Imaging prices at Jackson Healthcare Center

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

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $137 $171 1.6×
Abdomen 2 views (74019) $137 $171 1.3×
Ankle 2 views (73600) $137 $171 1.6×
Bone age studies (77072) $106 $132 1.0×
Chest 1 view (71045) $137 $171 1.6×
Chest 2 views (71046)
range across 2 matching MRF lines		 $137–$290 $171–$363 varies
Chest 3 views (71047) $141 $176 1.6×
Chest 4 or more views (71048) $138 $173 1.3×
Cholecystography Oral Contrast (74290) $278 $348 1.6×
Clavicle complete (73000) $137 $171 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $898 $1,122 8.6×
CT abdomen and pelvis without and with contrast (74178) $1,309 $1,636 3.7×
CT abdomen and pelvis without contrast (74176) $1,147 $1,434 4.8×
CT abdomen w contrast (74160) $952 $1,190 5.4×
CT abdomen w wo contrast (74170) $947 $1,184 5.4×
CT abdomen w/o contrast (74150) $765 $956 7.3×
CT Angio Abdomen and Pelvis (74174) $1,360 $1,700 3.9×
CT Angio Chest (71275) $1,360 $1,700 7.7×
CT Angio Head (70496) $1,358 $1,697 7.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $995 $1,244 5.6×
CT Angio Neck (70498) $1,380 $1,725 7.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $995 $1,244 5.6×
CT cervical spine w/ contrast (72126) $813 $1,016 2.3×
CT cervical spine w/o contrast (72125) $607 $759 5.8×
CT cervical spine w/wo cont (72127) $947 $1,184 5.4×
CT chest w contrast (71260)
range across 2 matching MRF lines		 $901–$1,840 $1,126–$2,300 varies
CT chest w/wo contrast (71270)
range across 2 matching MRF lines		 $947–$2,000 $1,184–$2,500 varies
CT head/brain with contrast (70460) $1,110 $1,388 6.3×
CT head/brain without and with contrast (70470) $1,242 $1,553 7.0×
CT iac w contrast (70481) $593 $741 3.4×
CT l-spine w&w/o contrast (72133) $1,858 $2,323 10.5×
CT lower ext w/o (73700) $593 $741 5.6×
CT lower extremity w/contrast material (73701) $813 $1,016 4.6×
CT lumbar spine w contrast (72132) $947 $1,184 2.7×
CT lumbar spine w/o contrast (72131) $911 $1,139 8.7×
CT maxillofacial w contrast (70487) $813 $1,016 4.6×
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines		 $593–$850 $741–$1,063 varies
CT neck tissue combo (70492) $947 $1,184 5.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $813 $1,016 4.6×
CT orbits w/o contrast (70480) $593 $741 5.6×
CT pelvis w&w/o contrast (72194) $947 $1,184 5.4×
CT pelvis w/o contrast (72192) $683 $854 6.5×
CT scan of leg combo (73702) $947 $1,184 5.4×
CT scans face/jaw combo (70488) $947 $1,184 5.4×
CT soft tissue neck w contrast (70491) $813 $1,016 4.6×
CT soft tissue neck w/o contrast (70490) $593 $741 5.6×
CT thoracic spine w contrast (72129) $813 $1,016 4.6×
CT thoracic spine w/o contrast (72128) $607 $759 5.8×
CT thoracic spine w/wo cont (72130) $1,238 $1,547 7.0×
CT thorax w/o contrast (71250)
range across 2 matching MRF lines		 $898–$1,680 $1,122–$2,100 varies
CT upper ext wo (73200) $593 $741 5.6×
CT upper extremity w/o & w/contrast material (73202) $947 $1,184 5.4×
CT upper extremity with contrast (73201) $813 $1,016 2.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,242 $1,553 7.0×
Cta Abdomen (74175)
range across 3 matching MRF lines		 $1,242–$1,360 $1,553–$1,700 varies
Dxa Bone Density Axial (77080) $276 $345 2.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $66 $83 0.8×
Echo exam uterus (76831) $252 $315 1.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $320 $400 3.0×
Fluoroscopy up to 1 hr (76000) $248 $310 1.0×
Foot 2 views (73620) $137 $171 1.6×
Forearm 2 views (73090) $137 $171 1.6×
Hand 2 views (73120) $137 $171 1.3×
Knee 3 Views (73562) $137 $171 1.6×
Lymphangiography extremity only unilateral rs&i (75801)
range across 3 matching MRF lines		 $18–$26 $23–$32 varies
Magnetic Image Jaw Joint (70336) $1,109 $1,386 4.6×
Mra Head W/O & W/Contrast Material (70546) $1,608 $2,010 4.6×
MRA head w/o contrast (70544) $1,116 $1,395 4.7×
MRA head with contrast (70545) $1,243 $1,554 3.5×
MRA neck w contrast (70548) $1,243 $1,554 3.5×
Mra Neck W/O &W/Contrast Material (70549) $1,608 $2,010 4.6×
MRA neck w/o contrast (70547) $1,116 $1,395 4.7×
MRI abdomen w contrast (74182) $1,243 $1,554 3.5×
MRI abdomen w/o contrast (74181) $1,116 $1,395 4.7×
MRI any jt lower extrem w/contrast material (73722) $1,243 $1,554 1.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,608 $2,010 4.6×
MRI any jt upper extremity w/contrast matrl (73222) $1,243 $1,554 1.6×
MRI bone marrow blood supply (77084) $947 $1,184 4.0×
MRI cervical spine w contrast (72142) $1,243 $1,554 3.5×
MRI cervical spine w/o cont (72141) $1,116 $1,395 4.7×
MRI chest w/o contrast (71550) $1,116 $1,395 4.7×
MRI chest with contrast (71551) $1,243 $1,554 1.6×
MRI chest wo w contrast (71552) $1,608 $2,010 4.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,243 $1,554 3.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,608 $2,010 4.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,116 $1,395 4.7×
MRI lumbar spine w contrast (72149) $1,243 $1,554 3.5×
Mri Neck Spine W/O & W/Dye (72156) $1,608 $2,010 4.6×
MRI orbit face &/neck w/o contrast (70540) $1,116 $1,395 4.7×
MRI orbit face neck w contrast (70542) $1,243 $1,554 3.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,608 $2,010 4.6×
MRI pelvis w contrast (72196) $1,243 $1,554 3.5×
MRI pelvis w/o & w contrast (72197) $1,608 $2,010 4.6×
MRI pelvis w/o contrast (72195) $1,116 $1,395 4.7×
MRI thoracic spine w/o contrast (72146) $1,116 $1,395 4.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,116 $1,395 4.7×
Mri Uppr Extremity W/O&W/Dye (73220) $1,608 $2,010 4.6×
MRI, abdomen, combo (74183) $1,608 $2,010 4.6×
MRI, dorsal spine combo (72157) $1,608 $2,010 4.6×
MRI, dorsal spine contrast (72147) $1,243 $1,554 3.5×
MRI, joint upper extrem (73221) $1,116 $1,395 4.7×
MRI, joint upper extrem combo (73223) $1,608 $2,010 4.6×
MRI, lumbar spine combo (72158) $1,608 $2,010 4.6×
Neck soft tissue (70360) $329 $411 3.8×
Pelvis 1 or 2 views (72170) $141 $176 1.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $230 $288 2.2×
Radex abscess/fistula/sinus tract rs&i (76080) $144 $180 0.3×
Radex Ankle Complete Minimum 3 Views (73610) $137 $171 1.6×
Radex Calcaneus Minimum 2 Views (73650) $137 $171 1.6×
Radex elbow complete minimum 3 views (73080) $137 $171 1.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $137 $171 1.3×
Radex fingr minimum 2 views (73140) $137 $171 1.6×
Radex foot complete minimum 3 views (73630) $137 $171 1.6×
Radex Hand Minimum 3 Views (73130) $137 $171 1.6×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $137 $171 1.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $137 $171 1.6×
Radex Ribs Unilateral 2 Views (71100) $137 $171 1.6×
Radex shoulder complete minimum 2 views (73030) $137 $171 1.6×
Radex Sinuses Paransl < 3 Views (70210) $137 $171 1.6×
Radex Spine 1 View Specify Level (72020) $137 $171 1.6×
Radex Sternum Minimum 2 Views (71120) $137 $171 1.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $137 $171 1.6×
Radex Toe Minimum 2 Views (73660)
range across 11 matching MRF lines		 $106–$137 $132–$171 varies
Radex Wrist Complete Minimum 3 Views (73110) $137 $171 1.6×
Radiolog exam mandible compl minimum 4 views (70110) $137 $171 1.3×
Radiologic exam knee complete 4/more views (73564) $137 $171 1.3×
Radiologic Exam Small Int Single Contrast Study (74250) $278 $348 1.6×
Radiologic examination femur 1 view (73551) $137 $171 1.6×
Radiologic examination femur minimum 2 views (73552) $137 $171 1.6×
Radiologic examination knee 1/2 views (73560) $137 $171 1.6×
Radiologic examination tibia & fibula 2 views (73590) $137 $171 1.6×
Red Cell Volume Determination Spx Mult Samplings (78121) $2 $3 0.0×
Ribs bilateral 3 views (71110) $182 $228 1.7×
Scapula (73010) $137 $171 1.3×
Screening Digital Breast Tomosynthesis Bi (77063) $40 $50 1.7×
Shoulder 1 view (73020) $137 $171 1.6×
Shoulder Arthrography (73040) $400 $500 1.1×
Skull less than 4 views (70250) $137 $171 1.3×
Sternoclavicular joints (71130) $137 $171 1.6×
Thoracic spine 2 views (72070) $137 $171 1.3×
Thoracic spine 3 views (72072) $143 $179 1.4×
Ultrasound Breast Limited (76642) $203 $254 2.3×
Ultrasound Exam Aaa Screen (76706) $242 $303 2.3×
Ultrasound, abdomen limited (76705)
range across 6 matching MRF lines		 $230–$282 $288–$352 varies
Unlisted us procedure (76999) $190 $238 2.2×
Urethrocystogram voiding (74455) $358 $447 1.5×
Us breast unilateral complete (76641) $246 $308 2.3×
Us chest (76604) $282 $352 2.7×
Us complete joint (76881) $282 $352 2.7×
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $210–$282 $263–$352 varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $282 $352 2.7×
Us ob limited 1 or more fetuses (76815) $180 $225 1.7×
Us ob transvaginal (76817) $222 $278 2.1×
Us pelvic non ob complete (76856) $298 $372 2.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $284 $355 2.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $180 $225 1.7×
Us retroperitoneal complete (76770) $282 $352 2.7×
Us scrotum and contents (76870) $282 $352 2.7×
Us spinal canal and contents (76800) $314 $393 3.0×
Us thyroid (76536)
range across 2 matching MRF lines		 $233–$282 $291–$352 varies
Wrist 2 views (73100) $137 $171 1.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $137 $171 1.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $137 $171 1.6×
X-Ray Exam Entire Spi 1 Vw (72081) $176 $220 2.0×
X-Ray Exam Hip Uni 1 View (73501) $137 $171 1.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $137 $171 1.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $137 $171 1.6×
X-Ray Exam Neck Spine 6/>Vws (72052) $230 $288 2.2×
X-ray eye for foreign body (70030) $137 $171 1.6×
X-ray humerus (73060) $137 $171 1.6×
X-ray IV pyelogram (ivp) (74400) $472 $590 2.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $137 $171 1.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $137 $171 1.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $137 $171 1.3×
X-ray nose-rectum child f.b. (76010) $137 $171 1.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $137 $171 1.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $137 $171 1.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $137 $171 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $230 $288 2.2×
X-Rays Bone Length Studies (77073) $137 $171 1.3×
X-Rays Bone Survey Complete (77075) $182 $228 1.7×
Xr c-spine 4 or 5 views (72050) $230 $288 2.2×
Xr facial bones less than 3 views (70140) $137 $171 1.6×
XR Mastoids < 3 Views Bilateral (70120) $137 $171 1.3×
Xr orbits complete 4 views (70200) $137 $171 1.3×

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.