Imaging prices at Medina Regional Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $333.71 $370.78 3.2×
Ankle 2 views (73600) $214.04 $237.82 2.4×
Bone age studies (77072) $175.20 $194.66 1.7×
Bone survey complete (77075) $503.93 $559.92 4.8×
Cervical spine 2 or 3 views (72040) $316.43 $351.58 3.6×
Chest 1 view (71045) $247.96 $275.51 2.8×
Chest 3 views (71047) $367.63 $408.47 4.2×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $470.63 $522.92 2.7×
Clavicle complete (73000) $384.88 $427.64 4.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $723.34 $803.71 6.9×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $940.68 $1,045.19 5.3×
CT abdomen and pelvis without and with contrast (74178) $3,186.99 $3,541.10 9.1×
CT abdomen and pelvis without contrast (74176) $2,548.64 $2,831.82 10.6×
CT abdomen w contrast (74160) $2,202.61 $2,447.34 12.5×
CT abdomen w wo contrast (74170) $2,447.47 $2,719.41 13.9×
CT abdomen w/o contrast (74150) $1,668.47 $1,853.85 15.9×
CT angio hrt w/3d image (75574) $792.90 $881 2.3×
CT angiography upper extremity lt (73206) $2,395.66 $2,661.84 13.6×
CT c-spine w/o contrast (72125) $1,796.77 $1,996.41 17.1×
CT cervical spine w&w/o contrast (72127) $2,139.07 $2,376.74 12.1×
CT cervical spine with contrast (72126) $1,968.21 $2,186.89 5.6×
CT chest w/wo contrast (71270) $2,464.12 $2,737.91 14.0×
CT chest with contrast (71260) $2,224.80 $2,471.99 12.6×
CT head/brain with contrast (70460) $2,022.50 $2,247.22 11.5×
CT head/brain without and with contrast (70470) $2,609.69 $2,899.65 14.8×
CT heart contrast eval cardiac structure&morph (75572) $634.50 $705 1.8×
CT heart no contrast quant eval coronry calcium (75571) $473.11 $525.67 5.4×
CT hrt w/3d image congen (75573) $792.90 $881 2.3×
CT iac w contrast (70481) $2,224.80 $2,471.99 12.6×
CT lower ext w/o (73700) $1,519.19 $1,687.98 14.5×
CT lower extremity w wo contrast (73702) $1,530.90 $1,701 8.7×
CT lower extremity with contrast (73701) $1,520.40 $1,689.33 8.6×
CT lumbar spine w & w/o contrast (72133) $2,224.80 $2,471.99 12.6×
CT lumbar spine w/o contrast (72131) $1,882.48 $2,091.64 17.9×
CT lumbar spine with contrast (72132) $2,053.95 $2,282.16 5.9×
CT maxillofacial w contrast (70487) $2,053.95 $2,282.16 11.7×
CT maxillofacial w/o contrast (70486) $1,711.63 $1,901.81 16.3×
CT maxillofacial w/wo contrast (70488) $2,224.80 $2,471.99 12.6×
CT neck soft tissue w contrast (70491) $1,882.48 $2,091.64 10.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,395.66 $2,661.84 13.6×
CT orbits w/o contrast (70480) $1,625.89 $1,806.54 15.5×
CT pelvis w & w/o contrast (72194) $2,207.54 $2,452.82 12.5×
CT pelvis w/o contrast (72192) $1,711.63 $1,901.81 16.3×
CT soft tissue neck w/o & w/contrast material (70492) $1,505.46 $1,672.72 8.5×
CT soft tissue neck w/o contrast (70490) $1,711.63 $1,901.81 16.3×
CT thoracic spine w/contrast (72129) $2,224.80 $2,471.99 12.6×
CT thoracic spine w/o contrast (72128) $2,053.95 $2,282.16 19.6×
CT thoracic spine w/wo contrast (72130) $2,430.19 $2,700.21 13.8×
CT thorax w/o contrast (71250) $1,968.21 $2,186.89 18.7×
CT upper extremity w/o & w/contrast material (73202) $1,715.94 $1,906.60 9.7×
CT upper extremity w/o contrast rt (73200) $1,250.87 $1,389.85 11.9×
CT upper extremity with contrast (73201) $1,506.24 $1,673.59 4.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,823.72 $3,137.46 16.0×
Cta Abdomen (74175) $2,823.72 $3,137.46 16.0×
CTA abdomen pelvis (74174) $3,176.91 $3,529.89 9.1×
CTA chest (71275) $2,604.34 $2,893.71 14.8×
Cta Head (70496) $2,310.53 $2,567.25 13.1×
CTA lwr ext w&w/o contrast (73706) $2,395.66 $2,661.84 13.6×
Cta Neck (70498) $2,310.53 $2,567.25 13.1×
Cta Pelvis (72191) $2,395.66 $2,661.84 13.6×
Cystography minimum 3 views rs&i (74430) $634.07 $704.52 1.8×
Dxa bone density study 1/> sites axial skel (77080) $547.73 $608.58 5.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $355.90 $395.44 4.1×
Dxa bone density study axial skeleton (77085) $361.68 $401.86 3.4×
Echoencephalography real time imaging (76506) $880.20 $977.99 8.4×
Esophagus (74220) $410.79 $456.43 2.3×
Fetal biophysical profile non-stress testing (76818) $301.50 $335 2.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $625.44 $694.93 6.0×
Fluoroscopy up to 1 hr (76000) $347.88 $386.53 1.5×
Foot 2 views (73620) $209.12 $232.35 2.4×
Forearm 2 views (73090) $241.17 $267.96 2.8×
Hand 2 views (73120) $165.31 $183.67 1.6×
Hand 3 views (73130) $247.96 $275.51 2.8×
Humerus Min 2 Views Left (73060) $195.54 $217.26 2.2×
Hysterosalpingogram (74740) $775.95 $862.16 3.2×
Knee 3 views (73562) $371.02 $412.24 4.2×
Mammary ductogram or galactogram multiple (77054) $849.96 $944.39 3.5×
MRA head w & w/o contrast (70546) $3,417.09 $3,796.76 9.8×
MRA head w/o contrast (70544) $3,161.72 $3,513.02 13.2×
MRA head with contrast (70545) $3,353.55 $3,726.16 9.6×
MRA neck w contrast (70548) $2,931.66 $3,257.39 8.4×
Mra Neck W/O &W/Contrast Material (70549) $2,995.21 $3,328.01 8.5×
MRA neck w/o contrast (70547) $2,741.07 $3,045.63 11.4×
MRI abdomen w contrast (74182) $3,080.31 $3,422.56 8.8×
MRI abdomen w/o & w/contrast material (74183) $3,524.40 $3,915.99 10.1×
MRI abdomen w/o contrast (74181) $2,737.98 $3,042.20 11.4×
MRI any jnt lwr ext with con lt (73722) $2,369.74 $2,633.04 3.0×
MRI any jt upper extremity w/contrast matrl (73222) $2,267.36 $2,519.28 2.9×
MRI breast w/o contrast bilateral (77047) $1,255.50 $1,395 5.2×
MRI breast w/o contrast unilat (77046) $1,165.50 $1,295 4.9×
MRI c-spine with contrast (72142) $2,823.72 $3,137.46 8.1×
MRI cervical spine w/o contrast (72141) $2,567.13 $2,852.36 10.7×
MRI chest w/o & w/contrast material (71552) $2,936.59 $3,262.87 8.4×
MRI chest w/o contrast (71550) $2,395.66 $2,661.84 10.0×
MRI chest with contrast (71551) $2,580.69 $2,867.43 3.3×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $2,303.77 $2,559.74 6.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,303.77 $2,559.74 6.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,200.77 $2,445.29 9.2×
MRI orbit face &/neck w/o contrast (70540) $2,567.13 $2,852.36 10.7×
MRI orbit/face/neck w&w/o cont (70543) $3,354.16 $3,726.84 9.6×
MRI orbit/face/neck w/contrast (70542) $3,014.92 $3,349.91 8.6×
MRI pelvis w contrast (72196) $2,823.72 $3,137.46 8.1×
MRI pelvis w/o & w/contrast material (72197) $2,540.07 $2,822.30 7.2×
MRI pelvis w/o contrast (72195) $1,545.72 $1,717.46 6.4×
MRI scan of arm joint before and after contrast (73223) $2,267.36 $2,519.28 6.5×
MRI scan of leg joint before and after contrast (73723) $2,501.13 $2,779.03 7.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,230.82 $3,589.80 9.2×
MRI spinal canal lumbar w/contrast material (72149) $2,892.19 $3,213.54 8.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,594.12 $3,993.46 10.3×
MRI spinal canal thoracic w/contrast matrl (72147) $2,686.79 $2,985.32 7.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,269.05 $3,632.27 9.3×
MRI thoracic spine w/o contrast (72146) $2,652.85 $2,947.61 11.1×
MRI tmj (70336) $2,990.25 $3,322.49 12.5×
MRI upper ext joint w/o contrast (73221) $2,200.77 $2,445.29 9.2×
MRI upper extrem other than jt w/o & w/contras (73220) $2,485.09 $2,761.21 7.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,200.77 $2,445.29 9.2×
Myelogram Cervical (72240) $346.52 $385.02 0.4×
Myelogram Lumbar (72265) $329.83 $366.47 0.4×
Myelogram thoracic (72255) $311.87 $346.52 0.4×
Neck soft tissue (70360) $196.78 $218.64 2.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $485.56 $539.51 4.6×
Osseous survey infant (77076) $323.21 $359.12 3.1×
Pelvis 1 or 2 views (72170) $258.46 $287.17 2.5×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,501.13 $2,779.03 7.1×
Radex abscess/fistula/sinus tract rs&i (76080) $775.95 $862.16 1.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $107 $118.88 1.2×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $125.60 $139.55 1.2×
Radex hips bilateral with pelvis 2 views (73521) $122.11 $135.67 1.2×
Radex mastoids compl minimum 3 views pr side (70130) $270.18 $300.19 2.6×
Radiolog exam mandible compl minimum 4 views (70110) $282.50 $313.88 2.7×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $265.23 $294.70 3.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $333.71 $370.78 3.2×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $299.78 $333.08 3.4×
Radiologic exam colon single contrast study (74270) $616.20 $684.66 3.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $616.20 $684.66 3.5×
Radiologic exam upr gi trc double contrast study (74246) $633.46 $703.84 3.6×
Radiologic exam upr gi trc single contrast study (74240) $323.21 $359.12 1.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $100.01 $111.12 1.1×
Radiological examination surgical specimen (76098) $1,393.98 $1,548.86 2.5×
Ribs bilateral 3 views (71110) $392.30 $435.88 3.7×
Saline Infus Sonohysterography W/Color Doppler (76831) $742.03 $824.47 3.1×
Scanogram (77073) $389.83 $433.14 3.7×
Scapula complete (73010) $269.24 $299.16 2.6×
Screening digital breast tomosynthesis (77063) $70.23 $78.03 3.0×
Sella turcica (70240) $165.31 $183.67 1.9×
Small bowel series (74250) $333.07 $370.07 1.9×
Ultrasound, abdomen limited (76705) $357.75 $397.50 3.4×
Unlisted Diagnostic Radiographic Procedure (76499) $165.31 $183.67 1.9×
Upper Extremity Infant (73092) $272.66 $302.94 2.6×
Urethrocystography retrograde rs&i (74450) $634.07 $704.52 2.6×
Urethrocystography voiding (74455) $634.07 $704.52 2.6×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $695.76 $773.06 3.9×
Us abdl aorta screen aaa (76706) $382.51 $425.01 3.6×
Us breast unilateral complete (76641) $431.16 $479.06 4.1×
Us breast unilateral limited (76642) $330.56 $367.28 3.8×
Us chest (76604) $412.04 $457.82 3.9×
Us compl joint r-t w/image documentation (76881) $532.32 $591.46 5.1×
Us elastography parenchyma (76981) $341.78 $379.75 3.3×
Us infant hips dynamic (76885) $610.64 $678.48 7.0×
Us ob transvaginal (76817) $684.64 $760.71 6.5×
Us pelvic non ob complete (76856) $746.34 $829.26 7.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $359.61 $399.56 3.4×
Us pregnancy ltd (76815) $411.43 $457.14 3.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $564.99 $627.76 5.4×
Us retroperitoneal complete (76770) $549.58 $610.63 5.2×
Us scrotum and contents (76870) $556.38 $618.19 5.3×
Us soft tissue head/neck (76536) $559.44 $621.60 5.3×
Us spinal canal and contents (76800) $412.04 $457.82 3.9×
Us transrectal (76872) $495.90 $551 4.7×
Us xtr non-vasc lmtd (76882) $372.66 $414.06 3.5×
Venogram extremity bilateral (75822) $2,562.21 $2,846.89 1.6×
Venography extremity unilateral rs&i (75820) $2,562.21 $2,846.89 1.6×
Vertebral fracture assessment via dxa (77086) $165.31 $183.67 1.9×
Wrist 2 views (73100) $275.74 $306.37 3.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $376.28 $418.08 3.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $191.85 $213.16 2.2×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $273.87 $304.30 3.1×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $718.60 $798.44 4.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $179.49 $199.43 2.1×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $334.01 $371.12 3.8×
X-ray exam hip uni 1 view (73501) $79.07 $87.85 0.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $88.38 $98.20 1.0×
X-ray exam hip uni 4/> views (73503) $125.60 $139.55 1.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $125.60 $139.55 1.2×
X-ray exam of femur 1 (73551) $88.38 $98.20 1.0×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $442.43 $491.58 2.5×
X-ray eye for foreign body (70030) $214.21 $238.01 2.5×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $316.43 $351.58 3.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $239.32 $265.91 2.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $410.80 $456.44 4.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $372.88 $414.30 4.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $229.46 $254.95 2.6×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $397.84 $442.05 3.8×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $241.17 $267.96 2.8×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $272.66 $302.94 3.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $484.84 $538.71 4.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $574.32 $638.13 5.5×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $351 $389.99 3.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $251.67 $279.63 2.9×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $165.31 $183.67 1.9×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $307.80 $342 2.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $316.43 $351.58 3.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $359.61 $399.56 3.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $381.82 $424.24 3.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $247.96 $275.51 2.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $265.23 $294.70 3.0×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $174.56 $193.95 2.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $323.21 $359.12 3.7×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $165.31 $183.67 1.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $453.37 $503.74 4.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $287.44 $319.37 2.7×
X-Ray Spine One View - Xr Spine (72020) $196.78 $218.64 2.3×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $214.65 $238.50 2.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $245.49 $272.76 2.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $299.16 $332.40 2.8×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $434.25 $482.49 4.1×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $197.37 $219.30 2.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $256.59 $285.09 2.9×
Xr c-spine 6 or more views (72052) $518.74 $576.37 4.9×
Xr chest 4+ views (71048) $359.61 $399.56 3.4×
Xr finger(s) 2+ views (73140) $201.69 $224.10 2.3×
XR Mastoids < 3 Views Bilateral (70120) $205.42 $228.24 2.0×
Xr optic foramina (70190) $287.44 $319.37 3.3×
Xr shoulder 1 view (73020) $254.14 $282.37 2.9×
Xr spine cervical 4 or 5 views (72050) $445.33 $494.81 4.2×
Xr tibia/fibula 2 views (73590) $258.46 $287.17 3.0×
Xr tmj bilateral (70330) $273.87 $304.30 3.1×
Xray knee 1 or 2 views rt (73560) $361.46 $401.61 4.1×