Imaging prices at Covenant Hospital Levelland

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $141.12 $336 1.6×
Abdomen 2 views (74019) $189.84 $452 1.8×
Ankle 2 views (73600) $147 $350 1.7×
Bone age studies (77072) $197.82 $471 1.9×
Bone survey infant (77076) $197.82 $471 1.9×
Cat Scan Follow-Up Study (76380) $461.58 $1,099 5.3×
Chest 1 view (71045) $160.44 $382 1.8×
Chest 2 views (71046) $160.44 $382 1.8×
Chest 3 views (71047) $160.44 $382 1.8×
Chest 4 or more views (71048) $215.88 $514 2.1×
Clavicle complete (73000) $147 $350 1.7×
Contrast X-Ray Bladder (74430) $641.34 $1,527 1.8×
Contrast X-Ray Of Elbow (73085) $431.34 $1,027 1.2×
CT abdomen and pelvis without and with contrast (74178) $1,771.56 $4,218 5.1×
CT abdomen and pelvis without contrast (74176) $1,077.72 $2,566 4.5×
CT abdomen w contrast (74160) $836.22 $1,991 4.7×
CT abdomen w wo contrast (74170) $884.52 $2,106 5.0×
CT abdomen w/o contrast (74150) $509.88 $1,214 4.9×
CT Angio Abdomen and Pelvis (74174) $2,101.68 $5,004 6.0×
CT Angio Chest (71275) $836.22 $1,991 4.7×
CT Angio Head (70496) $1,530.90 $3,645 8.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,019.76 $2,428 5.8×
CT Angio Neck (70498) $1,530.90 $3,645 8.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,019.76 $2,428 5.8×
CT bone density (77078) $378.84 $902 4.3×
CT cervical spine w/ contrast (72126) $3,156.30 $7,515 9.0×
CT cervical spine w/o contrast (72125) $747.60 $1,780 7.1×
CT cervical spine w/wo cont (72127) $3,209.64 $7,642 18.2×
CT chest w contrast (71260) $836.22 $1,991 4.7×
CT chest w/wo contrast (71270) $884.52 $2,106 5.0×
CT head/brain with contrast (70460) $1,224.72 $2,916 7.0×
CT head/brain without and with contrast (70470) $1,277.64 $3,042 7.3×
CT iac w contrast (70481) $1,530.90 $3,645 8.7×
CT l-spine w&w/o contrast (72133) $2,149.98 $5,119 12.2×
CT lower ext w/o (73700) $509.88 $1,214 4.9×
CT lower extremity w/contrast material (73701) $1,253.70 $2,985 7.1×
CT lumbar spine w contrast (72132) $2,101.68 $5,004 6.0×
CT lumbar spine w/o contrast (72131) $509.88 $1,214 4.9×
CT maxillofacial w contrast (70487) $1,530.90 $3,645 8.7×
CT maxillofacial wo contrast (70486) $747.60 $1,780 7.1×
CT neck tissue combo (70492) $1,277.64 $3,042 7.3×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,583.82 $3,771 9.0×
CT orbits w/o contrast (70480) $747.60 $1,780 7.1×
CT pelvis w&w/o contrast (72194) $1,019.76 $2,428 5.8×
CT pelvis w/o contrast (72192) $509.88 $1,214 4.9×
CT scan of leg combo (73702) $1,302 $3,100 7.4×
CT scans face/jaw combo (70488) $1,583.82 $3,771 9.0×
CT soft tissue neck w contrast (70491) $1,224.72 $2,916 7.0×
CT soft tissue neck w/o contrast (70490) $747.60 $1,780 7.1×
CT thoracic spine w contrast (72129) $1,019.76 $2,428 5.8×
CT thoracic spine w/o contrast (72128) $509.88 $1,214 4.9×
CT thoracic spine w/wo cont (72130) $1,068.06 $2,543 6.1×
CT thorax w/o contrast (71250) $509.88 $1,214 4.9×
CT upper ext wo (73200) $509.88 $1,214 4.9×
CT upper extremity w/o & w/contrast material (73202) $1,771.56 $4,218 10.1×
CT upper extremity with contrast (73201) $1,723.26 $4,103 4.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,019.76 $2,428 5.8×
Cta Abdomen (74175) $1,019.76 $2,428 5.8×
CTA pelvis (72191) $1,019.76 $2,428 5.8×
Doppler Echo Fetal Spectral Display Complete (76827) $270.06 $643 2.6×
Dxa Bone Density Axial (77080) $197.82 $471 1.9×
Dxa bone density study (77085) $293.16 $698 2.8×
Esophagram (74220) $311.22 $741 1.8×
Fetal Biophys Profile W/Nst (76818) $270.06 $643 2.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $270.06 $643 2.6×
Fluoroscopy up to 1 hr (76000) $263.34 $627 1.1×
Foot 2 views (73620) $147 $350 1.7×
Forearm 2 views (73090)
range across 2 matching MRF lines		 $110.04–$147 $262–$350 varies
Hand 2 views (73120)
range across 2 matching MRF lines		 $154.14–$241.50 $367–$575 varies
Infant hip ultrasound with hip movement (dynamic) (76885) $250.74 $597 2.9×
Infant hip ultrasound, limited static exam (76886) $250.74 $597 2.9×
Joint Survey Single View (77077) $134.40 $320 1.3×
Knee 3 Views (73562) $147 $350 1.7×
Lymph System Imaging (78195) $417.06 $993 0.8×
Mra Head W/O & W/Contrast Material (70546) $2,056.32 $4,896 5.9×
MRA head w/o contrast (70544) $1,259.16 $2,998 5.3×
MRA head with contrast (70545) $2,014.32 $4,796 5.7×
MRA neck w contrast (70548) $2,014.32 $4,796 5.7×
Mra Neck W/O &W/Contrast Material (70549) $2,056.32 $4,896 5.9×
MRA neck w/o contrast (70547) $1,259.16 $2,998 5.3×
MRI abdomen w contrast (74182) $2,024.82 $4,821 5.8×
MRI abdomen w/o contrast (74181) $1,265.88 $3,014 5.3×
MRI any jt lower extrem w/contrast material (73722) $1,619.94 $3,857 2.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,661.94 $3,957 4.7×
MRI any jt upper extremity w/contrast matrl (73222) $1,619.94 $3,857 2.1×
MRI cervical spine w contrast (72142) $2,014.32 $4,796 5.7×
MRI cervical spine w/o cont (72141) $1,259.16 $2,998 5.3×
MRI chest w/o contrast (71550) $1,265.88 $3,014 5.3×
MRI chest wo w contrast (71552) $2,024.82 $4,821 5.8×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,024.82 $4,821 5.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,012.62 $2,411 4.2×
MRI lumbar spine w contrast (72149) $2,024.82 $4,821 5.8×
Mri Neck Spine W/O & W/Dye (72156) $2,056.32 $4,896 5.9×
MRI orbit face &/neck w/o contrast (70540) $1,259.16 $2,998 5.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,014.32 $4,796 5.7×
MRI pelvis w contrast (72196) $2,024.82 $4,821 5.8×
MRI pelvis w/o & w contrast (72197) $2,066.82 $4,921 5.9×
MRI pelvis w/o contrast (72195) $1,012.62 $2,411 4.2×
MRI thoracic spine w/o contrast (72146) $676.62 $1,611 2.8×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,265.88 $3,014 5.3×
Mri Uppr Extremity W/O&W/Dye (73220) $2,024.82 $4,821 5.8×
MRI, abdomen, combo (74183) $2,066.82 $4,921 5.9×
MRI, dorsal spine combo (72157) $2,066.82 $4,921 5.9×
MRI, dorsal spine contrast (72147) $2,024.82 $4,821 5.8×
MRI, joint upper extrem (73221) $1,012.62 $2,411 4.2×
MRI, joint upper extrem combo (73223) $1,661.94 $3,957 4.7×
MRI, lumbar spine combo (72158) $2,066.82 $4,921 5.9×
Neck soft tissue (70360) $141.12 $336 1.6×
Nonvascular Shunt X-Ray (75809) $189.84 $452 1.8×
Ob us nuchal meas 1 gest (76813) $293.58 $699 2.8×
Optic foramina (70190) $147 $350 1.7×
Pelvis 1 or 2 views (72170) $197.82 $471 1.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $189.84 $452 1.8×
Radex abscess/fistula/sinus tract rs&i (76080) $841.68 $2,004 1.5×
Radex Ankle Complete Minimum 3 Views (73610) $147 $350 1.7×
Radex Calcaneus Minimum 2 Views (73650) $147 $350 1.7×
Radex elbow complete minimum 3 views (73080) $147 $350 1.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $197.82 $471 1.9×
Radex fingr minimum 2 views (73140) $147 $350 1.7×
Radex foot complete minimum 3 views (73630) $147 $350 1.7×
Radex Hand Minimum 3 Views (73130) $283.92 $676 3.2×
Radex lower extremity infant minimum 2 views (73592) $147 $350 1.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $197.82 $471 1.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $147 $350 1.7×
Radex Ribs Unilateral 2 Views (71100) $147 $350 1.7×
Radex shoulder complete minimum 2 views (73030) $147 $350 1.7×
Radex Sinuses Paransl < 3 Views (70210) $147 $350 1.7×
Radex Spine 1 View Specify Level (72020) $147 $350 1.7×
Radex Sternum Minimum 2 Views (71120) $147 $350 1.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $147 $350 1.7×
Radex Toe Minimum 2 Views (73660) $147 $350 1.7×
Radex upper extremity infant minimum 2 views (73092) $197.82 $471 1.9×
Radex Wrist Complete Minimum 3 Views (73110) $147 $350 1.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $197.82 $471 1.9×
Radiolog exam mandible compl minimum 4 views (70110) $197.82 $471 1.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $189.84 $452 1.8×
Radiologic exam colon double contrast study (74280) $311.22 $741 1.8×
Radiologic exam colon single contrast study (74270) $311.22 $741 1.8×
Radiologic Exam Esophagus Double Contrast Study (74221) $311.22 $741 1.8×
Radiologic exam knee complete 4/more views (73564) $197.82 $471 1.9×
Radiologic exam pelvis compl minimum 3 views (72190) $197.82 $471 1.9×
Radiologic Exam Small Int Single Contrast Study (74250) $311.22 $741 1.8×
Radiologic exam swallow function contrast study (74230) $311.22 $741 1.8×
Radiologic exam upr gi trc double contrast study (74246) $311.22 $741 1.8×
Radiologic examination femur 1 view (73551) $147 $350 1.7×
Radiologic examination femur minimum 2 views (73552) $147 $350 1.7×
Radiologic examination knee 1/2 views (73560) $147 $350 1.7×
Radiologic Examination Osseous Survey Limited (77074) $197.82 $471 1.9×
Radiologic examination tibia & fibula 2 views (73590)
range across 2 matching MRF lines		 $110.04–$147 $262–$350 varies
Ribs bilateral 3 views (71110) $197.82 $471 1.9×
Scapula (73010) $197.82 $471 1.9×
Screening Digital Breast Tomosynthesis Bi (77063) $44.10 $105 1.9×
Shoulder 1 view (73020) $147 $350 1.7×
Shoulder Arthrography (73040) $431.34 $1,027 1.2×
Skull less than 4 views (70250) $197.82 $471 1.9×
Sternoclavicular joints (71130) $147 $350 1.7×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $174.72 $416 1.0×
Thoracic spine 2 views (72070) $197.82 $471 1.9×
Thoracic spine 3 views (72072) $197.82 $471 1.9×
Thoracolumbar 2 views (72080) $147 $350 1.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $354.90 $845 0.9×
Ultrasound Breast Limited (76642) $200.76 $478 2.3×
Ultrasound Exam Aaa Screen (76706) $270.06 $643 2.6×
Ultrasound, abdomen limited (76705) $270.06 $643 2.6×
Unlisted us procedure (76999) $200.76 $478 2.3×
Upper gi w/o kub (74240) $311.22 $741 1.8×
Urethrocystogram voiding (74455) $400.68 $954 1.7×
Urethrocystography retrograde (74450) $400.68 $954 1.7×
Us breast unilateral complete (76641) $270.06 $643 2.6×
Us chest (76604) $270.06 $643 2.6×
Us complete joint (76881) $270.06 $643 2.6×
Us exam, pelvic, limited (76857) $270.06 $643 2.6×
Us head (76506) $270.06 $643 2.6×
Us kidney transplant (76776) $270.06 $643 2.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $270.06 $643 2.6×
Us ob detailed single fetus (76811) $737.94 $1,757 3.1×
Us ob limited 1 or more fetuses (76815) $270.06 $643 2.6×
Us ob transvaginal (76817) $270.06 $643 2.6×
Us pelvic non ob complete (76856) $270.06 $643 2.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $270.06 $643 2.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $270.06 $643 2.6×
Us retroperitoneal complete (76770) $270.06 $643 2.6×
Us retroperitoneal limited (76775) $270.06 $643 2.6×
Us scrotum and contents (76870) $270.06 $643 2.6×
Us spinal canal and contents (76800) $270.06 $643 2.6×
Us thyroid (76536) $270.06 $643 2.6×
Venography extremity bilateral rs&i (75822) $1,260 $3,000 0.8×
Venography extremity unilateral rs&i (75820) $1,107.96 $2,638 0.7×
Wrist 2 views (73100) $147 $350 1.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $147 $350 1.7×
X-Ray Bend Only L-S Spine (72120) $197.82 $471 1.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $147 $350 1.7×
X-Ray Exam Breast Specimen (76098) $956.76 $2,278 1.7×
X-Ray Exam Entire Spi 1 Vw (72081) $147 $350 1.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $197.82 $471 1.9×
X-Ray Exam Entire Spi 4/5 Vw (72083) $197.82 $471 1.9×
X-Ray Exam Hip Uni 1 View (73501) $147 $350 1.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $147 $350 1.7×
X-Ray Exam Hip Uni 4/> Views (73503) $197.82 $471 1.9×
X-Ray Exam Hips Bi 2 Views (73521) $197.82 $471 1.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $197.82 $471 1.9×
X-Ray Exam Hips Bi 5/> Views (73523) $197.82 $471 1.9×
X-Ray Exam L-S Spine Bending (72114) $197.82 $471 1.9×
X-Ray Exam Neck Spine 2-3 Vw (72040) $147 $350 1.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $197.82 $471 1.9×
X-Ray Exam Unilat Ribs/Chest (71101) $197.82 $471 1.9×
X-ray eye for foreign body (70030) $141.12 $336 1.6×
X-ray humerus (73060) $147 $350 1.7×
X-ray IV pyelogram (ivp) (74400) $311.22 $741 1.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $147 $350 1.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $147 $350 1.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $197.82 $471 1.9×
X-ray nose-rectum child f.b. (76010) $141.12 $336 1.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $197.82 $471 1.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $197.82 $471 1.9×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $197.82 $471 1.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $147 $350 1.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $147 $350 1.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $197.82 $471 1.9×
X-Ray Stress View (77071) $147 $350 1.7×
X-ray thoracic spine 4 vw (72074) $197.82 $471 1.9×
X-Ray Tmj Unilat (70328) $147 $350 1.7×
X-Rays Bone Length Studies (77073) $197.82 $471 1.9×
X-Rays Bone Survey Complete (77075) $197.82 $471 1.9×
Xr c-spine 4 or 5 views (72050) $197.82 $471 1.9×
Xr facial bones less than 3 views (70140) $147 $350 1.7×
Xr orbits complete 4 views (70200) $197.82 $471 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.