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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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $137 $171 1.3×
Ankle 2 views (73600) $137 $171 1.6×
Arthrogram shoulder (73040) $400 $500 1.1×
Bone age studies (77072) $106 $132 1.0×
Bone survey complete (77075) $182 $228 1.7×
Cervical spine 2 or 3 views (72040) $137 $171 1.6×
Chest 1 view (71045) $137 $171 1.6×
Chest 3 views (71047) $141 $176 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 angiography upper extremity lt (73206) $995 $1,244 5.6×
CT c-spine w/o contrast (72125) $607 $759 5.8×
CT cervical spine w&w/o contrast (72127) $947 $1,184 5.4×
CT cervical spine with contrast (72126) $813 $1,016 2.3×
CT chest w/wo contrast (71270) $1,473.50 $1,842 8.4×
CT chest with contrast (71260) $1,370.50 $1,713 7.8×
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 lower ext w/o (73700) $593 $741 5.6×
CT lower extremity w wo contrast (73702) $947 $1,184 5.4×
CT lower extremity with contrast (73701) $813 $1,016 4.6×
CT lumbar spine w & w/o contrast (72133) $1,858 $2,323 10.5×
CT lumbar spine w/o contrast (72131) $911 $1,139 8.7×
CT lumbar spine with contrast (72132) $947 $1,184 2.7×
CT maxillofacial w contrast (70487) $813 $1,016 4.6×
CT maxillofacial w/o contrast (70486) $721.50 $902 6.9×
CT maxillofacial w/wo contrast (70488) $947 $1,184 5.4×
CT neck soft tissue w contrast (70491) $813 $1,016 4.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) $947 $1,184 5.4×
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 contrast (72130) $1,238 $1,547 7.0×
CT thorax w/o contrast (71250) $1,289 $1,611 12.3×
CT upper extremity w/o & w/contrast material (73202) $947 $1,184 5.4×
CT upper extremity w/o contrast rt (73200) $593 $741 5.6×
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) $1,352 $1,690 7.7×
CTA abdomen pelvis (74174) $1,360 $1,700 3.9×
CTA chest (71275) $1,360 $1,700 7.7×
Cta Head (70496) $1,358 $1,697 7.7×
CTA lwr ext w&w/o contrast (73706) $995 $1,244 5.6×
Cta Neck (70498) $1,380 $1,725 7.8×
Dxa bone density study 1/> sites axial skel (77080) $276 $345 2.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $66 $83 0.8×
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×
Hand 3 views (73130) $137 $171 1.6×
Humerus Min 2 Views Left (73060) $137 $171 1.6×
Knee 3 views (73562) $137 $171 1.6×
Lymphangio extrem unilat - ir lymphangiogram extremity (75801) $25 $31 0.0×
MRA head w & w/o contrast (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 & w/contrast material (74183) $1,608 $2,010 4.6×
MRI abdomen w/o contrast (74181) $1,116 $1,395 4.7×
MRI any jnt lwr ext with con lt (73722) $1,243 $1,554 1.6×
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 c-spine with contrast (72142) $1,243 $1,554 3.5×
MRI cervical spine w/o contrast (72141) $1,116 $1,395 4.7×
MRI chest w/o & w/contrast material (71552) $1,608 $2,010 4.6×
MRI chest w/o contrast (71550) $1,116 $1,395 4.7×
MRI chest with contrast (71551) $1,243 $1,554 1.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,243 $1,554 3.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,116 $1,395 4.7×
MRI orbit face &/neck w/o contrast (70540) $1,116 $1,395 4.7×
MRI orbit/face/neck w&w/o cont (70543) $1,608 $2,010 4.6×
MRI orbit/face/neck w/contrast (70542) $1,243 $1,554 3.5×
MRI pelvis w contrast (72196) $1,243 $1,554 3.5×
MRI pelvis w/o & w/contrast material (72197) $1,608 $2,010 4.6×
MRI pelvis w/o contrast (72195) $1,116 $1,395 4.7×
MRI scan of arm joint before and after contrast (73223) $1,608 $2,010 4.6×
MRI scan of leg joint before and after contrast (73723) $1,608 $2,010 4.6×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,608 $2,010 4.6×
MRI spinal canal lumbar w/contrast material (72149) $1,243 $1,554 3.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,608 $2,010 4.6×
MRI spinal canal thoracic w/contrast matrl (72147) $1,243 $1,554 3.5×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,608 $2,010 4.6×
MRI thoracic spine w/o contrast (72146) $1,116 $1,395 4.7×
MRI tmj (70336) $1,109 $1,386 4.6×
MRI upper ext joint w/o contrast (73221) $1,116 $1,395 4.7×
MRI upper extrem other than jt w/o & w/contras (73220) $1,608 $2,010 4.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,116 $1,395 4.7×
Neck soft tissue (70360) $329 $411 3.8×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $180 $225 1.7×
Pelvis 1 or 2 views (72170) $141 $176 1.3×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,608 $2,010 4.6×
Radex abscess/fistula/sinus tract rs&i (76080) $144 $180 0.3×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $176 $220 2.0×
Radex mastoids compl minimum 3 views pr side (70130) $137 $171 1.3×
Radiolog exam mandible compl minimum 4 views (70110) $137 $171 1.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $137 $171 1.6×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $213.50 $267 2.4×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $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×
Saline Infus Sonohysterography W/Color Doppler (76831) $252 $315 1.1×
Scanogram (77073) $137 $171 1.3×
Scapula complete (73010) $137 $171 1.3×
Screening digital breast tomosynthesis (77063) $40 $50 1.7×
Small bowel series (74250) $278 $348 1.6×
Spine thoracic 3 views (72072) $143 $179 1.4×
Ultrasound, abdomen limited (76705) $282 $352 2.7×
Unlisted Ultrasound Procedure (76999) $190 $238 2.2×
Urethrocystography voiding (74455) $358 $447 1.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $472 $590 2.7×
Us abdl aorta screen aaa (76706) $242 $303 2.3×
Us breast unilateral complete (76641) $246 $308 2.3×
Us breast unilateral limited (76642) $203 $254 2.3×
Us chest (76604) $282 $352 2.7×
Us compl joint r-t w/image documentation (76881) $282 $352 2.7×
Us ob transvaginal (76817) $222 $278 2.1×
Us pelvic non ob complete (76856) $298 $372 2.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $246 $307.50 2.3×
Us pregnancy ltd (76815) $180 $225 1.7×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $284 $355 2.7×
Us retroperitoneal complete (76770) $282 $352 2.7×
Us scrotum and contents (76870) $282 $352 2.7×
Us soft tissue head/neck (76536) $257.50 $321.50 2.5×
Us spinal canal and contents (76800) $314 $393 3.0×
Us xtr non-vasc lmtd (76882) $282 $352 2.7×
Wrist 2 views (73100) $137 $171 1.6×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $230 $288 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $137 $171 1.6×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $137 $171 1.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $137 $171 1.6×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $137 $171 1.6×
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 of femur 1 (73551) $137 $171 1.6×
X-ray eye for foreign body (70030) $137 $171 1.6×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $137 $171 1.3×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $137 $171 1.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $137 $171 1.6×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $137 $171 1.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $137 $171 1.6×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $137 $171 1.3×
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 Nasal Bones - Xr Nasal Bones (70160) $137 $171 1.6×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $137 $171 1.6×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $137 $171 1.3×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $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 Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $137 $171 1.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $137 $171 1.6×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $137 $171 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $230 $288 2.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $137 $171 1.3×
X-Ray Spine One View - Xr Spine (72020) $137 $171 1.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $137 $171 1.6×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $137 $171 1.6×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $137 $171 1.3×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $137 $171 1.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $137 $171 1.6×
Xr c-spine 6 or more views (72052) $230 $288 2.2×
Xr chest 4+ views (71048) $138 $173 1.3×
Xr Cholecystography Oral Contrast (74290) $278 $348 1.6×
Xr finger(s) 2+ views (73140) $137 $171 1.6×
XR Mastoids < 3 Views Bilateral (70120) $137 $171 1.3×
Xr shoulder 1 view (73020) $137 $171 1.6×
Xr spine cervical 4 or 5 views (72050) $230 $288 2.2×
Xr tibia/fibula 2 views (73590) $137 $171 1.6×
Xr tmj bilateral (70330) $137 $171 1.6×
Xray knee 1 or 2 views rt (73560) $137 $171 1.6×