Imaging prices at Fisher County Hospital District

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $162 $190 1.9×
Abdomen 2 views (74019) $224 $263 2.1×
Ankle 2 views (73600) $147 $173 1.7×
Bone age studies (77072) $161 $189 1.5×
Chest 1 view (71045) $149 $175 1.7×
Chest 2 views (71046) $187 $220 2.1×
Chest 3 views (71047) $275 $323 3.1×
Chest 4 or more views (71048) $306 $360 2.9×
Cholecystography Oral Contrast (74290) $247 $291 1.4×
Clavicle complete (73000) $169 $199 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $404 $475 3.8×
Contrast Xray Throat/Cerv Esopha (74210) $295 $347 1.7×
CT abdomen and pelvis without and with contrast (74178) $3,730 $4,388 10.6×
CT abdomen and pelvis without contrast (74176) $2,965 $3,488 12.4×
CT abdomen w contrast (74160) $2,004 $2,358 11.4×
CT abdomen w wo contrast (74170) $2,404 $2,828 13.6×
CT abdomen w/o contrast (74150) $1,742 $2,049 16.6×
CT Angio Abdomen and Pelvis (74174) $2,032 $2,390 5.8×
CT Angio Chest (71275) $1,618 $1,904 9.2×
CT Angio Head (70496) $2,125 $2,500 12.1×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,060 $3,600 17.4×
CT Angio Neck (70498) $3,230 $3,800 18.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,635 $3,100 15.0×
CT bone density (77078) $383 $450 4.4×
CT cervical spine w/ contrast (72126) $1,568 $1,845 4.5×
CT cervical spine w/o contrast (72125) $1,351 $1,589 12.9×
CT cervical spine w/wo cont (72127) $1,865 $2,194 10.6×
CT chest w contrast (71260) $1,614 $1,899 9.2×
CT chest w/wo contrast (71270) $2,100 $2,471 11.9×
CT head/brain with contrast (70460) $1,208 $1,421 6.9×
CT head/brain without and with contrast (70470) $1,448 $1,704 8.2×
CT heart no contrast quant eval coronry calcium (75571) $340 $400 3.9×
CT iac w contrast (70481) $1,216 $1,430 6.9×
CT l-spine w&w/o contrast (72133) $1,681 $1,978 9.5×
CT lower ext w/o (73700) $912 $1,073 8.7×
CT lower extremity w/contrast material (73701) $912 $1,073 5.2×
CT lumbar spine w contrast (72132) $1,568 $1,845 4.5×
CT lumbar spine w/o contrast (72131) $1,351 $1,589 12.9×
CT maxillofacial w contrast (70487)
range across 2 matching MRF lines		 $1,384–$1,422 $1,628–$1,673 varies
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines		 $1,202–$1,235 $1,414–$1,453 varies
CT neck tissue combo (70492) $1,705 $2,006 9.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,965 $2,312 11.2×
CT orbits w/o contrast (70480) $1,403 $1,650 13.4×
CT pelvis w&w/o contrast (72194) $1,561 $1,836 8.9×
CT pelvis w/o contrast (72192) $1,223 $1,439 11.6×
CT scan of leg combo (73702) $1,094 $1,287 6.2×
CT scans face/jaw combo (70488)
range across 2 matching MRF lines		 $1,955–$1,989 $2,300–$2,340 varies
CT soft tissue neck w contrast (70491) $1,422 $1,673 8.1×
CT soft tissue neck w/o contrast (70490) $1,235 $1,453 11.8×
CT thoracic spine w contrast (72129) $1,568 $1,845 8.9×
CT thoracic spine w/o contrast (72128) $1,351 $1,589 12.9×
CT thoracic spine w/wo cont (72130) $1,865 $2,194 10.6×
CT thorax w/o contrast (71250) $1,522 $1,790 14.5×
CT upper ext wo (73200) $912 $1,073 8.7×
CT upper extremity w/o & w/contrast material (73202) $1,094 $1,287 6.2×
CT upper extremity with contrast (73201) $912 $1,073 2.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,550 $3,000 14.5×
Cta Abdomen (74175) $2,635 $3,100 15.0×
CTA pelvis (72191) $2,380 $2,800 13.5×
Dxa Bone Density Axial (77080) $297 $349 2.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $297 $349 3.4×
Esophagram (74220) $284 $334 1.6×
Fluoroscopy up to 1 hr (76000) $187 $220 0.8×
Foot 2 views (73620) $153 $180 1.8×
Forearm 2 views (73090) $136 $160 1.6×
Hand 2 views (73120) $128 $151 1.2×
Infusion Ivp (74410) $456 $537 2.6×
Knee 3 Views (73562) $177 $208 2.0×
Neck soft tissue (70360) $190 $223 2.2×
Nm red cell survival study (78130) $20 $23 0.0×
Nm whole blood volume (78122) $8 $9 0.0×
Optic foramina (70190) $195 $229 2.2×
Pelvis 1 or 2 views (72170) $139 $163 1.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $309 $364 2.9×
Radex Ankle Complete Minimum 3 Views (73610) $158 $186 1.8×
Radex Calcaneus Minimum 2 Views (73650) $136 $160 1.6×
Radex elbow complete minimum 3 views (73080) $146 $172 1.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $243 $286 2.3×
Radex fingr minimum 2 views (73140) $107 $126 1.2×
Radex foot complete minimum 3 views (73630) $158 $186 1.8×
Radex Hand Minimum 3 Views (73130) $142 $167 1.6×
Radex lower extremity infant minimum 2 views (73592) $162 $191 1.9×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $210 $247 2.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $153 $180 1.8×
Radex Ribs Unilateral 2 Views (71100) $213 $250 2.4×
Radex shoulder complete minimum 2 views (73030) $190 $224 2.2×
Radex Sinuses Paransl < 3 Views (70210) $167 $197 1.9×
Radex Spine 1 View Specify Level (72020) $146 $172 1.7×
Radex Sternum Minimum 2 Views (71120) $187 $220 2.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $365 $429 4.2×
Radex Toe Minimum 2 Views (73660) $120 $141 1.4×
Radex upper extremity infant minimum 2 views (73092) $162 $191 1.5×
Radex Wrist Complete Minimum 3 Views (73110) $142 $167 1.6×
Radiolog exam mandible compl minimum 4 views (70110) $231 $272 2.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $255 $300 2.4×
Radiologic exam colon double contrast study (74280) $632 $743 3.6×
Radiologic exam colon single contrast study (74270) $483 $568 2.7×
Radiologic exam knee complete 4/more views (73564) $198 $233 1.9×
Radiologic exam pelvis compl minimum 3 views (72190) $175 $206 1.7×
Radiologic Exam Small Int Single Contrast Study (74250) $343 $403 1.9×
Radiologic examination femur 1 view (73551) $145 $171 1.7×
Radiologic examination femur minimum 2 views (73552) $162 $191 1.9×
Radiologic examination knee 1/2 views (73560) $150 $176 1.7×
Radiologic examination tibia & fibula 2 views (73590) $162 $191 1.9×
Radiologic examination, teeth; single view Non-Facility (70300) $13 $15 0.1×
Red Cell Volume Determination Spx 1 Sampling (78120)
range across 3 matching MRF lines		 $2–$4 $2–$5 varies
Scapula (73010) $177 $208 1.7×
Sella turcica (70240) $167 $197 1.9×
Shoulder 1 view (73020) $150 $176 1.7×
Skull less than 4 views (70250) $197 $232 1.9×
Sternoclavicular joints (71130) $225 $265 2.6×
Thoracic spine 2 views (72070) $201 $237 1.9×
Thoracic spine 3 views (72072) $216 $254 2.1×
Thoracolumbar 2 views (72080) $209 $246 2.4×
Ultrasound Breast Limited (76642) $157 $185 1.8×
Ultrasound Exam Aaa Screen (76706) $492 $579 4.7×
Ultrasound, abdomen limited (76705) $316 $372 3.0×
Us breast unilateral complete (76641) $314 $369 3.0×
Us chest (76604) $314 $369 3.0×
Us complete joint (76881) $292 $343 2.8×
Us exam, pelvic, limited (76857) $327 $385 3.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $240 $282 2.3×
Us ob limited 1 or more fetuses (76815) $253 $298 2.4×
Us ob transvaginal (76817) $422 $497 4.0×
Us pelvic non ob complete (76856) $369 $434 3.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $345 $406 3.3×
Us retroperitoneal complete (76770) $371 $437 3.5×
Us retroperitoneal limited (76775) $240 $282 2.3×
Us scrotum and contents (76870) $316 $372 3.0×
Us thyroid (76536) $335 $394 3.2×
Wrist 2 views (73100) $125 $147 1.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $169 $199 1.9×
X-Ray Bend Only L-S Spine (72120) $88 $103 0.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $142 $167 1.6×
X-Ray Exam Entire Spi 1 Vw (72081) $247 $291 2.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $366 $431 3.5×
X-Ray Exam Hip Uni 1 View (73501) $126 $148 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 5 matching MRF lines		 $168–$184 $198–$217 varies
X-Ray Exam Hips Bi 2 Views (73521) $218 $256 2.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $235 $276 2.2×
X-Ray Exam L-S Spine Bending (72114) $349 $411 3.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $208 $245 2.4×
X-Ray Exam Neck Spine 6/>Vws (72052) $314 $369 3.0×
X-Ray Exam Unilat Ribs/Chest (71101)
range across 4 matching MRF lines		 $9–$246 $10–$289 varies
X-ray humerus (73060) $158 $186 1.8×
X-ray IV pyelogram (ivp) (74400) $428 $503 2.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $150 $176 1.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $190 $223 1.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $306 $360 2.9×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $135 $159 1.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $148 $174 1.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $275 $323 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $275 $323 2.6×
X-ray thoracic spine 4 vw (72074) $247 $291 2.4×
X-Rays Bone Survey Complete (77075) $451 $531 4.3×
Xr c-spine 4 or 5 views (72050) $264 $311 2.5×
Xr orbits complete 4 views (70200) $228 $268 2.2×

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.