Imaging prices at Glen Rose Medical Center

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $450 $450 5.1×
Abdomen 2 views (74019) $632 $632 6.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,580 $1,580 3.9×
Ankle 2 views (73600) $450 $450 5.1×
Arthrogram hip (73525) $2,155 $2,155 6.1×
Arthrogram Wrist (73115) $2,155 $2,155 6.1×
Bone age studies (77072) $632 $632 6.0×
Bone Imaging 3 Phase (78315) $1,745 $1,745 4.3×
Bone Imaging Limited Area (78300) $1,178 $1,178 2.9×
Bone Imaging Whole Body (78306) $1,745 $1,745 4.3×
Bone survey infant (77076) $632 $632 6.0×
Chest 1 view (71045) $450 $450 5.1×
Chest 2 views (71046) $450 $450 5.1×
Chest 3 views (71047) $450 $450 5.1×
Chest 4 or more views (71048) $632 $632 6.0×
Clavicle complete (73000) $450 $450 5.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $332 $332 3.2×
Contrast X-Ray Of Knee Joint (73580) $2,155 $2,155 6.1×
CT abdomen and pelvis without and with contrast (74178) $1,953 $1,953 5.6×
CT abdomen and pelvis without contrast (74176) $1,192 $1,192 5.0×
CT abdomen w contrast (74160) $932 $932 5.3×
CT abdomen w wo contrast (74170) $932 $932 5.3×
CT abdomen w/o contrast (74150) $573 $573 5.5×
CT Angio Abdomen and Pelvis (74174) $1,486 $1,486 4.2×
CT Angio Chest (71275) $932 $932 5.3×
CT Angio Head (70496) $932 $932 5.3×
Ct Angio Lwr Extr W/O&W/Dye (73706) $932 $932 5.3×
CT Angio Neck (70498) $932 $932 5.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $932 $932 5.3×
CT cervical spine w/ contrast (72126) $1,953 $1,953 5.6×
CT cervical spine w/o contrast (72125) $573 $573 5.5×
CT cervical spine w/wo cont (72127) $932 $932 5.3×
CT chest w contrast (71260) $932 $932 5.3×
CT chest w/wo contrast (71270) $932 $932 5.3×
CT head/brain with contrast (70460) $932 $932 5.3×
CT head/brain without and with contrast (70470) $932 $932 5.3×
CT heart no contrast quant eval coronry calcium (75571) $301 $301 3.4×
CT iac w contrast (70481) $932 $932 5.3×
CT l-spine w&w/o contrast (72133) $932 $932 5.3×
CT lower ext w/o (73700) $573 $573 5.5×
CT lower extremity w/contrast material (73701) $932 $932 5.3×
CT lumbar spine w contrast (72132) $1,953 $1,953 5.6×
CT lumbar spine w/o contrast (72131) $573 $573 5.5×
CT maxillofacial w contrast (70487) $932 $932 5.3×
CT maxillofacial wo contrast (70486) $573 $573 5.5×
CT neck tissue combo (70492) $932 $932 5.3×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,254 $3,254 18.5×
CT orbits w/o contrast (70480) $573 $573 5.5×
CT pelvis w&w/o contrast (72194) $932 $932 5.3×
CT pelvis w/o contrast (72192) $573 $573 5.5×
CT scan of leg combo (73702) $932 $932 5.3×
CT scans face/jaw combo (70488) $932 $932 5.3×
CT soft tissue neck w contrast (70491) $932 $932 5.3×
CT soft tissue neck w/o contrast (70490) $573 $573 5.5×
CT thoracic spine w contrast (72129) $932 $932 5.3×
CT thoracic spine w/o contrast (72128) $573 $573 5.5×
CT thoracic spine w/wo cont (72130) $932 $932 5.3×
CT thorax w/o contrast (71250) $573 $573 5.5×
CT upper ext wo (73200) $573 $573 5.5×
CT upper extremity w/o & w/contrast material (73202) $932 $932 5.3×
CT upper extremity with contrast (73201)
range across 2 matching MRF lines		 $42–$1,953 $42–$1,953 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $932 $932 5.3×
Cta Abdomen (74175) $932 $932 5.3×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,233 $1,233 3.5×
CTA pelvis (72191) $932 $932 5.3×
Dxa Bone Density Axial (77080) $173 $173 1.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $132 $132 1.5×
Fluoroscopy up to 1 hr (76000) $181 $181 0.8×
Foot 2 views (73620) $450 $450 5.1×
Forearm 2 views (73090) $450 $450 5.1×
Gastric emptying imaging study (78264) $1,345 $1,345 3.3×
Gated Heart Planar Single (78472) $2,183 $2,183 5.4×
Hand 2 views (73120) $632 $632 6.0×
Hepatobil Syst Image W/Drug (78227) $1,781 $1,781 3.3×
Hepatobiliary System Imaging (78226) $2,303 $2,303 5.7×
Ht Muscle Image Spect Sing (78451) $5,612 $5,612 4.3×
K Flow/Funct Image W/Drug (78708) $2,143 $2,143 3.9×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $84 $84 0.2×
Knee 3 Views (73562) $450 $450 5.1×
Lung Ventilat&Perfus Imaging (78582) $3,160 $3,160 5.8×
Lung Ventilation Imaging (78579) $1,729 $1,729 4.3×
Mr safety implt electronics prepj supvj phys/qhp (76018) $318 $318 3.3×
Mra Head W/O & W/Contrast Material (70546) $1,953 $1,953 5.6×
MRA head w/o contrast (70544) $1,169 $1,169 4.9×
MRA head with contrast (70545) $1,953 $1,953 5.6×
MRA neck w contrast (70548) $1,301 $1,301 3.7×
Mra Neck W/O &W/Contrast Material (70549) $1,915 $1,915 5.5×
MRA neck w/o contrast (70547) $1,169 $1,169 4.9×
MRI abdomen w contrast (74182) $1,953 $1,953 5.6×
MRI abdomen w/o contrast (74181) $1,192 $1,192 5.0×
MRI any jt lower extrem w/contrast material (73722) $3,482 $3,482 4.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,953 $1,953 5.6×
MRI any jt upper extremity w/contrast matrl (73222) $3,482 $3,482 4.4×
MRI cervical spine w contrast (72142) $1,953 $1,953 5.6×
MRI cervical spine w/o cont (72141) $1,192 $1,192 5.0×
MRI chest wo w contrast (71552) $1,953 $1,953 5.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,953 $1,953 5.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,953 $1,953 5.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,192 $1,192 5.0×
MRI lumbar spine w contrast (72149) $1,953 $1,953 5.6×
Mri Neck Spine W/O & W/Dye (72156) $1,953 $1,953 5.6×
MRI orbit face &/neck w/o contrast (70540) $1,192 $1,192 5.0×
MRI orbit face neck w contrast (70542) $1,953 $1,953 5.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,953 $1,953 5.6×
MRI pelvis w contrast (72196) $1,953 $1,953 5.6×
MRI pelvis w/o & w contrast (72197) $1,953 $1,953 5.6×
MRI pelvis w/o contrast (72195) $1,192 $1,192 5.0×
MRI spectroscopy (76390) $308 $308 3.5×
MRI thoracic spine w/o contrast (72146) $1,192 $1,192 5.0×
MRI upper extremity oth than jt w/contr matrl (73219) $1,953 $1,953 5.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,192 $1,192 5.0×
Mri Uppr Extremity W/O&W/Dye (73220) $1,953 $1,953 5.6×
MRI, abdomen, combo (74183) $1,953 $1,953 5.6×
MRI, dorsal spine combo (72157) $1,953 $1,953 5.6×
MRI, dorsal spine contrast (72147) $1,953 $1,953 5.6×
MRI, joint upper extrem (73221) $1,192 $1,192 5.0×
MRI, joint upper extrem combo (73223) $1,953 $1,953 5.6×
MRI, lumbar spine combo (72158) $1,953 $1,953 5.6×
Myocardial Spect Multiple Studies (78452) $5,948 $5,948 4.6×
Neck soft tissue (70360) $450 $450 5.1×
Parathyroid Planar Imaging (78070) $1,628 $1,628 4.1×
Pelvis 1 or 2 views (72170) $632 $632 6.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,807 $1,807 4.5×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $632 $632 6.0×
Radex Ankle Complete Minimum 3 Views (73610) $450 $450 5.1×
Radex Calcaneus Minimum 2 Views (73650) $450 $450 5.1×
Radex elbow complete minimum 3 views (73080) $450 $450 5.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $632 $632 6.0×
Radex fingr minimum 2 views (73140) $450 $450 5.1×
Radex foot complete minimum 3 views (73630) $450 $450 5.1×
Radex Hand Minimum 3 Views (73130) $450 $450 5.1×
Radex lower extremity infant minimum 2 views (73592) $450 $450 5.1×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $632 $632 6.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $450 $450 5.1×
Radex Ribs Unilateral 2 Views (71100) $450 $450 5.1×
Radex shoulder complete minimum 2 views (73030) $450 $450 5.1×
Radex Sinuses Paransl < 3 Views (70210) $450 $450 5.1×
Radex Spine 1 View Specify Level (72020) $450 $450 5.1×
Radex Sternum Minimum 2 Views (71120) $450 $450 5.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $450 $450 5.1×
Radex Toe Minimum 2 Views (73660) $450 $450 5.1×
Radex upper extremity infant minimum 2 views (73092) $632 $632 6.0×
Radex Wrist Complete Minimum 3 Views (73110) $450 $450 5.1×
Radiolog exam mandible compl minimum 4 views (70110) $632 $632 6.0×
Radiologic exam knee complete 4/more views (73564) $632 $632 6.0×
Radiologic exam pelvis compl minimum 3 views (72190) $632 $632 6.0×
Radiologic Exam Small Int Single Contrast Study (74250) $1,028 $1,028 5.8×
Radiologic exam swallow function contrast study (74230) $1,028 $1,028 5.8×
Radiologic examination femur minimum 2 views (73552) $450 $450 5.1×
Radiologic examination knee 1/2 views (73560) $450 $450 5.1×
Radiologic Examination Osseous Survey Limited (77074) $632 $632 6.0×
Radiologic examination tibia & fibula 2 views (73590) $450 $450 5.1×
Ribs bilateral 3 views (71110) $385 $385 3.7×
Scapula (73010) $632 $632 6.0×
Screening Digital Breast Tomosynthesis Bi (77063) $96 $96 4.1×
Sella turcica (70240) $450 $450 5.1×
Shoulder 1 view (73020) $450 $450 5.1×
Shoulder Arthrography (73040) $2,155 $2,155 6.1×
Skull less than 4 views (70250) $632 $632 6.0×
Sternoclavicular joints (71130) $450 $450 5.1×
Thoracic spine 2 views (72070) $632 $632 6.0×
Thoracic spine 3 views (72072) $632 $632 6.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,345 $1,345 3.3×
Ultrasound Breast Limited (76642) $550 $550 6.3×
Ultrasound Exam Aaa Screen (76706) $690 $690 6.6×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $362–$784 $362–$784 varies
Unlisted fluoroscopic procedure (76496) $450 $450 5.1×
Urethrocystography retrograde (74450) $894 $894 3.7×
Us breast unilateral complete (76641) $550 $550 5.2×
Us chest (76604) $697 $697 6.6×
Us complete joint (76881) $697 $697 6.6×
Us exam, pelvic, limited (76857) $550 $550 5.2×
Us ob limited 1 or more fetuses (76815) $644 $644 6.1×
Us ob transvaginal (76817) $847 $847 8.1×
Us pelvic non ob complete (76856) $1,238 $1,238 11.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $565 $565 5.4×
Us preg uterus real time f/u trnsabdl per fetus (76816) $366 $366 3.5×
Us retroperitoneal complete (76770) $1,067 $1,067 10.2×
Us retroperitoneal limited (76775) $674 $674 6.4×
Us scrotum and contents (76870) $817 $817 7.8×
Us thyroid (76536) $863 $863 8.2×
Us transrectal (76872) $817 $817 7.8×
Vascular Flow Imaging (78445) $2,183 $2,183 5.4×
Vertebral fracture assessment via dxa (77086) $450 $450 5.1×
Wrist 2 views (73100) $450 $450 5.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $450 $450 5.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $450 $450 5.1×
X-Ray Exam Entire Spi 1 Vw (72081) $450 $450 5.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $632 $632 6.0×
X-Ray Exam Hip Uni 1 View (73501)
range across 3 matching MRF lines		 $85–$450 $85–$450 varies
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 2 matching MRF lines		 $110–$450 $110–$450 varies
X-Ray Exam Hips Bi 2 Views (73521) $632 $632 6.0×
X-Ray Exam L-S Spine Bending (72114) $632 $632 6.0×
X-Ray Exam Neck Spine 2-3 Vw (72040) $450 $450 5.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $632 $632 6.0×
X-Ray Exam Unilat Ribs/Chest (71101) $632 $632 6.0×
X-ray eye for foreign body (70030) $450 $450 5.1×
X-ray humerus (73060) $450 $450 5.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $450 $450 5.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $450 $450 5.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $632 $632 6.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $632 $632 6.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $331 $331 3.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $450 $450 5.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $450 $450 5.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $632 $632 6.0×
X-ray thoracic spine 4 vw (72074) $632 $632 6.0×
X-Rays Bone Length Studies (77073) $632 $632 6.0×
X-Rays Bone Survey Complete (77075) $632 $632 6.0×
Xr c-spine 4 or 5 views (72050) $632 $632 6.0×
Xr facial bones less than 3 views (70140) $450 $450 5.1×
Xr orbits complete 4 views (70200) $632 $632 6.0×

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.