270) $1,676.40 $2,794 2.1×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $2,336.40 $3,894 2.7×
Neck soft tissue (70360) $216 $360 2.5×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $224.40 $374 2.1×
Osseous survey limited (77074) $352.80 $588 3.3×
Pelvis 1 or 2 views (72170) $233.40 $389 2.2×
Peritoneogram rs&i (74190) $839.40 $1,399 1.5×
Pr MRI brain w/o & w/ dye (70559) $5,310.60 $8,851 30.0×
Pr MRI brain w/o dye (70557) $4,035.60 $6,726 7.3×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,792.80 $2,988 5.1×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $1,315.20 $2,192 1.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $382.80 $638 4.4×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $382.80 $638 3.6×
Radex hips bilateral with pelvis 2 views (73521) $292.20 $487 2.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $382.80 $638 3.6×
Radiolog exam mandible compl minimum 4 views (70110) $283.20 $472 2.7×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $216 $360 2.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $250.20 $417 2.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $292.20 $487 3.3×
Radiologic exam colon single contrast study (74270) $799.20 $1,332 4.5×
Radiologic exam teeth prtl exam < full mouth (70310) $266.40 $444 1.1×
Radiologic exam upr gi trc double contrast study (74246) $700.20 $1,167 4.0×
Radiologic exam upr gi trc single contrast study (74240) $634.20 $1,057 3.6×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $325.80 $543 3.7×
Radiological examination surgical specimen (76098) $809.40 $1,349 1.5×
Ribs bilateral 3 views (71110) $367.20 $612 3.5×
Sacroiliac Joints < 3 Views (72200) $175.20 $292 1.7×
Scapula complete (73010) $488.10 $813.50 4.6×
Small bowel series (74250) $591.60 $986 3.3×
Spine thoracic 3 views (72072) $416.40 $694 4.0×
Thoracolumbar 2 views (72080) $382.80 $638 4.4×
Tmj unilateral (70328) $382.80 $638 4.4×
Ultrasound, abdomen limited (76705) $325.80 $543 3.1×
Unlisted fluoroscopic procedure (76496) $332.40 $554 3.8×
Unlisted magnetic resonance procedure (76498) $3,120.60 $5,201 35.6×
Unlisted Ultrasound Procedure (76999) $224.40 $374 2.6×
Upper Extremity Infant (73092) $233.40 $389 2.2×
Urethrocystography retrograde rs&i (74450) $411.60 $686 1.7×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $709.20 $1,182 4.0×
Us abdl aorta screen aaa (76706) $298.20 $497 2.8×
Us breast unilateral complete (76641) $224.40 $374 2.1×
Us breast unilateral limited (76642) $224.40 $374 2.6×
Us chest (76604) $325.80 $543 3.1×
Us compl joint r-t w/image documentation (76881) $325.80 $543 3.1×
Us ob detailed single fetus (76811) $459 $765 1.9×
Us ob transvaginal (76817) $325.80 $543 3.1×
Us pelvic non ob complete (76856) $313.38 $522.30 3.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $283.20 $472 2.7×
Us pregnancy ltd (76815) $224.40 $374 2.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $325.80 $543 3.1×
Us retroperitoneal complete (76770) $325.80 $543 3.1×
Us retroperitoneal limited (76775) $325.80 $543 3.1×
Us scrotum and contents (76870) $325.80 $543 3.1×
Us soft tissue head/neck (76536) $325.80 $543 3.1×
Us spinal canal and contents (76800) $250.20 $417 2.4×
Us transrectal (76872) $325.80 $543 3.1×
Us transrectal prostate volume (76873) $459 $765 4.4×
Us xtr non-vasc lmtd (76882) $224.40 $374 2.1×
Venogram extremity bilateral (75822) $2,460.60 $4,101 1.6×
Venography caval inferior serialography rs&i (75825) $4,256.40 $7,094 1.3×
Venography caval superior serialography rs&i (75827) $2,090.70 $3,484.50 1.3×
Venography extremity unilateral rs&i (75820) $2,413.20 $4,022 1.5×
Venography Renal Bilateral (75833) $2,286.60 $3,811 0.7×
Wrist 2 views (73100) $241.20 $402 2.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $275.40 $459 2.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $375.60 $626 4.3×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $299.40 $499 3.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $258 $430 2.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $325.80 $543 3.7×
X-ray exam entire spi 4/5 vw (72083) $382.80 $638 3.6×
X-ray exam hip uni 1 view (73501) $258 $430 2.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $325.80 $543 3.7×
X-ray exam hip uni 4/> views (73503) $325.80 $543 3.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $292.20 $487 2.8×
X-Ray Exam Hips Bi 5/> Views (73523) $292.20 $487 2.8×
X-ray exam of femur 1 (73551) $325.80 $543 3.7×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $260.40 $434 1.5×
X-ray eye for foreign body (70030) $266.40 $444 3.0×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $325.80 $543 3.1×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $266.40 $444 3.0×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $292.20 $487 3.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $250.20 $417 2.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $150.60 $251 1.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $375.60 $626 3.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $266.40 $444 3.0×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $233.40 $389 2.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $358.20 $597 3.4×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $641.40 $1,069 6.1×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $499.80 $833 4.7×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $208.20 $347 2.4×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $341.40 $569 3.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $266.40 $444 2.5×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $641.40 $1,069 1.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $275.40 $459 3.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $316.80 $528 3.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $434.40 $724 4.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $233.40 $389 2.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $208.20 $347 2.4×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $332.40 $554 3.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $400.80 $668 4.6×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $150.60 $251 1.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $382.80 $638 3.6×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $266.40 $444 2.5×
X-Ray Spine One View - Xr Spine (72020) $233.40 $389 2.7×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $150.60 $251 1.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $299.40 $499 3.4×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $350.40 $584 3.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $508.80 $848 4.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $241.20 $402 2.7×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $275.40 $459 3.1×
Xr arthrogram ankle (73615) $992.40 $1,654 2.8×
Xr c-spine 6 or more views (72052) $575.40 $959 5.5×
Xr chest 4+ views (71048) $347.40 $579 3.3×
Xr finger(s) 2+ views (73140) $208.20 $347 2.4×
XR Mastoids < 3 Views Bilateral (70120) $260.40 $434 2.5×
Xr shoulder 1 view (73020) $233.40 $389 2.7×
Xr spine cervical 4 or 5 views (72050) $484.20 $807 4.6×
Xr tibia/fibula 2 views (73590) $283.20 $472 3.2×
Xray knee 1 or 2 views rt (73560) $283.20 $472 3.2×