Imaging prices at Faith Community Hospital
Jacksboro, TX · every code in this section with a posted price and a Medicare benchmark.
176 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) | $121.13 | $173.04 | 1.4× |
| Abdomen 2 views (74019) | $128.70 | $183.86 | 1.2× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$83.64–$113.56 | $119.48–$162.23 | varies |
| Bone age studies (77072) | $188.18 | $268.83 | 1.8× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$105.99–$208.19 | $151.41–$297.41 | varies |
| Chest 2 views (71046) | $192.50 | $275 | 2.2× |
| Chest 3 views (71047) range across 3 matching MRF lines |
$56.78–$220.50 | $81.11–$315 | varies |
| Clavicle complete (73000) | $113.56 | $162.23 | 1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $525 | $750 | 5.0× |
| CT abdomen and pelvis without and with contrast (74178) | $2,414.99 | $3,449.99 | 6.9× |
| CT abdomen and pelvis without contrast (74176) | $961.46 | $1,373.51 | 4.0× |
| CT abdomen w contrast (74160) | $1,695.79 | $2,422.56 | 9.6× |
| CT abdomen w wo contrast (74170) | $2,119.74 | $3,028.20 | 12.0× |
| CT abdomen w/o contrast (74150) | $1,362.69 | $1,946.70 | 13.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,736.59 | $5,337.98 | 10.7× |
| CT Angio Chest (71275) | $2,541.42 | $3,630.60 | 14.4× |
| CT Angio Head (70496) | $2,187.50 | $3,125 | 12.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,939.56 | $2,770.80 | 11.0× |
| CT Angio Neck (70498) | $2,187.50 | $3,125 | 12.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,985.63 | $2,836.62 | 11.3× |
| CT cervical spine w/ contrast (72126) | $1,395.80 | $1,994 | 4.0× |
| CT cervical spine w/o contrast (72125) | $1,453.54 | $2,076.48 | 13.8× |
| CT cervical spine w/wo cont (72127) | $1,435 | $2,050 | 8.1× |
| CT chest w contrast (71260) | $1,718.51 | $2,455.01 | 9.8× |
| CT chest w/wo contrast (71270) | $2,142.46 | $3,060.65 | 12.2× |
| CT head/brain with contrast (70460) | $1,367.23 | $1,953.19 | 7.8× |
| CT head/brain without and with contrast (70470) | $1,832.06 | $2,617.23 | 10.4× |
| CT iac w contrast (70481) | $1,234 | $1,762.85 | 7.0× |
| CT l-spine w&w/o contrast (72133) | $2,244.47 | $3,206.39 | 12.7× |
| CT lower ext w/o (73700) | $416.38 | $594.83 | 4.0× |
| CT lower extremity w/contrast material (73701) | $805 | $1,150 | 4.6× |
| CT lumbar spine w contrast (72132) | $1,437.67 | $2,053.82 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,453.54 | $2,076.48 | 13.8× |
| CT maxillofacial w contrast (70487) | $1,430.83 | $2,044.04 | 8.1× |
| CT maxillofacial wo contrast (70486) | $1,234 | $1,762.85 | 11.8× |
| CT neck tissue combo (70492) | $1,832.06 | $2,617.23 | 10.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,384.64 | $1,978.06 | 7.9× |
| CT orbits w/o contrast (70480) | $1,234 | $1,762.85 | 11.8× |
| CT pelvis w&w/o contrast (72194) | $2,081.89 | $2,974.13 | 11.8× |
| CT pelvis w/o contrast (72192) | $1,476.25 | $2,108.93 | 14.1× |
| CT scan of leg combo (73702) | $1,318.71 | $1,883.87 | 7.5× |
| CT scans face/jaw combo (70488) | $1,832.06 | $2,617.23 | 10.4× |
| CT soft tissue neck w contrast (70491) | $1,191.09 | $1,701.56 | 6.8× |
| CT soft tissue neck w/o contrast (70490) | $1,234 | $1,762.85 | 11.8× |
| CT thoracic spine w contrast (72129) | $1,437.67 | $2,053.82 | 8.2× |
| CT thoracic spine w/o contrast (72128) | $1,453.54 | $2,076.48 | 13.8× |
| CT thoracic spine w/wo cont (72130) | $2,244.47 | $3,206.39 | 12.7× |
| CT thorax w/o contrast (71250) | $1,468.68 | $2,098.11 | 14.0× |
| CT upper ext wo (73200) | $416.38 | $594.83 | 4.0× |
| CT upper extremity w/o & w/contrast material (73202) | $1,517.13 | $2,167.33 | 8.6× |
| CT upper extremity with contrast (73201) | $1,108.90 | $1,584.14 | 3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,934.47 | $4,192.10 | 16.7× |
| Cta Abdomen (74175) | $2,614.35 | $3,734.78 | 14.8× |
| CTA pelvis (72191) | $2,244.47 | $3,206.39 | 12.7× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$35–$245 | $50–$350 | varies |
| Esophagram (74220) | $315 | $450 | 1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $364 | $520 | 3.5× |
| Fluoroscopy up to 1 hr (76000) | $780.50 | $1,115 | 3.3× |
| Foot 2 views (73620) | $105.99 | $151.41 | 1.2× |
| Forearm 2 views (73090) | $113.56 | $162.23 | 1.3× |
| Hand 2 views (73120) | $105.99 | $151.41 | 1.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$136.27–$272.54 | $194.67–$389.34 | varies |
| Magnetic Image Jaw Joint (70336) | $1,413.88 | $2,019.83 | 5.9× |
| MRA head w/o contrast (70544) | $1,789.52 | $2,556.46 | 7.5× |
| MRA neck w contrast (70548) | $1,138.46 | $1,626.37 | 3.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,317.27 | $1,881.81 | 3.8× |
| MRA neck w/o contrast (70547) | $956.77 | $1,366.81 | 4.0× |
| MRI abdomen w contrast (74182) | $1,820 | $2,600 | 5.2× |
| MRI abdomen w/o contrast (74181) | $1,814.04 | $2,591.48 | 7.6× |
| MRI any jt lower extrem w/contrast material (73722) | $1,821.25 | $2,601.78 | 2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,630.21 | $3,757.44 | 7.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,662.63 | $2,375.18 | 2.1× |
| MRI cervical spine w contrast (72142) | $1,664 | $2,377.14 | 4.7× |
| MRI cervical spine w/o cont (72141) | $2,057.66 | $2,939.52 | 8.6× |
| MRI chest w/o contrast (71550) | $1,795.72 | $2,565.32 | 7.5× |
| MRI chest with contrast (71551) | $2,477.07 | $3,538.67 | 3.1× |
| MRI chest wo w contrast (71552) | $3,174.31 | $4,534.73 | 9.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,934.44 | $2,763.49 | 5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $764.15 | $1,091.64 | 2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,559.52 | $2,227.89 | 6.5× |
| MRI lumbar spine w contrast (72149) | $2,107.63 | $3,010.90 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,907.83 | $4,154.04 | 8.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,548.71 | $2,212.44 | 6.5× |
| MRI orbit face neck w contrast (70542) | $1,656.14 | $2,365.91 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,138.51 | $4,483.59 | 9.0× |
| MRI pelvis w contrast (72196) | $1,478.05 | $2,111.50 | 4.2× |
| MRI pelvis w/o & w contrast (72197) | $2,824.56 | $4,035.08 | 8.1× |
| MRI pelvis w/o contrast (72195) | $1,333.16 | $1,904.52 | 5.6× |
| MRI thoracic spine w/o contrast (72146) | $2,057.66 | $2,939.52 | 8.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,031.16 | $2,901.66 | 5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,637.50 | $2,339.28 | 6.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,408.18 | $3,440.25 | 6.9× |
| MRI, abdomen, combo (74183) | $3,023.15 | $4,318.79 | 8.6× |
| MRI, dorsal spine combo (72157) | $2,907.83 | $4,154.04 | 8.3× |
| MRI, dorsal spine contrast (72147) | $1,690.50 | $2,415 | 4.8× |
| MRI, joint upper extrem (73221) | $1,560.24 | $2,228.92 | 6.5× |
| MRI, joint upper extrem combo (73223) | $2,880.40 | $4,114.85 | 8.2× |
| MRI, lumbar spine combo (72158) | $3,330.26 | $4,757.52 | 9.5× |
| Neck soft tissue (70360) | $105.99 | $151.41 | 1.2× |
| Pelvis 1 or 2 views (72170) | $151.41 | $216.30 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $304.26 | $434.66 | 2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $136.27 | $194.67 | 1.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $113.56 | $162.23 | 1.3× |
| Radex elbow complete minimum 3 views (73080) | $128.70 | $183.86 | 1.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $196.83 | $281.19 | 1.9× |
| Radex fingr minimum 2 views (73140) | $99.18 | $141.68 | 1.1× |
| Radex foot complete minimum 3 views (73630) | $121.13 | $173.04 | 1.4× |
| Radex Hand Minimum 3 Views (73130) | $136.27 | $194.67 | 1.6× |
| Radex lower extremity infant minimum 2 views (73592) | $266 | $380 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $189.27 | $270.38 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $151.41 | $216.30 | 1.7× |
| Radex Ribs Unilateral 2 Views (71100) | $151.41 | $216.30 | 1.7× |
| Radex shoulder complete minimum 2 views (73030) | $130.21 | $186.02 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $95.17 | $135.96 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $151.41 | $216.30 | 1.7× |
| Radex Toe Minimum 2 Views (73660) | $99.18 | $141.68 | 1.1× |
| Radex upper extremity infant minimum 2 views (73092) | $364 | $520 | 3.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $121.13 | $173.04 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $181.69 | $259.56 | 1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $304.26 | $434.66 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $147.81 | $211.15 | 1.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $152.13 | $217.33 | 1.4× |
| Radiologic examination femur 1 view (73551) | $136.27 | $194.67 | 1.6× |
| Radiologic examination femur minimum 2 views (73552) | $136.27 | $194.67 | 1.6× |
| Radiologic examination knee 1/2 views (73560) | $121.13 | $173.04 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $128.70 | $183.86 | 1.5× |
| Ribs bilateral 3 views (71110) | $196.83 | $281.19 | 1.9× |
| Scapula (73010) | $128.70 | $183.86 | 1.2× |
| Shoulder 1 view (73020) | $105.99 | $151.41 | 1.2× |
| Skull less than 4 views (70250) | $151.41 | $216.30 | 1.4× |
| Sternoclavicular joints (71130) | $180.97 | $258.53 | 2.1× |
| Thoracic spine 2 views (72070) | $151.41 | $216.30 | 1.4× |
| Ultrasound Breast Limited (76642) | $315 | $450 | 3.6× |
| Ultrasound Exam Aaa Screen (76706) | $303.30 | $433.29 | 2.9× |
| Ultrasound, abdomen limited (76705) | $361.87 | $516.96 | 3.4× |
| Unlisted us procedure (76999) | $263.45 | $376.36 | 3.0× |
| Us chest (76604) | $493.50 | $705 | 4.7× |
| Us complete joint (76881) | $628.36 | $897.65 | 6.0× |
| Us exam, pelvic, limited (76857) | $196.11 | $280.16 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $227.12 | $324.45 | 2.2× |
| Us ob detailed single fetus (76811) | $899.50 | $1,285 | 3.8× |
| Us ob limited 1 or more fetuses (76815) | $387.18 | $553.11 | 3.7× |
| Us ob transvaginal (76817) | $403.20 | $576 | 3.8× |
| Us pelvic non ob complete (76856) | $378.53 | $540.75 | 3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $416.38 | $594.83 | 4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $464.32 | $663.32 | 4.4× |
| Us retroperitoneal complete (76770) | $423.95 | $605.64 | 4.0× |
| Us retroperitoneal limited (76775) | $310.39 | $443.42 | 3.0× |
| Us scrotum and contents (76870) | $340.68 | $486.68 | 3.2× |
| Us thyroid (76536) | $376.26 | $537.51 | 3.6× |
| Wrist 2 views (73100) | $113.56 | $162.23 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $151.41 | $216.30 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $503.30 | $719 | 4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $175 | $250 | 2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $129.93 | $185.61 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $151.41 | $216.30 | 1.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $206.68 | $295.25 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $503.30 | $719 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $151.41 | $216.30 | 1.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $378.53 | $540.75 | 3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $227.84 | $325.48 | 2.2× |
| X-ray eye for foreign body (70030) | $137.71 | $196.73 | 1.6× |
| X-ray humerus (73060) | $136.27 | $194.67 | 1.6× |
| X-ray IV pyelogram (ivp) (74400) | $386.40 | $552 | 2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $163.67 | $233.81 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $151.41 | $216.30 | 1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $445.90 | $637 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $224 | $320 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $128.70 | $183.86 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $174.13 | $248.75 | 2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $227.12 | $324.45 | 2.2× |
| X-Ray Tmj Unilat (70328) | $154.44 | $220.63 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $340.68 | $486.68 | 3.2× |
| Xr c-spine 4 or 5 views (72050) | $206.68 | $295.25 | 2.0× |
| Xr facial bones less than 3 views (70140) | $196.83 | $281.19 | 2.3× |
| Xr orbits complete 4 views (70200) | $196.83 | $281.19 | 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.