Imaging prices at Hsa Port Arthur, LLC
Port Arthur, 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.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $1,404.92 | $1,404.92 | 13.4× |
| Acute gastrointestinal blood loss imaging (78278) | $2,638.65 | $2,638.65 | 6.6× |
| Angiography extremity bilateral rs&i (75716) | $9,126.29 | $9,126.29 | 2.9× |
| Ankle 2 views (73600) | $1,366.88 | $1,366.88 | 15.6× |
| Aortography abdominal serialography rs&i (75625) | $9,126.29 | $9,126.29 | 2.9× |
| Arthrogram shoulder (73040) | $3,339.53 | $3,339.53 | 9.5× |
| Bone &/joint imaging whole body (78306) | $4,069.91 | $4,069.91 | 10.1× |
| Bone age studies (77072) | $866.90 | $866.90 | 8.3× |
| Bone Imaging 3 Phase (78315) | $6,366.68 | $6,366.68 | 15.9× |
| Cervical spine 2 or 3 views (72040) | $1,356.74 | $1,356.74 | 15.5× |
| Chest 1 view (71045) | $642.21 | $642.21 | 7.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,059.77 | $1,059.77 | 6.0× |
| Clavicle complete (73000) | $2,364.86 | $2,364.86 | 27.1× |
| CT abdomen and pelvis without and with contrast (74178) | $13,397.03 | $13,397.03 | 38.2× |
| CT abdomen and pelvis without contrast (74176) | $8,242.07 | $8,242.07 | 34.4× |
| CT abdomen w contrast (74160) | $5,224.53 | $5,224.53 | 29.7× |
| CT abdomen w wo contrast (74170) | $6,698.46 | $6,698.46 | 38.0× |
| CT abdomen w/o contrast (74150) | $3,256.79 | $3,256.79 | 31.0× |
| CT c-spine w/o contrast (72125) | $4,208.58 | $4,208.58 | 40.1× |
| CT cervical spine with contrast (72126) | $2,885.58 | $2,885.58 | 8.2× |
| CT chest w/wo contrast (71270) | $6,297.60 | $6,297.60 | 35.7× |
| CT chest with contrast (71260) | $5,634.44 | $5,634.44 | 32.0× |
| CT head/brain with contrast (70460) | $3,253.26 | $3,253.26 | 18.5× |
| CT head/brain without and with contrast (70470) | $6,090.55 | $6,090.55 | 34.6× |
| CT iac w contrast (70481) | $2,247.56 | $2,247.56 | 12.8× |
| CT lower ext w/o (73700) | $3,849.38 | $3,849.38 | 36.7× |
| CT lower extremity with contrast (73701) | $2,679.52 | $2,679.52 | 15.2× |
| CT lumbar spine w & w/o contrast (72133) | $4,680.11 | $4,680.11 | 26.6× |
| CT lumbar spine w/o contrast (72131) | $4,208.58 | $4,208.58 | 40.1× |
| CT lumbar spine with contrast (72132) | $3,372.99 | $3,372.99 | 9.6× |
| CT maxillofacial w contrast (70487) | $3,100.89 | $3,100.89 | 17.6× |
| CT maxillofacial w/o contrast (70486) | $3,772.76 | $3,772.76 | 35.9× |
| CT maxillofacial w/wo contrast (70488) | $4,255.21 | $4,255.21 | 24.1× |
| CT neck soft tissue w contrast (70491) | $4,453.88 | $4,453.88 | 25.3× |
| CT orbits w/o contrast (70480) | $3,772.76 | $3,772.76 | 35.9× |
| CT pelvis w/o contrast (72192) | $3,761.95 | $3,761.95 | 35.8× |
| CT soft tissue neck w/o & w/contrast material (70492) | $6,090.55 | $6,090.55 | 34.6× |
| CT soft tissue neck w/o contrast (70490) | $3,280.60 | $3,280.60 | 31.2× |
| CT thoracic spine w/o contrast (72128) | $3,924.80 | $3,924.80 | 37.4× |
| CT thorax w/o contrast (71250) | $4,208.58 | $4,208.58 | 40.1× |
| CT upper extremity w/o contrast rt (73200) | $3,397.02 | $3,397.02 | 32.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,511.87 | $4,511.87 | 25.6× |
| Cta Abdomen (74175) | $5,393.22 | $5,393.22 | 30.6× |
| CTA abdomen pelvis (74174) | $9,234.44 | $9,234.44 | 26.3× |
| CTA chest (71275) | $8,594.76 | $8,594.76 | 48.8× |
| Cta Head (70496) | $4,656.19 | $4,656.19 | 26.4× |
| CTA lwr ext w&w/o contrast (73706) | $2,513.77 | $2,513.77 | 14.3× |
| Cta Neck (70498) | $6,272.60 | $6,272.60 | 35.6× |
| Dxa bone density study 1/> sites axial skel (77080) | $607.74 | $607.74 | 5.8× |
| Echoencephalography real time imaging (76506) | $763.56 | $763.56 | 7.3× |
| Esophagus (74220) | $1,395.66 | $1,395.66 | 7.9× |
| Fetal biophysical profile non-stress testing (76818) | $2,033.80 | $2,033.80 | 19.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,984.19 | $1,984.19 | 18.9× |
| Fluoroscopy up to 1 hr (76000) | $1,590.05 | $1,590.05 | 6.6× |
| Foot 2 views (73620) | $1,608.77 | $1,608.77 | 18.4× |
| Forearm 2 views (73090) | $2,478.42 | $2,478.42 | 28.4× |
| Hand 2 views (73120) | $2,214.26 | $2,214.26 | 21.1× |
| Hand 3 views (73130) | $2,700.90 | $2,700.90 | 30.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $4,933.32 | $4,933.32 | 9.0× |
| Hepatobiliary syst imaging including gallbladder (78226) | $3,064.74 | $3,064.74 | 7.6× |
| Humerus Min 2 Views Left (73060) | $1,203.05 | $1,203.05 | 13.8× |
| Knee 3 views (73562) | $2,514.14 | $2,514.14 | 28.8× |
| MRA head w/o contrast (70544) | $7,042.04 | $7,042.04 | 29.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $10,106.36 | $10,106.36 | 28.8× |
| MRA neck w/o contrast (70547) | $3,562.44 | $3,562.44 | 14.9× |
| MRI abdomen w/o & w/contrast material (74183) | $14,177.52 | $14,177.52 | 40.5× |
| MRI abdomen w/o contrast (74181) | $6,419.81 | $6,419.81 | 26.8× |
| MRI any jnt lwr ext with con lt (73722) | $3,946.68 | $3,946.68 | 5.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $5,171.50 | $5,171.50 | 6.6× |
| MRI cervical spine w/o contrast (72141) | $7,973.94 | $7,973.94 | 33.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $6,877.27 | $6,877.27 | 28.7× |
| MRI pelvis w/o & w/contrast material (72197) | $7,169.34 | $7,169.34 | 20.5× |
| MRI scan of arm joint before and after contrast (73223) | $7,634.59 | $7,634.59 | 21.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $5,457.95 | $5,457.95 | 15.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $11,315.12 | $11,315.12 | 32.3× |
| MRI thoracic spine w/o contrast (72146) | $8,423.84 | $8,423.84 | 35.1× |
| MRI upper ext joint w/o contrast (73221) | $7,802.07 | $7,802.07 | 32.6× |
| Neck soft tissue (70360) | $595.79 | $595.79 | 6.8× |
| Nm gastric emptying study (78264) | $2,984.52 | $2,984.52 | 7.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) | $645.76 | $645.76 | 6.1× |
| Pelvis 1 or 2 views (72170) | $806.48 | $806.48 | 7.7× |
| PET image w/CT, skull-thigh (78815) | $12,539.73 | $12,539.73 | 8.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) | $10,690.16 | $10,690.16 | 30.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $8,093.35 | $8,093.35 | 14.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $1,435.01 | $1,435.01 | 16.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $2,955.36 | $2,955.36 | 28.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $976.37 | $976.37 | 11.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,749.12 | $1,749.12 | 16.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) | $1,501.28 | $1,501.28 | 17.2× |
| Radiologic exam upr gi trc single contrast study (74240) | $2,005.45 | $2,005.45 | 11.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) | $1,325.87 | $1,325.87 | 15.2× |
| Ribs bilateral 3 views (71110) | $1,223.11 | $1,223.11 | 11.6× |
| Sacroiliac Joints < 3 Views (72200) | $517.41 | $517.41 | 4.9× |
| Scapula complete (73010) | $999.97 | $999.97 | 9.5× |
| Screening digital breast tomosynthesis (77063) | $100.17 | $100.17 | 4.3× |
| Small bowel series (74250) | $2,528.40 | $2,528.40 | 14.3× |
| Spine thoracic 3 views (72072) | $1,854.08 | $1,854.08 | 17.7× |
| Thoracolumbar 2 views (72080) | $196.25 | $196.25 | 2.2× |
| Ultrasound, abdomen limited (76705) | $2,083.40 | $2,083.40 | 19.8× |
| Umbilical-artery Doppler (OB) (76820) | $441.89 | $441.89 | 4.2× |
| Us abdl aorta screen aaa (76706) | $1,054.33 | $1,054.33 | 10.0× |
| Us breast unilateral complete (76641) | $316.26 | $316.26 | 3.0× |
| Us breast unilateral limited (76642) | $316.26 | $316.26 | 3.6× |
| Us chest (76604) | $1,250.55 | $1,250.55 | 11.9× |
| Us compl joint r-t w/image documentation (76881) | $3,347.85 | $3,347.85 | 31.9× |
| Us kidney transplant (76776) | $851.91 | $851.91 | 8.1× |
| Us ob transvaginal (76817) | $2,083.40 | $2,083.40 | 19.8× |
| Us pelvic non ob complete (76856) | $2,083.40 | $2,083.40 | 19.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $983.10 | $983.10 | 9.4× |
| Us pregnancy ltd (76815) | $881.13 | $881.13 | 8.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) | $2,083.40 | $2,083.40 | 19.8× |
| Us retroperitoneal complete (76770) | $2,083.40 | $2,083.40 | 19.8× |
| Us retroperitoneal limited (76775) | $1,800.06 | $1,800.06 | 17.1× |
| Us scrotum and contents (76870) | $2,083.40 | $2,083.40 | 19.8× |
| Us soft tissue head/neck (76536) | $2,083.40 | $2,083.40 | 19.8× |
| Us xtr non-vasc lmtd (76882) | $2,776.54 | $2,776.54 | 26.4× |
| Wrist 2 views (73100) | $1,448.91 | $1,448.91 | 16.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $1,749.12 | $1,749.12 | 16.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $512.88 | $512.88 | 5.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) | $2,628.80 | $2,628.80 | 30.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $924.12 | $924.12 | 10.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) | $2,319.66 | $2,319.66 | 26.5× |
| X-ray exam hip uni 1 view (73501) | $891.38 | $891.38 | 10.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,122.02 | $1,122.02 | 12.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $378.58 | $378.58 | 3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $966.67 | $966.67 | 9.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) | $1,168.13 | $1,168.13 | 11.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $1,448.24 | $1,448.24 | 16.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) | $2,532 | $2,532 | 29.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) | $2,303.34 | $2,303.34 | 26.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) | $3,215.55 | $3,215.55 | 30.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,010.89 | $1,010.89 | 11.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,878.22 | $1,878.22 | 17.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $1,503.48 | $1,503.48 | 14.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) | $974.61 | $974.61 | 11.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) | $920.81 | $920.81 | 8.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) | $2,381.61 | $2,381.61 | 6.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $1,356.74 | $1,356.74 | 15.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $2,390.66 | $2,390.66 | 22.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,056.28 | $2,056.28 | 19.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $705.82 | $705.82 | 6.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $879.80 | $879.80 | 10.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) | $1,380.55 | $1,380.55 | 15.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,705.94 | $1,705.94 | 19.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) | $888.73 | $888.73 | 10.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $1,076.38 | $1,076.38 | 10.2× |
| X-Ray Spine One View - Xr Spine (72020) | $517.85 | $517.85 | 5.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $1,344.61 | $1,344.61 | 15.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $448.28 | $448.28 | 4.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $705.60 | $705.60 | 6.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) | $900.08 | $900.08 | 10.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) | $2,646.88 | $2,646.88 | 30.3× |
| Xr c-spine 6 or more views (72052) | $2,441.71 | $2,441.71 | 23.2× |
| Xr chest 4+ views (71048) | $929.04 | $929.04 | 8.8× |
| Xr finger(s) 2+ views (73140) | $819.05 | $819.05 | 9.4× |
| Xr shoulder 1 view (73020) | $709.46 | $709.46 | 8.1× |
| Xr spine cervical 4 or 5 views (72050) | $1,692.67 | $1,692.67 | 16.1× |
| Xr tibia/fibula 2 views (73590) | $2,734.20 | $2,734.20 | 31.3× |
| Xray knee 1 or 2 views rt (73560) | $1,630.82 | $1,630.82 | 18.7× |