Imaging prices at Ochsner Stennis Hospital

De Kalb, MS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $968.07 $1,403 0.8×
Abdomen 2 views (74019) $89.70 $130 1.0×
Ankle 2 views (73600) $70.38 $102 0.9×
Antegrade urography radiological supvj & interpj (74425) $93.50 $135.50 0.3×
Aortogram thoracic (75605) $820.41 $1,189 0.2×
Artery X-Rays Adrenal Gland (75731) $2,139 $3,100 0.8×
Arthrogram elbow (73085) $509.91 $739 1.7×
Arthrogram shoulder (73040) $509.91 $739 1.7×
Arthrogram wrist (73115) $169.74 $246 0.6×
Arthrography knee lt (73580) $764.86 $1,108.50 2.5×
Basic radiation dosimetry calculation (77300) $48.30 $70 0.4×
Bone age studies (77072) $72.80 $105.50 0.8×
Bone survey complete (77075) $519.57 $753 5.8×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $114.88 $166.50 0.2×
Cervical spine 2 or 3 views (72040) $48.99 $71 0.7×
Chest 1 view (71045) $52.78 $76.50 0.7×
Chest 3 views (71047) $271.86 $394 3.6×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $335.34 $486 2.2×
Clavicle complete (73000) $77.28 $112 1.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $228.39 $331 2.5×
Continuing medical physics consltj pr wk (77336) $160.08 $232 1.4×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $435.39 $631 2.9×
CT abdomen and pelvis without and with contrast (74178) $1,833.33 $2,657 6.1×
CT abdomen and pelvis without contrast (74176) $1,062.60 $1,540 5.2×
CT abdomen w contrast (74160) $1,283.40 $1,860 8.5×
CT abdomen w wo contrast (74170) $1,530.42 $2,218 10.1×
CT abdomen w/o contrast (74150) $787.98 $1,142 8.7×
CT angiography upper extremity lt (73206) $1,283.40 $1,860 8.5×
CT c-spine w/o contrast (72125) $986.70 $1,430 10.9×
CT cervical spine w&w/o contrast (72127) $1,868.52 $2,708 12.4×
CT cervical spine with contrast (72126) $1,535.94 $2,226 5.1×
CT chest w/wo contrast (71270) $1,674.63 $2,427 11.1×
CT chest with contrast (71260) $1,526.28 $2,212 10.1×
CT head/brain with contrast (70460) $1,283.40 $1,860 8.5×
CT head/brain without and with contrast (70470) $1,573.20 $2,280 10.4×
CT iac w contrast (70481) $1,339.29 $1,941 8.9×
CT limited/localized follow up study (76380) $839.04 $1,216 11.2×
CT lower ext w/o (73700) $1,182.32 $1,713.50 13.1×
CT lower extremity w wo contrast (73702) $2,511.60 $3,640 16.6×
CT lower extremity with contrast (73701) $2,008.94 $2,911.50 13.3×
CT lumbar spine w & w/o contrast (72133) $1,868.52 $2,708 12.4×
CT lumbar spine w/o contrast (72131) $986.70 $1,430 10.9×
CT lumbar spine with contrast (72132) $1,535.94 $2,226 5.1×
CT maxillofacial w contrast (70487) $1,339.29 $1,941 8.9×
CT maxillofacial w/o contrast (70486) $624.80 $905.50 6.9×
CT maxillofacial w/wo contrast (70488) $1,674.63 $2,427 11.1×
CT neck soft tissue w contrast (70491) $1,339.29 $1,941 8.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,674.63 $2,427 11.1×
CT orbits w/o contrast (70480) $787.98 $1,142 8.7×
CT pelvis w & w/o contrast (72194) $1,573.20 $2,280 10.4×
CT pelvis w/o contrast (72192) $787.98 $1,142 8.7×
CT scan for measuring calcium and other minerals in bone (77078) $563.73 $817 7.5×
CT soft tissue neck w/o & w/contrast material (70492) $1,674.63 $2,427 11.1×
CT soft tissue neck w/o contrast (70490) $787.98 $1,142 8.7×
CT thoracic spine w/contrast (72129) $1,535.94 $2,226 10.2×
CT thoracic spine w/o contrast (72128) $986.70 $1,430 10.9×
CT thoracic spine w/wo contrast (72130) $1,868.52 $2,708 12.4×
CT thorax w/o contrast (71250) $787.98 $1,142 8.7×
CT upper extremity w/o & w/contrast material (73202) $2,511.60 $3,640 16.6×
CT upper extremity w/o contrast rt (73200) $521.64 $756 5.8×
CT upper extremity with contrast (73201) $599.26 $868.50 2.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,283.40 $1,860 8.5×
Cta Abdomen (74175) $1,269.60 $1,840 8.4×
CTA abdomen pelvis (74174) $1,368.96 $1,984 4.6×
CTA chest (71275) $1,283.40 $1,860 8.5×
Cta Head (70496) $1,283.40 $1,860 8.5×
CTA lwr ext w&w/o contrast (73706) $1,283.40 $1,860 8.5×
Cta Neck (70498) $1,283.40 $1,860 8.5×
Cta Pelvis (72191) $1,269.60 $1,840 8.4×
Cystography minimum 3 views rs&i (74430) $85.22 $123.50 0.3×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $66.93 $97 0.7×
Doppler Echo Fetal Spectral Display Complete (76827) $90.39 $131 1.0×
Dx ophthalmic us ant segment immersion uni/bi (76513) $84.87 $123 0.9×
Dxa bone density study axial skeleton (77085) $82.41 $119.44 0.9×
Echo exam of eye (76529) $77.28 $112 1.0×
Echo exam of fetal heart (76825) $151.80 $220 0.3×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $94.18 $136.50 0.5×
Echoencephalography real time imaging (76506) $220.46 $319.50 2.4×
Esophagus (74220) $123.86 $179.50 0.8×
Fetal biophysical profile non-stress testing (76818) $110.40 $160 1.2×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $167.32 $242.50 1.9×
Fluoroscopy up to 1 hr (76000) $122.48 $177.50 0.6×
Foot 2 views (73620) $72.45 $105 1.0×
Forearm 2 views (73090) $57.96 $84 0.8×
Gated Heart Planar Single (78472) $403.65 $585 1.2×
Hand 2 views (73120) $66.24 $96 0.7×
Hand 3 views (73130) $69.69 $101 0.9×
Humerus Min 2 Views Left (73060) $54.86 $79.50 0.7×
Hysterosalpingogram (74740) $420.90 $610 2.0×
Knee 3 views (73562) $75.21 $109 1.0×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $488.18 $707.50 0.2×
Mammary ductogram or galactogram multiple (77054) $509.91 $739 2.5×
Mammary ductogram or galactogram single (77053) $509.91 $739 2.5×
MRA head w & w/o contrast (70546) $1,995.48 $2,892 6.6×
MRA head w/o contrast (70544) $1,413.12 $2,048 6.9×
MRA head with contrast (70545) $1,793.31 $2,599 6.0×
MRA neck w contrast (70548) $1,995.48 $2,892 6.6×
Mra Neck W/O &W/Contrast Material (70549) $2,511.60 $3,640 8.4×
MRA neck w/o contrast (70547) $1,413.12 $2,048 6.9×
MRI abdomen w contrast (74182) $2,093.46 $3,034 7.0×
MRI abdomen w/o & w/contrast material (74183) $2,377.74 $3,446 7.9×
MRI abdomen w/o contrast (74181) $1,722.24 $2,496 8.4×
MRI any jnt lwr ext with con lt (73722) $2,053.44 $2,976 3.0×
MRI any jt upper extremity w/contrast matrl (73222) $2,049.30 $2,970 3.0×
MRI bone marrow blood supply (77084) $1,763.64 $2,556 8.6×
MRI breast w/o contrast bilateral (77047) $3,746.70 $5,430 18.2×
MRI breast w/o contrast unilat (77046) $2,851.08 $4,132 13.9×
MRI c-spine with contrast (72142) $1,557.33 $2,257 5.2×
MRI cervical spine w/o contrast (72141) $1,098.48 $1,592 5.3×
MRI chest w/o contrast (71550) $1,860.93 $2,697 9.0×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,854.72 $2,688 6.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,964.43 $2,847 6.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,064.67 $1,543 5.2×
MRI orbit face &/neck w/o contrast (70540) $1,745.01 $2,529 8.5×
MRI orbit/face/neck w&w/o cont (70543) $2,311.50 $3,350 7.7×
MRI orbit/face/neck w/contrast (70542) $2,007.90 $2,910 6.7×
MRI pelvis w contrast (72196) $1,292.72 $1,873.50 4.3×
MRI pelvis w/o & w/contrast material (72197) $2,001.69 $2,901 6.7×
MRI pelvis w/o contrast (72195) $1,449.69 $2,101 7.0×
MRI scan of arm joint before and after contrast (73223) $2,463.30 $3,570 8.2×
MRI scan of leg joint before and after contrast (73723) $2,467.44 $3,576 8.2×
MRI spectroscopy (76390) $1,522.83 $2,207 20.3×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,930.62 $2,798 6.4×
MRI spinal canal lumbar w/contrast material (72149) $1,667.73 $2,417 5.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,001.69 $2,901 6.7×
MRI spinal canal thoracic w/contrast matrl (72147) $1,754.67 $2,543 5.8×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,106.57 $3,053 7.0×
MRI thoracic spine w/o contrast (72146) $1,526.28 $2,212 7.4×
MRI tmj (70336) $1,914.06 $2,774 9.3×
MRI upper ext joint w/o contrast (73221) $933.22 $1,352.50 4.5×
MRI upper extrem other than jt w/o & w/contras (73220) $1,463.49 $2,121 4.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,600.11 $2,319 7.8×
Myocardial Spect Multiple Studies (78452) $138 $200 0.1×
Neck soft tissue (70360) $117.99 $171 1.6×
Nuclear Rx Oral Admin (79005) $138 $200 0.7×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $110.40 $160 1.2×
Ophthalmic biometry us echograpy a-scan (76516) $56.92 $82.50 0.6×
Ophthalmic us dx quantitative a-scan only (76511) $77.28 $112 0.9×
Orthopantogram (70355) $52.10 $75.50 0.7×
Osseous survey infant (77076) $220.80 $320 2.4×
Pelvis 1 or 2 views (72170) $170.43 $247 1.9×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,571.82 $2,278 5.2×
Radex abscess/fistula/sinus tract rs&i (76080) $80.73 $117 0.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $79.35 $115 1.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $75.90 $110 0.8×
Radex hips bilateral with pelvis 2 views (73521) $31.74 $46 0.4×
Radex mastoids compl minimum 3 views pr side (70130) $350.52 $508 3.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $64.86 $94 0.7×
Radiation treatment delivery 1 mev >= complex (77412) $99.36 $144 0.2×
Radiation treatment delivery 1 mev >= simple (77402) $96.60 $140 1.1×
Radiation tx delivery 1 mev >= intermediate (77407) $89.01 $129 0.3×
Radiolog exam mandible compl minimum 4 views (70110) $83.84 $121.50 0.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $41.40 $60 0.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $235.98 $342 2.6×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $42.78 $62 0.6×
Radiologic exam colon single contrast study (74270) $410.55 $595 2.7×
Radiologic exam upr gi trc double contrast study (74246) $460.92 $668 3.0×
Radiologic exam upr gi trc single contrast study (74240) $460.92 $668 3.0×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $110.40 $160 1.5×
Radiological examination surgical specimen (76098) $136.62 $198 0.3×
Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) $150.08 $217.50 0.7×
Ribs bilateral 3 views (71110) $93.84 $136 1.0×
Rp loclzj tum spect 1 area single day imaging (78803) $350.52 $508 0.7×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $202.86 $294 0.2×
Rp Therapy Intravenous Administration (79101) $241.50 $350 1.2×
Scanogram (77073) $257.37 $373 2.9×
Scapula complete (73010) $35.88 $52 0.4×
Screening digital breast tomosynthesis (77063) $57.62 $83.50 2.5×
Sella turcica (70240) $235.98 $342 3.1×
Shuntogram indwelling nonvascular shunt rs&i (75809) $528.54 $766 5.9×
Sialogram (70390) $509.91 $739 2.5×
Simulation intermediate (77285) $194.58 $282 0.6×
Small bowel series (74250) $405.72 $588 2.7×
Spec medical radj physics consltj (77370) $187.68 $272 1.6×
Spec telethx port pln parts hemibdy tot bdy (77321) $114.54 $166 0.4×
Special dosimetry (77331) $41.74 $60.50 0.4×
Special treatment procedure (77470) $300.15 $435 0.6×
Surface Applic Low Dose Rate Radionuclide Source (77789) $56.58 $82 0.6×
Temporomandble Jt Arthrography Rs&I (70332) $509.91 $739 2.5×
Ther rad simulaj-aided field setting complex (77290) $218.38 $316.50 0.7×
Ther rad simulaj-aided field setting simple (77280) $122.13 $177 1.1×
Therapeutic Enema (74283) $353.97 $513 2.3×
Thoracolumbar 2 views (72080) $235.98 $342 3.1×
Tomogram (76100) $576.84 $836 6.4×
Treatment device intermediate (77333) $66.58 $96.50 0.6×
Treatment devices simple (77332) $44.85 $65 0.4×
Tx devices design & construction complex (77334) $117.30 $170 0.4×
Ultrasound scan to determine eye length and lens power (76519) $57.96 $84 0.6×
Ultrasound, abdomen limited (76705) $112.47 $163 1.2×
Umbilical-artery Doppler (OB) (76820) $211.14 $306 2.3×
Unlisted Ultrasound Procedure (76999) $76.24 $110.50 1.0×
Upper Extremity Infant (73092) $102.12 $148 1.1×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $79.35 $115 0.2×
Urethrocystography retrograde rs&i (74450) $68.83 $99.75 0.3×
Urethrocystography voiding (74455) $130.76 $189.50 0.6×
Us abdl aorta screen aaa (76706) $174.34 $252.66 1.9×
Us breast unilateral complete (76641) $110.40 $160 1.2×
Us breast unilateral limited (76642) $101.78 $147.50 1.4×
Us chest (76604) $104.19 $151 1.2×
Us compl joint r-t w/image documentation (76881) $51.75 $75 0.6×
Us fetal nuchal translucency 1st gestation (76813) $93.84 $136 1.0×
Us guided compression repair (76936) $858.36 $1,244 4.6×
Us infant hips dynamic (76885) $160.77 $233 2.1×
Us ob detailed single fetus (76811) $188.37 $273 0.9×
Us ob transvaginal (76817) $141.80 $205.50 1.6×
Us pelvic non ob complete (76856) $150.76 $218.50 1.7×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $113.85 $165 1.3×
Us pregnancy ltd (76815) $145.59 $211 1.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $141.80 $205.50 1.6×
Us retroperitoneal complete (76770) $148 $214.50 1.6×
Us retroperitoneal limited (76775) $116.61 $169 1.3×
Us scrotum and contents (76870) $121.78 $176.50 1.4×
Us soft tissue head/neck (76536) $126.96 $184 1.4×
Us spinal canal and contents (76800) $268.41 $389 3.0×
Us transrectal (76872) $145.65 $211.09 1.6×
Us transrectal prostate volume (76873) $115.58 $167.50 1.3×
Us xtr non-vasc lmtd (76882) $88.32 $128 1.0×
Us, eye b-scan (76512) $73.48 $106.50 0.8×
Vertebral fracture assessment via dxa (77086) $42.09 $61 0.6×
Wrist 2 views (73100) $55.20 $80 0.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $105.92 $153.50 1.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $222.87 $323 3.0×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $65.20 $94.50 0.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $520.26 $754 3.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $69.69 $101 0.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $85.90 $124.50 1.1×
X-ray exam entire spi 4/5 vw (72083) $53.82 $78 0.6×
X-ray exam hip uni 1 view (73501) $35.19 $51 0.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $94.88 $137.50 1.3×
X-ray exam hip uni 4/> views (73503) $63.48 $92 0.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $59.34 $86 0.7×
X-Ray Exam Hips Bi 5/> Views (73523) $69.69 $101 0.8×
X-ray exam of femur 1 (73551) $23.12 $33.50 0.3×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $198.72 $288 1.3×
X-ray eye for foreign body (70030) $87.63 $127 1.2×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $271.86 $394 3.0×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $48.99 $71 0.7×
X-ray head for orthodontia (70350) $124.89 $181 1.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $57.96 $84 0.8×
X-ray IV pyelogram+drip infusn (74410) $937.71 $1,359 6.2×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $81.42 $118 0.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $50.72 $73.50 0.7×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $102.12 $148 1.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $61.06 $88.50 0.7×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $389.16 $564 4.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $389.16 $564 4.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $51.40 $74.50 0.7×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $230.46 $334 3.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $291.87 $423 3.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $65.55 $95 0.7×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $167.67 $243 0.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $64.17 $93 0.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $48.30 $70 0.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $382.95 $555 4.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $235.98 $342 2.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $73.83 $107 1.0×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $86.25 $125 1.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $86.94 $126 1.2×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $51.40 $74.50 0.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $86.94 $126 1.0×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $186.30 $270 2.1×
X-Ray Spine One View - Xr Spine (72020) $180.78 $262 2.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $37.95 $55 0.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $56.58 $82 0.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $69 $100 0.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $43.12 $62.50 0.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $151.80 $220 2.0×
Xr c-spine 6 or more views (72052) $99.02 $143.50 1.1×
Xr chest 4+ views (71048) $271.86 $394 3.0×
Xr finger(s) 2+ views (73140) $59.68 $86.50 0.8×
Xr shoulder 1 view (73020) $117.99 $171 1.6×
Xr spine cervical 4 or 5 views (72050) $89.36 $129.50 1.0×
Xr tibia/fibula 2 views (73590) $71.07 $103 0.9×
Xr tmj bilateral (70330) $291.87 $423 3.9×
Xray knee 1 or 2 views rt (73560) $73.14 $106 1.0×