Imaging prices at Clay County Memorial Hospital
Henrietta, TX · every code in this section with a posted price and a Medicare benchmark.
160 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $146 | $209 | 1.7× |
| Abdomen 2 views (74019) | $182 | $260 | 1.7× |
| Ankle 2 views (73600) | $151 | $216 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $917 | $1,310 | 10.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$106–$149 | $151–$213 | varies |
| Chest 2 views (71046) | $151 | $216 | 1.7× |
| Chest 3 views (71047) | $251 | $359 | 2.9× |
| Clavicle complete (73000) | $157 | $224 | 1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,160 | $1,657 | 11.0× |
| Contrast X-Ray Bladder (74430) | $617 | $881 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $3,755 | $5,365 | 10.7× |
| CT abdomen and pelvis without contrast (74176) | $3,073 | $4,390 | 12.8× |
| CT abdomen w contrast (74160) | $1,684 | $2,406 | 9.6× |
| CT abdomen w wo contrast (74170) | $2,033 | $2,905 | 11.5× |
| CT abdomen w/o contrast (74150) | $1,437 | $2,053 | 13.7× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,757–$2,426 | $2,510–$3,466 | varies |
| CT Angio Chest (71275) | $2,570 | $3,671 | 14.6× |
| CT Angio Head (70496) | $1,771 | $2,530 | 10.1× |
| CT Angio Neck (70498) | $1,896 | $2,709 | 10.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,562 | $2,231 | 8.9× |
| CT bone density (77078) range across 3 matching MRF lines |
$190–$489 | $272–$699 | varies |
| CT cervical spine w/ contrast (72126) | $1,728 | $2,468 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,474 | $2,106 | 14.0× |
| CT cervical spine w/wo cont (72127) | $1,540 | $2,200 | 8.7× |
| CT chest w contrast (71260) | $1,718 | $2,454 | 9.8× |
| CT chest w/wo contrast (71270) | $2,092 | $2,988 | 11.9× |
| CT head/brain with contrast (70460) | $1,419 | $2,027 | 8.1× |
| CT head/brain without and with contrast (70470) | $1,728 | $2,468 | 9.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $88 | $125 | 1.0× |
| CT iac w contrast (70481) | $1,294 | $1,848 | 7.3× |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,474–$1,540 | $2,106–$2,200 | varies |
| CT lower ext w/o (73700) range across 13 matching MRF lines |
$1,062–$1,237 | $1,517–$1,767 | varies |
| CT lower extremity w/contrast material (73701) | $1,718 | $2,454 | 9.8× |
| CT lumbar spine w contrast (72132) | $1,728 | $2,468 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $1,474 | $2,106 | 14.0× |
| CT maxillofacial wo contrast (70486) | $1,266 | $1,808 | 12.1× |
| CT neck tissue combo (70492) | $1,602 | $2,288 | 9.1× |
| CT orbits w/o contrast (70480) | $1,294 | $1,848 | 12.3× |
| CT pelvis w&w/o contrast (72194) | $1,973 | $2,819 | 11.2× |
| CT pelvis w/o contrast (72192) | $1,450 | $2,071 | 13.8× |
| CT scan of leg combo (73702) | $1,483 | $2,119 | 8.4× |
| CT scans face/jaw combo (70488) | $1,266 | $1,808 | 7.2× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,030–$1,294 | $1,471–$1,848 | varies |
| CT soft tissue neck w/o contrast (70490) | $1,294 | $1,848 | 12.3× |
| CT thoracic spine w contrast (72129) | $1,540 | $2,200 | 8.7× |
| CT thoracic spine w/o contrast (72128) | $1,474 | $2,106 | 14.0× |
| CT thoracic spine w/wo cont (72130) | $1,540 | $2,200 | 8.7× |
| CT thorax w/o contrast (71250) | $1,160 | $1,657 | 11.0× |
| CT upper ext wo (73200) range across 9 matching MRF lines |
$1,237–$1,274 | $1,767–$1,820 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,421 | $2,030 | 8.1× |
| CT upper extremity with contrast (73201) | $1,365 | $1,950 | 3.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,777–$2,195 | $2,539–$3,135 | varies |
| Cta Abdomen (74175) | $2,426 | $3,466 | 13.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,771 | $2,530 | 5.1× |
| CTA pelvis (72191) | $2,129 | $3,042 | 12.1× |
| Fetal Biophys Profile W/Nst (76818) | $744 | $1,063 | 7.1× |
| Fluoroscopy up to 1 hr (76000) | $464 | $663 | 1.9× |
| Foot 2 views (73620) | $129 | $184 | 1.5× |
| Forearm 2 views (73090) | $151 | $215 | 1.7× |
| Hand 2 views (73120) | $135 | $193 | 1.3× |
| Knee 3 Views (73562) | $174 | $249 | 2.0× |
| MRA head w/o contrast (70544) | $1,628 | $2,325 | 6.8× |
| MRA neck w contrast (70548) | $1,728 | $2,468 | 4.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,127 | $3,038 | 6.1× |
| MRA neck w/o contrast (70547) | $1,628 | $2,325 | 6.8× |
| MRI abdomen w contrast (74182) | $1,628 | $2,325 | 4.6× |
| MRI abdomen w/o contrast (74181) | $1,628 | $2,325 | 6.8× |
| MRI any jt lower extrem w/contrast material (73722) | $2,538 | $3,625 | 3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,255 | $4,650 | 9.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,538 | $3,625 | 3.2× |
| MRI cervical spine w/o cont (72141) | $1,628 | $2,325 | 6.8× |
| MRI chest w/o contrast (71550) | $1,628 | $2,325 | 6.8× |
| MRI chest with contrast (71551) | $2,538 | $3,625 | 3.2× |
| MRI chest wo w contrast (71552) | $3,255 | $4,650 | 9.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,456 | $3,509 | 7.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,955 | $4,222 | 8.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,628 | $2,325 | 6.8× |
| MRI lumbar spine w contrast (72149) | $2,538 | $3,625 | 7.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,255 | $4,650 | 9.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,628 | $2,325 | 6.8× |
| MRI orbit face neck w contrast (70542) | $2,538 | $3,625 | 7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,255 | $4,650 | 9.3× |
| MRI pelvis w contrast (72196) | $2,538 | $3,625 | 7.2× |
| MRI pelvis w/o & w contrast (72197) | $3,255 | $4,650 | 9.3× |
| MRI pelvis w/o contrast (72195) | $1,628 | $2,325 | 6.8× |
| MRI thoracic spine w/o contrast (72146) | $1,628 | $2,325 | 6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,628 | $2,325 | 6.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,255 | $4,650 | 9.3× |
| MRI, abdomen, combo (74183) | $3,255 | $4,650 | 9.3× |
| MRI, dorsal spine combo (72157) | $3,255 | $4,650 | 9.3× |
| MRI, dorsal spine contrast (72147) | $2,538 | $3,625 | 7.2× |
| MRI, joint upper extrem (73221) | $1,628 | $2,325 | 6.8× |
| MRI, joint upper extrem combo (73223) | $3,255 | $4,650 | 9.3× |
| MRI, lumbar spine combo (72158) | $3,255 | $4,650 | 9.3× |
| Neck soft tissue (70360) | $122 | $174 | 1.4× |
| Pelvis 1 or 2 views (72170) | $138 | $197 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $348 | $497 | 3.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $166 | $237 | 1.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $137 | $196 | 1.6× |
| Radex elbow complete minimum 3 views (73080) | $174 | $249 | 2.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$172–$237 | $246–$338 | varies |
| Radex fingr minimum 2 views (73140) | $125 | $179 | 1.4× |
| Radex foot complete minimum 3 views (73630) | $163 | $233 | 1.9× |
| Radex Hand Minimum 3 Views (73130) | $166 | $237 | 1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $251 | $359 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $148 | $212 | 1.7× |
| Radex Ribs Unilateral 2 Views (71100) | $174 | $249 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$158–$167 | $225–$239 | varies |
| Radex Spine 1 View Specify Level (72020) | $165 | $235 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $160 | $229 | 1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $210 | $300 | 2.4× |
| Radex Toe Minimum 2 Views (73660) | $135 | $193 | 1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $174 | $249 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $225 | $321 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $290 | $414 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $356 | $508 | 2.0× |
| Radiologic examination femur minimum 2 views (73552) | $169 | $242 | 1.9× |
| Radiologic examination knee 1/2 views (73560) | $141 | $202 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $160 | $229 | 1.8× |
| Ribs bilateral 3 views (71110) | $232 | $331 | 2.2× |
| Scapula (73010) | $158 | $226 | 1.5× |
| Sella turcica (70240) | $158 | $226 | 1.8× |
| Shoulder 1 view (73020) | $129 | $184 | 1.5× |
| Skull less than 4 views (70250) | $163 | $233 | 1.6× |
| Sternoclavicular joints (71130) | $174 | $249 | 2.0× |
| Thoracic spine 2 views (72070) | $174 | $249 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $205 | $293 | 0.5× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$316–$407 | $452–$581 | varies |
| Unlisted fluoroscopic procedure (76496) | $202 | $288 | 2.3× |
| Us breast unilateral complete (76641) | $278 | $397 | 2.6× |
| Us complete joint (76881) range across 2 matching MRF lines |
$335–$380 | $479–$543 | varies |
| Us exam, pelvic, limited (76857) | $114 | $163 | 1.1× |
| Us ob limited 1 or more fetuses (76815) | $410 | $585 | 3.9× |
| Us pelvic non ob complete (76856) | $407 | $581 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $706 | $1,008 | 6.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $410 | $585 | 3.9× |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$407–$443 | $581–$633 | varies |
| Us scrotum and contents (76870) | $447 | $638 | 4.3× |
| Us thyroid (76536) | $335 | $479 | 3.2× |
| Vertebral fracture assessment via dxa (77086) | $81 | $116 | 0.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$109–$174 | $155–$249 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $166 | $237 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $143 | $204 | 1.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $115 | $165 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $174 | $248 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $249 | $356 | 2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$241–$271 | $345–$387 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $293 | $419 | 2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $208 | $297 | 2.0× |
| X-ray humerus (73060) | $154 | $220 | 1.8× |
| X-ray IV pyelogram (ivp) (74400) | $571 | $815 | 3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $290 | $414 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$196–$232 | $280–$331 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $274 | $392 | 2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $190 | $271 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$127–$307 | $182–$439 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $239 | $341 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $297 | $424 | 2.8× |
| X-ray thoracic spine 4 vw (72074) | $273 | $390 | 2.6× |
| Xr orbits complete 4 views (70200) | $199 | $284 | 1.9× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.