Imaging prices at Claiborne County Medical Center

Port Gibson, MS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $346.50 $385 3.8×
Bone survey complete (77075) $161.51 $179.46 1.8×
Cervical spine 2 or 3 views (72040) $139.50 $155 1.9×
Chest 1 view (71045) $164.70 $183 2.2×
Chest 3 views (71047) $378 $420 5.0×
Clavicle complete (73000) $14.35 $15.94 0.2×
CT abdomen and pelvis without and with contrast (74178) $1,586.84 $1,763.16 5.3×
CT abdomen and pelvis without contrast (74176) $923.85 $1,026.50 4.5×
CT abdomen w contrast (74160) $1,090.86 $1,212.06 7.2×
CT abdomen w wo contrast (74170) $1,363.02 $1,514.46 9.0×
CT abdomen w/o contrast (74150) $903.08 $1,003.42 10.0×
CT angiography upper extremity lt (73206) $920.81 $1,023.12 6.1×
CT c-spine w/o contrast (72125) $613.91 $682.12 6.8×
CT cervical spine w&w/o contrast (72127) $888.02 $986.69 5.9×
CT cervical spine with contrast (72126) $423.43 $470.48 1.4×
CT chest w/wo contrast (71270) $737.55 $819.50 4.9×
CT chest with contrast (71260) $787.92 $875.46 5.2×
CT head/brain with contrast (70460) $726.95 $807.72 4.8×
CT head/brain without and with contrast (70470) $692.62 $769.58 4.6×
CT iac w contrast (70481) $545 $605.56 3.6×
CT limited/localized follow up study (76380) $241.76 $268.63 3.2×
CT lower ext w/o (73700) $469.24 $521.37 5.2×
CT lower extremity w wo contrast (73702) $667.68 $741.87 4.4×
CT lower extremity with contrast (73701) $406.84 $452.04 2.7×
CT lumbar spine w & w/o contrast (72133) $888.24 $986.94 5.9×
CT lumbar spine w/o contrast (72131) $608.74 $676.37 6.8×
CT lumbar spine with contrast (72132) $787.08 $874.53 2.6×
CT maxillofacial w contrast (70487) $599.98 $666.64 4.0×
CT maxillofacial w/o contrast (70486) $510.05 $566.72 5.7×
CT maxillofacial w/wo contrast (70488) $533.12 $592.35 3.5×
CT neck soft tissue w contrast (70491) $794.32 $882.57 5.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $613.37 $681.52 4.1×
CT orbits w/o contrast (70480) $427.50 $475 4.7×
CT pelvis w & w/o contrast (72194) $892.27 $991.41 5.9×
CT pelvis w/o contrast (72192) $597.95 $664.39 6.6×
CT scan for measuring calcium and other minerals in bone (77078) $386.18 $429.09 5.1×
CT soft tissue neck w/o & w/contrast material (70492) $895.59 $995.10 5.9×
CT soft tissue neck w/o contrast (70490) $622.60 $691.77 6.9×
CT thoracic spine w/contrast (72129) $787.82 $875.35 5.2×
CT thoracic spine w/o contrast (72128) $609.70 $677.44 6.8×
CT thoracic spine w/wo contrast (72130) $888.34 $987.05 5.9×
CT thorax w/o contrast (71250) $609.80 $677.56 6.8×
CT upper extremity w/o & w/contrast material (73202) $671.76 $746.40 4.4×
CT upper extremity w/o contrast rt (73200) $469.24 $521.37 5.2×
CT upper extremity with contrast (73201) $661.50 $735 2.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,466.52 $1,629.47 9.7×
Cta Abdomen (74175) $1,373.42 $1,526.03 9.1×
CTA abdomen pelvis (74174) $2,241 $2,490 7.5×
CTA chest (71275) $1,152 $1,280 7.6×
Cta Head (70496) $1,133.30 $1,259.22 7.5×
CTA lwr ext w&w/o contrast (73706) $943.52 $1,048.36 6.2×
Cta Neck (70498) $1,131.68 $1,257.43 7.5×
Cta Pelvis (72191) $1,103.38 $1,225.98 7.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $455.47 $506.08 5.1×
Foot 2 views (73620) $166.50 $185 2.2×
Forearm 2 views (73090) $229.50 $255 3.1×
Hand 2 views (73120) $166.50 $185 1.8×
Hand 3 views (73130) $202.50 $225 2.7×
Humerus Min 2 Views Left (73060) $122.24 $135.82 1.6×
Knee 3 views (73562) $136.78 $151.97 1.8×
Neck soft tissue (70360) $59.40 $66 0.8×
Osseous survey infant (77076) $155.46 $172.74 1.7×
Pelvis 1 or 2 views (72170) $71.84 $79.82 0.8×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $101.70 $113 1.4×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $166.50 $185 1.8×
Radex hips bilateral with pelvis 2 views (73521) $112.36 $124.85 1.2×
Radex mastoids compl minimum 3 views pr side (70130) $335.70 $373 3.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $232.20 $258 2.6×
Radiolog exam mandible compl minimum 4 views (70110) $59.40 $66 0.7×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $299.25 $332.50 4.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $369.20 $410.22 4.1×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $191.70 $213 2.6×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $306 $340 4.1×
Radiologic Examination Salivary Gland Calculus (70380) $59.40 $66 0.8×
Ribs bilateral 3 views (71110) $77.40 $86 0.9×
Sacroiliac Joints < 3 Views (72200) $14.44 $16.04 0.2×
Scapula complete (73010) $14.98 $16.64 0.2×
Sella turcica (70240) $94.05 $104.50 1.3×
Thoracolumbar 2 views (72080) $82.80 $92 1.1×
Ultrasound, abdomen limited (76705) $205.47 $228.30 2.3×
Us abdl aorta screen aaa (76706) $205.47 $228.30 2.3×
Us breast unilateral complete (76641) $176.16 $195.73 2.0×
Us breast unilateral limited (76642) $267.77 $297.52 3.6×
Us chest (76604) $379.80 $422 4.2×
Us compl joint r-t w/image documentation (76881) $765 $850 8.5×
Us guided compression repair (76936) $602.20 $669.11 3.2×
Us ob transvaginal (76817) $376.68 $418.53 4.2×
Us pelvic non ob complete (76856) $177.44 $197.15 2.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $272.78 $303.09 3.0×
Us pregnancy ltd (76815) $198.65 $220.72 2.2×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $363.08 $403.42 4.0×
Us retroperitoneal complete (76770) $450 $500 5.0×
Us retroperitoneal limited (76775) $421.20 $468 4.7×
Us scrotum and contents (76870) $432.36 $480.40 4.8×
Us soft tissue head/neck (76536) $352.30 $391.45 3.9×
Us spinal canal and contents (76800) $219.35 $243.72 2.4×
Us xtr non-vasc lmtd (76882) $585 $650 6.5×
Wrist 2 views (73100) $94.95 $105.50 1.3×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $59.40 $66 0.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $73.32 $81.47 1.0×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $79.22 $88.02 1.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $283.50 $315 3.8×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $153.47 $170.52 2.0×
X-ray exam entire spi 4/5 vw (72083) $189 $210 2.1×
X-ray exam hip uni 1 view (73501) $17.95 $19.94 0.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $133.04 $147.82 1.8×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $241.20 $268 3.2×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $202.50 $225 2.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $110.70 $123 1.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $371.70 $413 5.0×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $265.50 $295 2.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $282.60 $314 3.8×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $193.50 $215 2.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $210.60 $234 2.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $59.40 $66 0.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $233.10 $259 3.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $99.90 $111 1.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $16.24 $18.04 0.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $14.44 $16.04 0.2×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $351 $390 4.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $225.45 $250.50 3.0×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $133.20 $148 1.8×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $139.95 $155.50 1.6×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $81.90 $91 0.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $99.90 $111 1.3×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $58.50 $65 0.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $112.95 $125.50 1.5×
Xr c-spine 6 or more views (72052) $207.90 $231 2.3×
Xr chest 4+ views (71048) $254.70 $283 2.8×
Xr finger(s) 2+ views (73140) $11.39 $12.66 0.2×
Xr shoulder 1 view (73020) $163.80 $182 2.2×
Xr spine cervical 4 or 5 views (72050) $314.55 $349.50 3.5×
Xr tibia/fibula 2 views (73590) $202.50 $225 2.7×
Xr tmj bilateral (70330) $245.25 $272.50 3.3×
Xray knee 1 or 2 views rt (73560) $225 $250 3.0×