Imaging prices at Palo Pinto General Hospital
Mineral Wells, TX · every code in this section with a posted price and a Medicare benchmark.
227 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $134 | $268 | 1.5× |
| Abdomen 2 views (74019) | $171.45 | $342.90 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $565.50 | $1,131 | 1.4× |
| Angiography extremity bilateral rs&i (75716) | $1,509.35 | $3,018.70 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,388.05 | $2,776.10 | 0.4× |
| Ankle 2 views (73600) | $125.15 | $250.30 | 1.4× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,440.45 | $2,880.90 | 0.3× |
| Arthrogram hip (73525) | $401.30 | $802.60 | 1.1× |
| Arthrogram Wrist (73115) | $401.30 | $802.60 | 1.1× |
| Bone age studies (77072) | $147.75 | $295.50 | 1.4× |
| Bone Imaging 3 Phase (78315) | $331 | $662 | 0.8× |
| Bone Imaging Limited Area (78300) | $727 | $1,454 | 1.8× |
| Bone Imaging Whole Body (78306) | $331 | $662 | 0.8× |
| Bone survey infant (77076) | $173.10 | $346.20 | 1.6× |
| Chest 1 view (71045) | $130.10 | $260.20 | 1.5× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$124.60–$147.20 | $249.20–$294.40 | varies |
| Chest 3 views (71047) | $157.15 | $314.30 | 1.8× |
| Chest 4 or more views (71048) | $126.25 | $252.50 | 1.2× |
| Clavicle complete (73000) | $136.70 | $273.40 | 1.6× |
| Contrast Exam Abdominl Aorta (75625) | $1,438.25 | $2,876.50 | 0.5× |
| Contrast X-Ray Bladder (74430) | $280.05 | $560.10 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $401.30 | $802.60 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $401.30 | $802.60 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $917.30 | $1,834.60 | 2.6× |
| CT abdomen and pelvis without contrast (74176) | $687.95 | $1,375.90 | 2.9× |
| CT abdomen w contrast (74160) | $573.30 | $1,146.60 | 3.3× |
| CT abdomen w wo contrast (74170) | $687.95 | $1,375.90 | 3.9× |
| CT abdomen w/o contrast (74150) | $544.65 | $1,089.30 | 5.2× |
| CT Angio Abdomen and Pelvis (74174) | $1,031.95 | $2,063.90 | 2.9× |
| CT Angio Chest (71275) | $1,031.95 | $2,063.90 | 5.9× |
| CT Angio Head (70496) | $917.30 | $1,834.60 | 5.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,031.95 | $2,063.90 | 5.9× |
| CT Angio Neck (70498) | $917.30 | $1,834.60 | 5.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $917.30 | $1,834.60 | 5.2× |
| CT cervical spine w/ contrast (72126) | $573.30 | $1,146.60 | 1.6× |
| CT cervical spine w/o contrast (72125) | $544.65 | $1,089.30 | 5.2× |
| CT cervical spine w/wo cont (72127) | $687.95 | $1,375.90 | 3.9× |
| CT chest w contrast (71260) | $573.30 | $1,146.60 | 3.3× |
| CT chest w/wo contrast (71270) | $687.95 | $1,375.90 | 3.9× |
| CT head/brain with contrast (70460) | $573.30 | $1,146.60 | 3.3× |
| CT head/brain without and with contrast (70470) | $687.95 | $1,375.90 | 3.9× |
| CT iac w contrast (70481) | $573.30 | $1,146.60 | 3.3× |
| CT l-spine w&w/o contrast (72133) | $687.95 | $1,375.90 | 3.9× |
| CT lower ext w/o (73700) | $544.65 | $1,089.30 | 5.2× |
| CT lower extremity w/contrast material (73701) | $573.30 | $1,146.60 | 3.3× |
| CT lumbar spine w contrast (72132) | $573.30 | $1,146.60 | 1.6× |
| CT lumbar spine w/o contrast (72131) | $544.65 | $1,089.30 | 5.2× |
| CT maxillofacial w contrast (70487) | $573.30 | $1,146.60 | 3.3× |
| CT maxillofacial wo contrast (70486) | $544.65 | $1,089.30 | 5.2× |
| CT neck tissue combo (70492) | $687.95 | $1,375.90 | 3.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $687.95 | $1,375.90 | 3.9× |
| CT orbits w/o contrast (70480) | $544.65 | $1,089.30 | 5.2× |
| CT pelvis w&w/o contrast (72194) | $687.95 | $1,375.90 | 3.9× |
| CT pelvis w/o contrast (72192) | $544.65 | $1,089.30 | 5.2× |
| CT scan of leg combo (73702) | $687.95 | $1,375.90 | 3.9× |
| CT scans face/jaw combo (70488) | $687.95 | $1,375.90 | 3.9× |
| CT soft tissue neck w contrast (70491) | $573.30 | $1,146.60 | 3.3× |
| CT soft tissue neck w/o contrast (70490) | $544.65 | $1,089.30 | 5.2× |
| CT thoracic spine w contrast (72129) | $573.30 | $1,146.60 | 3.3× |
| CT thoracic spine w/o contrast (72128) | $544.65 | $1,089.30 | 5.2× |
| CT thoracic spine w/wo cont (72130) | $687.95 | $1,375.90 | 3.9× |
| CT thorax w/o contrast (71250) | $544.65 | $1,089.30 | 5.2× |
| CT upper ext wo (73200) | $544.65 | $1,089.30 | 5.2× |
| CT upper extremity w/o & w/contrast material (73202) | $687.95 | $1,375.90 | 3.9× |
| CT upper extremity with contrast (73201) | $551.85 | $1,103.70 | 1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,146.60 | $2,293.20 | 6.5× |
| Cta Abdomen (74175) | $1,031.95 | $2,063.90 | 5.9× |
| CTA pelvis (72191) | $1,031.95 | $2,063.90 | 5.9× |
| Dxa Bone Density Axial (77080) | $125 | $250 | 1.2× |
| Esophagram (74220) | $243.15 | $486.30 | 1.4× |
| Fetal Biophys Profile W/Nst (76818) | $296.60 | $593.20 | 2.8× |
| Fluoroscopy up to 1 hr (76000) | $62.30 | $124.60 | 0.3× |
| Foot 2 views (73620) | $125.70 | $251.40 | 1.4× |
| Forearm 2 views (73090) | $139.50 | $279 | 1.6× |
| Gastric emptying imaging study (78264) | $331 | $662 | 0.8× |
| Gated Heart Planar Single (78472) | $423 | $846 | 1.1× |
| Hand 2 views (73120) | $125.15 | $250.30 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $390.50 | $781 | 0.7× |
| Hepatobiliary System Imaging (78226) | $748.50 | $1,497 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $1,142.50 | $2,285 | 0.9× |
| Hysterosalpingogram (74740) | $320.85 | $641.70 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $442.50 | $885 | 0.8× |
| Knee 3 Views (73562) | $163.15 | $326.30 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $655 | $1,310 | 1.2× |
| Lymph System Imaging (78195) | $532.50 | $1,065 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $687.95 | $1,375.90 | 2.9× |
| Meckels Divert Exam (78290) | $565.50 | $1,131 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $917.30 | $1,834.60 | 2.6× |
| MRA head w/o contrast (70544) | $917.30 | $1,834.60 | 3.8× |
| MRA head with contrast (70545) | $917.30 | $1,834.60 | 2.6× |
| MRA neck w contrast (70548) | $917.30 | $1,834.60 | 2.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $917.30 | $1,834.60 | 2.6× |
| MRA neck w/o contrast (70547) | $917.30 | $1,834.60 | 3.8× |
| MRI abdomen w contrast (74182) | $802.60 | $1,605.20 | 2.3× |
| MRI abdomen w/o contrast (74181) | $802.60 | $1,605.20 | 3.3× |
| MRI any jt lower extrem w/contrast material (73722) | $802.60 | $1,605.20 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $917.30 | $1,834.60 | 2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $687.95 | $1,375.90 | 0.9× |
| MRI cervical spine w contrast (72142) | $802.60 | $1,605.20 | 2.3× |
| MRI cervical spine w/o cont (72141) | $687.95 | $1,375.90 | 2.9× |
| MRI chest w/o contrast (71550) | $687.95 | $1,375.90 | 2.9× |
| MRI chest with contrast (71551) | $802.60 | $1,605.20 | 1.0× |
| MRI chest wo w contrast (71552) | $917.30 | $1,834.60 | 2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $687.95 | $1,375.90 | 2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $917.30 | $1,834.60 | 2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $687.95 | $1,375.90 | 2.9× |
| MRI lumbar spine w contrast (72149) | $802.60 | $1,605.20 | 2.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $917.30 | $1,834.60 | 2.6× |
| MRI orbit face &/neck w/o contrast (70540) | $687.95 | $1,375.90 | 2.9× |
| MRI orbit face neck w contrast (70542) | $802.60 | $1,605.20 | 2.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $917.30 | $1,834.60 | 2.6× |
| MRI pelvis w contrast (72196) | $802.60 | $1,605.20 | 2.3× |
| MRI pelvis w/o & w contrast (72197) | $917.30 | $1,834.60 | 2.6× |
| MRI pelvis w/o contrast (72195) | $802.60 | $1,605.20 | 3.3× |
| MRI thoracic spine w/o contrast (72146) | $687.95 | $1,375.90 | 2.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $687.95 | $1,375.90 | 2.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $687.95 | $1,375.90 | 2.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $917.30 | $1,834.60 | 2.6× |
| MRI, abdomen, combo (74183) | $917.30 | $1,834.60 | 2.6× |
| MRI, dorsal spine combo (72157) | $917.30 | $1,834.60 | 2.6× |
| MRI, dorsal spine contrast (72147) | $802.60 | $1,605.20 | 2.3× |
| MRI, joint upper extrem (73221) | $687.95 | $1,375.90 | 2.9× |
| MRI, joint upper extrem combo (73223) | $917.30 | $1,834.60 | 2.6× |
| MRI, lumbar spine combo (72158) | $917.30 | $1,834.60 | 2.6× |
| Myelogram cervical (72240) | $745.30 | $1,490.60 | 0.9× |
| Myelogram Lumbar (72265) | $745.30 | $1,490.60 | 0.9× |
| Myelography thoracic (72255) | $745.30 | $1,490.60 | 0.9× |
| Myelograpy 2/more regions rs&i (72270) | $745.30 | $1,490.60 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $1,509.50 | $3,019 | 1.2× |
| Neck soft tissue (70360) | $132.30 | $264.60 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $143.35 | $286.70 | 1.4× |
| Parathyroid Planar Imaging (78070) | $300.50 | $601 | 0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $497.50 | $995 | 1.2× |
| Pelvis 1 or 2 views (72170) | $126.25 | $252.50 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $748.65 | $1,497.30 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$171.45–$231.55 | $342.90–$463.10 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $232.65 | $465.30 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $148.30 | $296.60 | 1.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $125.70 | $251.40 | 1.4× |
| Radex elbow complete minimum 3 views (73080) | $152.75 | $305.50 | 1.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $202.85 | $405.70 | 1.9× |
| Radex fingr minimum 2 views (73140) | $113.05 | $226.10 | 1.3× |
| Radex foot complete minimum 3 views (73630) | $147.75 | $295.50 | 1.7× |
| Radex Hand Minimum 3 Views (73130) | $149.95 | $299.90 | 1.7× |
| Radex lower extremity infant minimum 2 views (73592) | $109.75 | $219.50 | 1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $162.65 | $325.30 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $157.15 | $314.30 | 1.8× |
| Radex shoulder complete minimum 2 views (73030) | $159.85 | $319.70 | 1.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $116.35 | $232.70 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $122.40 | $244.80 | 1.4× |
| Radex Sternum Minimum 2 Views (71120) | $153.25 | $306.50 | 1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $188 | $376 | 2.2× |
| Radex Toe Minimum 2 Views (73660) | $112.45 | $224.90 | 1.3× |
| Radex upper extremity infant minimum 2 views (73092) | $59.55 | $119.10 | 0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $148.85 | $297.70 | 1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $196.25 | $392.50 | 1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $171.45 | $342.90 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $440.50 | $881 | 2.5× |
| Radiologic exam colon single contrast study (74270) | $346.75 | $693.50 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $186.35 | $372.70 | 1.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $164.30 | $328.60 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $296.05 | $592.10 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $243.15 | $486.30 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $300.45 | $600.90 | 1.7× |
| Radiologic examination femur minimum 2 views (73552) | $151.60 | $303.20 | 1.7× |
| Radiologic examination knee 1/2 views (73560) | $135.10 | $270.20 | 1.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $231.55 | $463.10 | 2.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $145.55 | $291.10 | 1.7× |
| Scapula (73010) | $141.10 | $282.20 | 1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $39.40 | $78.80 | 1.7× |
| Shoulder 1 view (73020) | $122.40 | $244.80 | 1.4× |
| Shoulder Arthrography (73040) | $401.30 | $802.60 | 1.1× |
| Skull less than 4 views (70250) | $144.45 | $288.90 | 1.4× |
| Sternoclavicular joints (71130) | $139.50 | $279 | 1.6× |
| Thoracic spine 2 views (72070) | $169.25 | $338.50 | 1.6× |
| Thoracic spine 3 views (72072) | $191.85 | $383.70 | 1.8× |
| Thoracolumbar 2 views (72080) | $167.05 | $334.10 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $300.50 | $601 | 0.7× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$117.95–$120 | $235.90–$240 | varies |
| Ultrasound, abdomen limited (76705) | $325.25 | $650.50 | 3.1× |
| Urethrocystogram voiding (74455) | $315.30 | $630.60 | 1.3× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$114.65–$147.50 | $229.30–$295 | varies |
| Us chest (76604) | $255.80 | $511.60 | 2.4× |
| Us complete joint (76881) | $200.65 | $401.30 | 1.9× |
| Us exam, pelvic, limited (76857) | $172 | $344 | 1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $143.35 | $286.70 | 1.4× |
| Us ob limited 1 or more fetuses (76815) | $203.95 | $407.90 | 1.9× |
| Us ob transvaginal (76817) | $296.60 | $593.20 | 2.8× |
| Us pelvic non ob complete (76856) | $118 | $236 | 1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $276.75 | $553.50 | 2.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $180.80 | $361.60 | 1.7× |
| Us retroperitoneal complete (76770) | $350.60 | $701.20 | 3.3× |
| Us scrotum and contents (76870) | $322.50 | $645 | 3.1× |
| Us thyroid (76536) | $302.10 | $604.20 | 2.9× |
| Us transrectal (76872) range across 2 matching MRF lines |
$154.50–$302.65 | $309–$605.30 | varies |
| Venography caval inferior serialography rs&i (75825) | $1,147.70 | $2,295.40 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $522.05 | $1,044.10 | 0.3× |
| Wrist 2 views (73100) | $121.85 | $243.70 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $146.65 | $293.30 | 1.7× |
| X-Ray Aorta Leg Arteries (75630) | $1,614.65 | $3,229.30 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $77.75 | $155.50 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $131.20 | $262.40 | 1.5× |
| X-Ray Exam Breast Specimen (76098) | $105.30 | $210.60 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $159.85 | $319.70 | 1.8× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$122.40–$234.30 | $244.80–$468.60 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$95.90–$151.60 | $191.80–$303.20 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $151.60 | $303.20 | 1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $205.65 | $411.30 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $285.05 | $570.10 | 2.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $173.10 | $346.20 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $266.80 | $533.60 | 2.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $191.85 | $383.70 | 1.8× |
| X-ray humerus (73060) | $142.80 | $285.60 | 1.6× |
| X-ray IV pyelogram (ivp) (74400) | $408.50 | $817 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $128.45 | $256.90 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $187.45 | $374.90 | 1.8× |
| X-ray nose-rectum child f.b. (76010) | $66.15 | $132.30 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $243.65 | $487.30 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $158.75 | $317.50 | 1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $155.45 | $310.90 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $191.30 | $382.60 | 2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $221.10 | $442.20 | 2.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $352.80 | $705.60 | 1.0× |
| X-Rays Bone Length Studies (77073) | $177 | $354 | 1.7× |
| X-Rays Bone Survey Complete (77075) | $353.40 | $706.80 | 3.4× |
| Xr c-spine 4 or 5 views (72050) | $237.60 | $475.20 | 2.3× |
| Xr orbits complete 4 views (70200) | $185.20 | $370.40 | 1.8× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.