Imaging prices at Goodall Witcher Hospital
Clifton, TX · every code in this section with a posted price and a Medicare benchmark.
159 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acute Gastrointestinal Blood Loss Imaging (78278) | $550.20 | $786 | 1.4× |
| Bone Imaging 3 Phase (78315) | $772.80 | $1,104 | 1.9× |
| Bone Imaging Limited Area (78300) | $432.60 | $618 | 1.1× |
| Bone Imaging Whole Body (78306) | $630 | $900 | 1.6× |
| Chest 1 view (71045) | $105.70 | $151 | 1.2× |
| Clavicle complete (73000) | $130.90 | $187 | 1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $121.39 | $173.41 | 1.2× |
| Contrast X-Ray Bladder (74430) | $350.70 | $501 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$41.30–$810.60 | $59–$1,158 | varies |
| CT abdomen and pelvis without contrast (74176) | $1,455.30 | $2,079 | 6.1× |
| CT abdomen w contrast (74160) | $423.50 | $605 | 2.4× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$318.50–$698.60 | $455–$998 | varies |
| CT Angio Abdomen and Pelvis (74174) | $347.89 | $496.98 | 1.0× |
| CT Angio Chest (71275) | $347.89 | $496.98 | 2.0× |
| CT Angio Head (70496) | $347.89 | $496.98 | 2.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $347.89 | $496.98 | 2.0× |
| CT Angio Neck (70498) | $347.89 | $496.98 | 2.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $347.89 | $496.98 | 2.0× |
| CT cervical spine w/ contrast (72126) | $802.20 | $1,146 | 2.3× |
| CT chest w contrast (71260) | $423.50 | $605 | 2.4× |
| CT chest w/wo contrast (71270) | $423.50 | $605 | 2.4× |
| CT head/brain with contrast (70460) | $698.60 | $998 | 4.0× |
| CT head/brain without and with contrast (70470) | $423.50 | $605 | 2.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $133 | $190 | 1.5× |
| CT iac w contrast (70481) | $410.36 | $586.23 | 2.3× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$235.20–$324.80 | $336–$464 | varies |
| CT lower extremity w/contrast material (73701) | $423.50 | $605 | 2.4× |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$235.20–$333.90 | $336–$477 | varies |
| CT maxillofacial w contrast (70487) | $423.50 | $605 | 2.4× |
| CT maxillofacial wo contrast (70486) | $331.80 | $474 | 3.2× |
| CT neck tissue combo (70492) | $382.90 | $547 | 2.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $410.36 | $586.23 | 2.3× |
| CT orbits w/o contrast (70480) | $185.84 | $265.49 | 1.8× |
| CT pelvis w&w/o contrast (72194) | $382.90 | $547 | 2.2× |
| CT pelvis w/o contrast (72192) | $331.10 | $473 | 3.2× |
| CT scan of leg combo (73702) | $382.90 | $547 | 2.2× |
| CT scans face/jaw combo (70488) | $1,173.90 | $1,677 | 6.7× |
| CT soft tissue neck w contrast (70491) | $423.50 | $605 | 2.4× |
| CT soft tissue neck w/o contrast (70490) | $327.60 | $468 | 3.1× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$235.20–$334.60 | $336–$478 | varies |
| CT thorax w/o contrast (71250) | $319.90 | $457 | 3.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$235.20–$336 | $336–$480 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,066.80 | $1,524 | 6.1× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$802.20–$810.60 | $1,146–$1,158 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $347.89 | $496.98 | 2.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$236.60–$263.20 | $338–$376 | varies |
| Esophagram (74220) | $186.40 | $266.29 | 1.1× |
| Fetal Biophys Profile W/Nst (76818) | $194.60 | $278 | 1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $212.10 | $303 | 2.0× |
| Forearm 2 views (73090) | $130.90 | $187 | 1.5× |
| Gastric emptying imaging study (78264) | $521.50 | $745 | 1.3× |
| Hand 2 views (73120) | $140.70 | $201 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$522.90–$597.10 | $747–$853 | varies |
| Hepatobiliary System Imaging (78226) | $522.90 | $747 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $1,996.09 | $2,851.55 | 1.5× |
| Knee 3 Views (73562) | $189.70 | $271 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) | $563.50 | $805 | 1.0× |
| Lymph System Imaging (78195) | $798 | $1,140 | 1.5× |
| Magnetic Image Jaw Joint (70336) | $1,240.40 | $1,772 | 5.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,031.40 | $2,902 | 5.8× |
| MRA head w/o contrast (70544) | $484.40 | $692 | 2.0× |
| MRA neck w contrast (70548) | $1,411.20 | $2,016 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,031.40 | $2,902 | 5.8× |
| MRA neck w/o contrast (70547) | $489.30 | $699 | 2.0× |
| MRI abdomen w/o contrast (74181) | $484.40 | $692 | 2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,494.50 | $2,135 | 1.9× |
| MRI cervical spine w contrast (72142) | $1,411.20 | $2,016 | 4.0× |
| MRI cervical spine w/o cont (72141) | $484.40 | $692 | 2.0× |
| MRI chest with contrast (71551) | $1,066.14 | $1,523.05 | 1.4× |
| MRI chest wo w contrast (71552) | $692.23 | $988.90 | 2.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$1,411.20–$1,523.90 | $2,016–$2,177 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$802.20–$1,240.40 | $1,146–$1,772 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$489.30–$1,733.90 | $699–$2,477 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $810.60 | $1,158 | 2.3× |
| MRI orbit face neck w contrast (70542) | $1,467.20 | $2,096 | 4.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $810.60 | $1,158 | 2.3× |
| MRI pelvis w contrast (72196) | $1,467.20 | $2,096 | 4.2× |
| MRI pelvis w/o & w contrast (72197) | $810.60 | $1,158 | 2.3× |
| MRI pelvis w/o contrast (72195) | $484.40 | $692 | 2.0× |
| MRI thoracic spine w/o contrast (72146) | $484.40 | $692 | 2.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$489.30–$1,733.90 | $699–$2,477 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$802.20–$1,240.40 | $1,146–$1,772 | varies |
| MRI, abdomen, combo (74183) | $810.60 | $1,158 | 2.3× |
| MRI, dorsal spine combo (72157) | $802.20 | $1,146 | 2.3× |
| MRI, dorsal spine contrast (72147) | $1,353.80 | $1,934 | 3.9× |
| MRI, joint upper extrem combo (73223) | $802.20 | $1,146 | 2.3× |
| MRI, lumbar spine combo (72158) | $810.60 | $1,158 | 2.3× |
| Myocardial Spect Multiple Studies (78452) | $2,082.50 | $2,975 | 1.6× |
| Parathyroid Planar Imaging (78070) | $540.58 | $772.25 | 1.3× |
| Pelvis 1 or 2 views (72170) | $151.90 | $217 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $550.72 | $786.74 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $181.30 | $259 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $172.20 | $246 | 2.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $130.90 | $187 | 1.5× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$130.90–$160.30 | $187–$229 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $236.60 | $338 | 2.3× |
| Radex fingr minimum 2 views (73140) | $130.90 | $187 | 1.5× |
| Radex foot complete minimum 3 views (73630) | $179.90 | $257 | 2.1× |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$167.30–$168 | $239–$240 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $167.30 | $239 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $130.90 | $187 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $65.10 | $93 | 0.7× |
| Radex shoulder complete minimum 2 views (73030) | $203.70 | $291 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $217 | $310 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $130.90 | $187 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $178.50 | $255 | 2.0× |
| Radex Toe Minimum 2 Views (73660) range across 12 matching MRF lines |
$130.90–$155.50 | $187–$222.14 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $222.60 | $318 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $382.90 | $547 | 2.2× |
| Radiologic exam colon single contrast study (74270) | $186.40 | $266.29 | 1.1× |
| Radiologic exam knee complete 4/more views (73564) | $221.90 | $317 | 2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $172.20 | $246 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $236.60 | $338 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $214.90 | $307 | 1.2× |
| Radiologic examination knee 1/2 views (73560) | $167.30 | $239 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $193.90 | $277 | 2.2× |
| Ribs bilateral 3 views (71110) | $214.20 | $306 | 2.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $887.52 | $1,267.89 | 1.6× |
| Scapula (73010) | $98.98 | $141.40 | 0.9× |
| Shoulder 1 view (73020) | $155.40 | $222 | 1.8× |
| Skull less than 4 views (70250) | $186.40 | $266.29 | 1.8× |
| Sternoclavicular joints (71130) | $123.90 | $177 | 1.4× |
| Thoracic spine 2 views (72070) | $158.90 | $227 | 1.5× |
| Thyroid Uptake Measurement (78012) | $386.40 | $552 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $625.10 | $893 | 1.6× |
| Ultrasound Breast Limited (76642) | $158.90 | $227 | 1.8× |
| Ultrasound Exam Aaa Screen (76706) | $212.10 | $303 | 2.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$224–$236.60 | $320–$338 | varies |
| Umbilical-artery Doppler (OB) (76820) | $212.10 | $303 | 2.0× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$423.50–$484.40 | $605–$692 | varies |
| Us breast unilateral complete (76641) | $285.60 | $408 | 2.7× |
| Us chest (76604) | $212.10 | $303 | 2.0× |
| Us exam, pelvic, limited (76857) | $212.10 | $303 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $212.10 | $303 | 2.0× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$448–$489.30 | $640–$699 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$163.10–$201.60 | $233–$288 | varies |
| Us pelvic non ob complete (76856) | $236.60 | $338 | 2.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $284.90 | $407 | 2.7× |
| Us retroperitoneal complete (76770) | $236.60 | $338 | 2.3× |
| Us retroperitoneal limited (76775) | $186.20 | $266 | 1.8× |
| Us scrotum and contents (76870) | $236.60 | $338 | 2.3× |
| Us thyroid (76536) range across 2 matching MRF lines |
$198.80–$236.60 | $284–$338 | varies |
| Wrist 2 views (73100) | $130.90 | $187 | 1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $95.90 | $137 | 1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $130.90 | $187 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $130.90 | $187 | 1.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $130.90 | $187 | 1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $292.60 | $418 | 2.8× |
| X-ray humerus (73060) | $130.90 | $187 | 1.5× |
| X-ray IV pyelogram (ivp) (74400) | $477.40 | $682 | 2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $235.20 | $336 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $236.60 | $338 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $136.50 | $195 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$130.90–$158.90 | $187–$227 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $130.90 | $187 | 1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $235.20 | $336 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $236.60 | $338 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $236.60 | $338 | 2.3× |
| Xr orbits complete 4 views (70200) | $192.50 | $275 | 1.8× |
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.