Imaging prices at Jackson Hospital

Marianna, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acute gi blood loss imaging (78278) $729 $1,458 1.7×
Ankle 2 views (73600) $150 $300 1.7×
Barium enema (74270) $265 $476 1.4×
Bone age studies (77072) $156 $300 1.4×
Bone imaging limited area (78300) $729 $1,458 1.7×
Bone survey complete (77075) $150 $503 1.4×
Bowel imaging (78290) $729 $1,458 1.7×
Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) $729 $1,458 1.7×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $238 $530 1.3×
Clavicle complete (73000) $142 $284 1.6×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) $729 $1,510 4.0×
CT - st neck w&wo contr (70492) $755 $1,563 4.1×
CT abdomen and pelvis without and with contrast (74178) $768.25 $1,510.50 2.1×
CT abdomen and pelvis without contrast (74176) $729 $1,458 2.9×
CT abdomen w wo contrast (74170) $755 $1,563 4.1×
CT abdomen w/contrast (74160) $729 $1,510 4.0×
CT abdomen w/o contrast (74150) $150 $1,458 1.4×
CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) $781.50 $1,060 2.1×
CT angio abdom w/o & w/dye (74175) $530 $1,458 2.9×
CT angio abdominal arteries (75635) $52 $1,458 0.3×
CT angiograph pelv w/o&w/dye (72191) $150 $1,563 0.8×
CT cervical spine w/contrast (72126) $729 $1,510 2.0×
CT cervical spine w/o contrast (72125) $150 $1,458 1.4×
CT chest w/contrast (71260) $729 $1,510 4.0×
CT extremity upper w & w/o contrast (73202) $781.50 $1,563 4.3×
CT head/brain with contrast (70460) $729 $1,510 4.0×
CT head/brain without and with contrast (70470) $755 $1,563 4.1×
CT heart w/o contrast quant eval coronary calcium (75571) $532 $104 5.9×
CT lower ext w/wo contrast (73702) $1,119.50 $2,239 6.1×
CT lower extremity w contrast (73701) $755 $1,510 4.1×
CT lower extremity w/o contrast unilateral (73700) $729 $1,458 6.7×
CT lumbar spine w/contrast (72132) $729 $1,510 2.0×
CT lumbar spine w/o contrast (72131) $781.50 $1,458 7.2×
CT lumbar spine w/o then w/ con (72133) $755 $1,563 4.1×
CT maxillofacial area w/o contrast (70486) $755.25 $1,458 6.9×
CT maxillofacial w/contrast (70487) $742 $1,510 4.1×
CT maxillofacial w/o then w/ con (70488) $755 $1,563 4.1×
CT orbit sella ear w/o con (70480) $729 $1,458 6.7×
CT orbit/ear/fossa w/o then w/ con (70482) $768.25 $1,563 4.2×
CT pelvis w & w/o contrast (72194) $755 $1,563 4.1×
CT pelvis w/o contrast (72192) $781.50 $1,458 7.2×
CT soft tissue neck w/contrast (70491) $729 $1,510 4.0×
CT soft tissue neck w/o contrast (70490) $781.50 $1,458 7.2×
CT spine cervical w/wo contrast (72127) $755 $1,563 4.1×
CT thoracic spine w/contrast (72129) $729 $1,510 4.0×
CT thoracic spine w/o contrast (72128) $781.50 $1,458 7.2×
CT thoracic spine w/o then w/ con (72130) $755 $1,563 4.1×
CT thorax lung cancer scr c- (71271) $755.25 $1,458 6.9×
CT thorax w/o contrast (71250) $142 $1,458 1.3×
CT thorax w/o then w/ contrast (71270) $755 $1,563 4.1×
CT upper extremity w/dye (73201) $1,106.25 $1,510 3.0×
CT upper extremity w/o contrast rt (73200) $729 $1,458 6.7×
CTA chest w/wo contrast (71275) $729 $1,458 4.0×
CTA head w contrast (70496) $781.50 $1,458 4.3×
CTA lower extremity w/wo contrast unilateral (73706) $781.50 $1,458 4.3×
Cta Neck (70498) $729 $1,458 4.0×
CTA upper extremity w/wo contrast unilateral (73206) $729 $1,458 4.0×
Esophogram (74220) $590.75 $503 3.2×
Fetal biophysical profile w/o nst (76819) $253.50 $426 2.3×
Fluoroscopy up to 1 hour physician/qhp time (76000) $729 $503 2.9×
Gastric emptying study (78264) $729 $1,458 1.7×
Gated heart planar single (78472) $1,798 $1,458 4.3×
Hepatobil syst image w/drug (78227) $729 $1,458 1.3×
Hepatobiliary system imaging (78226) $1,093.25 $1,458 2.6×
Humerus min 2 views (73060) $150 $284 1.7×
Hysterosalpingography (74740) $419 $1,064 1.7×
Ivp (74400) $142 $836 0.8×
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) $729 $1,458 1.3×
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) $729 $2,426 1.3×
Lung ventilat&perfus imaging (78582) $729 $1,458 1.3×
Lung ventilation imaging (78579) $729 $1,458 1.7×
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) $1,832.50 $1,833 5.0×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) $916.50 $1,833 2.5×
MRA head w/o contrast (70544) $916.50 $1,728 3.7×
MRA neck w/o contrast (70547) $864 $1,728 3.5×
MRI abdomen w/contrast (74182) $864 $1,780 2.4×
MRI abdomen w/o & w/contrast material (74183) $890 $1,833 2.4×
MRI abdomen w/o contrast (74181) $796.50 $1,728 3.2×
MRI any jnt lwr ext with con lt (73722) $890 $1,780 1.1×
MRI cervical spine w/o contrast (72141) $781.50 $1,728 3.1×
MRI cervical spine with contrast (72142) $864 $1,780 2.4×
MRI chest w & w/o contrast (71552) $864 $1,833 2.4×
MRI chest w/o contrast (71550) $729 $1,728 2.9×
MRI joint upper ext w/contrast (73222) $877 $1,780 1.1×
MRI joint upr extr w/o&w/dye (73223) $903.25 $1,833 2.5×
MRI joint upr extrem w/o dye (73221) $916.50 $1,728 3.7×
Mri Lower Extremity W/O Dye (73718) $890 $1,780 3.6×
MRI lumbar spine with contrast (72149) $864 $1,780 2.4×
MRI lumbar w/wo contrast (72158) $916.50 $1,833 2.5×
MRI lwr ext w/o jnts with con rt (73719) $1,296.25 $1,756 3.6×
MRI orbit/face/neck w/o & w/contrast (70543) $890.25 $1,833 2.4×
MRI orbit/face/neck w/o contrast (70540) $864 $1,728 3.5×
MRI pelvis w/o contrast (72195) $822.75 $1,728 3.3×
MRI pelvis w/wo contrast (72197) $864 $1,833 2.4×
MRI spine cervical wo/w contrast (72156) $890 $1,833 2.4×
MRI spine thoracic w/contrast (72147) $864 $1,780 2.4×
MRI thoracic spine w wo contrast (72157) $916.50 $1,833 2.5×
MRI thoracic spine w/o contrast (72146) $890 $1,728 3.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $864 $1,728 3.5×
Mri Upper Extremity W/Dye (73219) $877 $1,780 2.4×
MRI upr ext w/o jnts w/o-w/con rt (73220) $916.50 $1,833 2.5×
Myocardial spect single study at rest or stress (78451) $781.50 $3,594 0.6×
Nm bone 3 phase (78315) $807.50 $1,563 1.9×
Nm bone imaging whole body (78306) $729 $1,615 1.7×
Nm heart perfusion spect stress rest (78452) $1,797 $3,595 1.3×
Nm lymph system (78195) $667.75 $2,186.50 1.2×
Nm thyroid imaging only (78013) $142 $1,458 0.3×
Nose to rectum for fb child (76010) $201 $281 2.2×
Nuclear rx IV admin (79101) $1,113 $728 4.6×
Ob us < 14 wks single fetus (76801) $106.50 $213 1.0×
Pulmonary perfusion imaging particulate (78580) $729 $1,458 1.7×
Radex abscess/fistula/sinus tract rs&i (76080) $130.50 $1,062 0.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $150 $284 1.7×
Radex hip unilateral with pelvis 1 view (73501) $529.25 $284 5.8×
Radex hip unilateral with pelvis 2-3 views (73502) $142 $284 1.6×
Radex hips bilateral with pelvis 2 views (73521) $146 $300 1.3×
Radex spine cervical 2 or 3 views (72040) $150 $300 1.7×
Radex spine cervical 4 or 5 views (72050) $251.50 $300 2.3×
Radex spine cervical 6 or more views (72052) $150 $503 1.4×
Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) $150 $300 1.7×
Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) $128 $384 1.2×
Radiologic exam upr gi trc double contrast study (74246) $238.50 $477 1.3×
Radiologic exam upr gi trc single contrast study (74240) $265 $476 1.4×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $142 $284 1.6×
Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) $142 $300 1.3×
Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) $531 $300 4.9×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,213 $2,226 2.9×
Rp loclzj tum plnr whole body single day imaging (78802) $1,113 $2,226 2.0×
Screening digital breast tomosynthesis; bilateral (77063) $729 $312 31.2×
Shoulder arthrogram (73040) $341.75 $1,067 0.9×
Small bowel series (74250) $212.75 $425.50 1.2×
Therapeutic enema barium or air (74283) $238 $476 1.3×
Thyroid uptake w/blood flow sngle/mult quan meas (78014) $729 $1,213 1.7×
Ultrasound breast limited (76642) $184.50 $369 2.0×
Ultrasound, abdomen limited (76705) $239 $426 2.2×
Urethrocystography voiding (74455) $418 $838 1.7×
Urography antegrade (74425) $418 $837 1.1×
Us abdominal aorta real time screen study aaa (76706) $213 $557 2.0×
Us breast uni real time with image complete (76641) $213 $369 2.0×
Us chest (76604) $213 $426 2.0×
Us compl joint r-t w/image documentation (76881) $283.50 $565 2.6×
Us elastography parenchyma (76981) $184.50 $353 1.7×
Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) $276.50 $455 2.5×
Us ob detailed single fetus (76811) $184.50 $683 0.7×
Us ob followup per fetus (76816) $213 $369 2.0×
Us ob limited 1 or more fetuses (76815) $341.50 $426 3.1×
Us obstetric transvaginal (76817) $184.50 $588 1.7×
Us pelvic limited or f/u non-ob (76857) $184.50 $369 1.7×
Us pelvis complete (76856) $288.50 $426 2.6×
Us retroperitoneal complete (76770) $285 $583 2.6×
Us retroperitoneal limited (76775) $291.50 $426 2.7×
Us scrotum (76870) $184.50 $567 1.7×
Us soft tissue head/neck (76536) $223.25 $490.50 2.0×
Us spinal canal (76800) $213 $426 2.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $533.50 $599 5.9×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $299.50 $300 3.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $238 $476 1.3×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $142 $284 1.6×
X-ray exam of finger(s) (73140) $142 $284 1.6×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $150 $284 1.7×
X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) $142 $284 1.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $142 $284 1.6×
X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) $142 $284 1.3×
X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) $142 $284 1.6×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $212.75 $284 2.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $114.50 $284 1.3×
X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) $283.50 $284 3.1×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $150 $300 1.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $299.50 $284 3.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $142 $300 1.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $150 $300 1.4×
X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) $150 $300 1.4×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $167 $284 1.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $150 $384 1.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $916.50 $300 8.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $150 $284 1.7×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $150 $300 1.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $142 $300 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $150 $300 1.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $142 $284 1.6×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $212.75 $425.50 2.3×
X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) $283.50 $284 3.1×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $142 $284 1.6×
Xr abdomen 1 view (74018) $142.50 $285 1.6×
Xr abdomen 2 views (74019) $150 $300 1.4×
Xr bone density appendicular (77081) $150 $284 1.7×
Xr bone density axial (77080) $150 $300 1.4×
Xr bone length study (77073) $150 $300 1.4×
Xr bone survey infant (77076) $251.50 $300 2.3×
Xr bone survey limited (77074) $150 $300 1.4×
Xr chest 1 view (71045) $128 $256 1.4×
Xr chest 2 views (71046) $128 $300 1.4×
Xr chest 3 views (71047) $150 $256 1.7×
Xr cystogram 3+ views (74430) $419 $836 1.2×
Xr facial bones 3 views (70150) $142 $300 1.3×
Xr lower extremity 2 views infant (73592) $283.50 $300 3.1×
Xr lumbar spine 4 views w/ flex ext (72120) $150 $300 1.4×
Xr mandible 4 views (70110) $142 $300 1.3×
Xr nasal bones (70160) $150 $284 1.7×
Xr pelvis 3 views (72190) $150 $300 1.4×
Xr spine 1 view (72020) $529.25 $284 5.8×
Xr sternum 2 views (71120) $192 $284 2.1×
Xr surgical specimen (76098) $531 $1,062 0.9×
Xr upper extremity 2 views infant (73092) $150 $300 1.4×
Xray elbow 2 views (73070) $142 $284 1.6×
Xray forearm 2 views (73090) $142 $284 1.6×
Xray knee 1 or 2 views rt (73560) $142 $284 1.6×
Xray neck soft tissue (70360) $283.50 $284 3.1×
Xray orbits complete min 4 views (70200) $142 $300 1.3×
Xray pelvis 1 or 2 views (72170) $916.50 $300 8.4×
Xray ribs bilateral 3 views (71110) $150 $300 1.4×
Xray ribs unilat w/ pa chest 3v rt (71101) $146 $300 1.3×
Xray scapula complete (73010) $142 $284 1.3×
Xray shoulder 1 view (73020) $142 $284 1.6×
Xray sinuses paranasal <3 views (70210) $150 $284 1.7×
Xray spine thoracic 2 views (72070) $251.50 $300 2.3×
Xray spine thoracic 3 views (72072) $150 $300 1.4×
Xray tibia-fibula 2 views bil (73590) $142 $284 1.6×
Xray tmj open - closed unilat (70328) $150 $284 1.7×
Xray tmj's bilateral open-clsc (70330) $142 $567 1.6×