Imaging prices at Palestine Regional Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Antegrade urography radiological supvj & interpj (74425) $345.30 $1,151.01 1.0×
Bone survey complete (77075) $179.85 $599.50 1.7×
Brachytx isodose pln smpl w/dosimetry cal (77316) $103.28 $344.25 0.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $83.40 $278 0.5×
Cineradiography/videoradiography (76120) $60.60 $202 0.6×
Clavicle complete (73000) $69.96 $233.20 0.8×
Continuing medical physics consltj pr wk (77336) $103.28 $344.25 0.8×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $87 $290 0.5×
CT heart no contrast quant eval coronry calcium (75571) $81.99 $273.30 0.9×
CT limited/localized follow up study (76380) $110.40 $368 1.3×
CT maxillofacial w/o contrast (70486) $383.13 $1,277.10 3.6×
CT orbits w/o contrast (70480) $94.50 $315 0.9×
CT scan for measuring calcium and other minerals in bone (77078) $145.65 $485.50 1.7×
CT thoracic spine w/o contrast (72128) $554.40 $1,848 5.3×
CT thorax w/o contrast (71250) $500.25 $1,667.50 4.8×
Echoencephalography real time imaging (76506) $152.14 $507.15 1.4×
Esophagus (74220) $80.07 $266.90 0.5×
Fluoroscopy up to 1 hr (76000) $162.22 $540.75 0.7×
Forearm 2 views (73090) $59.40 $198 0.7×
Neck soft tissue (70360) $68.97 $229.90 0.8×
Pelvis 1 or 2 views (72170) $78.21 $260.70 0.7×
Radiation treatment delivery 1 mev >= complex (77412) $112.20 $374 0.2×
Radiation tx delivery 1 mev >= intermediate (77407) $103.28 $344.25 0.3×
Radiologic exam teeth prtl exam < full mouth (70310) $151.20 $504 0.6×
Radiologic Examination Salivary Gland Calculus (70380) $71.70 $239 0.8×
Sacroiliac Joints < 3 Views (72200) $119.38 $397.95 1.1×
Scanogram (77073) $94.05 $313.50 0.9×
Sella turcica (70240) $63.69 $212.30 0.7×
Sialogram (70390) $245.75 $819.16 1.0×
Special dosimetry (77331) $73.95 $246.50 0.5×
Spine thoracic 3 views (72072) $97.35 $324.50 0.9×
Telethx isodose pln smpl w/dosimetry calculation (77306) $48.45 $161.50 0.1×
Thoracolumbar 2 views (72080) $75.60 $252 0.9×
Us guided compression repair (76936) $180.60 $602 0.8×
Us transrectal prostate volume (76873) $105.52 $351.75 1.0×
Venography extremity unilateral rs&i (75820) $487.86 $1,626.19 0.3×
Wrist 2 views (73100) $50.10 $167 0.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $82.50 $275 0.9×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $72.60 $242 0.8×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $315 $1,050 1.8×
X-ray eye for foreign body (70030) $126.35 $421.16 1.4×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $227.56 $758.52 2.2×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $54.90 $183 0.6×
X-ray IV pyelogram+drip infusn (74410) $160.50 $535 0.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $53.10 $177 0.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $95.70 $319 0.9×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $81 $270 0.8×
X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) $61.80 $206 0.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $95.70 $319 0.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $85.80 $286 1.0×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $133.56 $445.20 1.5×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $113.06 $376.85 1.3×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $83.16 $277.20 1.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $52.80 $176 0.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $69.96 $233.20 0.8×
XR Mastoids < 3 Views Bilateral (70120) $119.38 $397.95 1.1×
Xr tibia/fibula 2 views (73590) $69.96 $233.20 0.8×