Imaging prices at Pointe Coupee General Hospital

New Roads, LA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $208.98 $208.98 2.7×
Abdomen 2 views (74019) $363 $363 3.8×
Ankle 2 views (73600) $259 $259 3.3×
Bone age studies (77072) $363 $363 3.8×
Bone Imaging 3 Phase (78315) $1,538 $1,538 4.2×
Bone Imaging Limited Area (78300) $1,192 $1,192 3.3×
Bone Imaging Multiple Areas (78305) $1,192 $1,192 3.3×
Bone Imaging Whole Body (78306) $1,192 $1,192 3.3×
Brain Image W/Flow < 4 Views (78601) $1,892 $1,892 5.2×
Brain imaging < 4 static views (78600) $1,192 $1,192 3.3×
Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) $1,529 $1,529 3.1×
Chest 1 view (71045) $259 $259 3.3×
Chest 2 views (71046) $259 $259 3.3×
Chest 4 or more views (71048) $363 $363 3.8×
Cholecystography Oral Contrast (74290) $590 $590 3.7×
Clavicle complete (73000) $259 $259 3.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,453 $1,453 15.3×
Contrast X-Ray Bladder (74430) $1,237 $1,237 3.9×
Contrast Xray Throat/Cerv Esopha (74210) $590 $590 3.7×
CT abdomen and pelvis without and with contrast (74178) $3,000 $3,000 9.5×
CT abdomen and pelvis without contrast (74176) $1,800 $1,800 8.3×
CT abdomen w contrast (74160) $1,615.73 $1,615.73 10.2×
CT abdomen w wo contrast (74170) $1,782 $1,782 11.2×
CT abdomen w/o contrast (74150) $1,396.13 $1,396.13 14.7×
CT Angio Abdomen and Pelvis (74174)
range across 4 matching MRF lines		 $1,237–$1,534.13 $1,237–$1,534.13 varies
CT Angio Chest (71275) $1,534.13 $1,534.13 9.7×
CT Angio Head (70496) $590 $590 3.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $630 $630 4.0×
CT Angio Neck (70498)
range across 3 matching MRF lines		 $590–$630 $590–$630 varies
CT cervical spine w/ contrast (72126) $1,237 $1,237 3.9×
CT cervical spine w/o contrast (72125) $1,415.40 $1,415.40 15.0×
CT cervical spine w/wo cont (72127) $1,484.62 $1,484.62 9.3×
CT chest w contrast (71260) $1,534.13 $1,534.13 9.7×
CT chest w/wo contrast (71270) $2,549.93 $2,549.93 16.1×
CT head/brain with contrast (70460) $850 $850 5.4×
CT head/brain without and with contrast (70470) $1,577.68 $1,577.68 9.9×
CT heart no contrast quant eval coronry calcium (75571) $110 $110 1.4×
CT iac w contrast (70481) $850 $850 5.4×
CT l-spine w&w/o contrast (72133) $2,004.59 $2,004.59 12.6×
CT lower ext w/o (73700)
range across 13 matching MRF lines		 $800–$1,510.60 $800–$1,510.60 varies
CT lower extremity w/contrast material (73701) $850 $850 5.4×
CT lumbar spine w contrast (72132) $1,237 $1,237 3.9×
CT lumbar spine w/o contrast (72131) $1,776.29 $1,776.29 18.8×
CT maxillofacial w contrast (70487) $850 $850 5.4×
CT maxillofacial wo contrast (70486) $1,403.42 $1,403.42 14.8×
CT neck tissue combo (70492) $900 $900 5.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,000 $1,000 6.3×
CT orbits w/o contrast (70480) $800 $800 8.5×
CT pelvis w&w/o contrast (72194) $1,745.10 $1,745.10 11.0×
CT pelvis w/o contrast (72192) $1,382.18 $1,382.18 14.6×
CT scan of leg combo (73702) $900 $900 5.7×
CT scans face/jaw combo (70488)
range across 3 matching MRF lines		 $900–$1,000 $900–$1,000 varies
CT soft tissue neck w contrast (70491) $1,294.65 $1,294.65 8.2×
CT soft tissue neck w/o contrast (70490) $800 $800 8.5×
CT thoracic spine w contrast (72129) $850 $850 5.4×
CT thoracic spine w/o contrast (72128) $1,230.30 $1,230.30 13.0×
CT thoracic spine w/wo cont (72130) $900 $900 5.7×
CT thorax w/o contrast (71250) $1,453.01 $1,453.01 15.3×
CT upper ext wo (73200)
range across 12 matching MRF lines		 $800–$1,882.10 $800–$1,882.10 varies
CT upper extremity w/o & w/contrast material (73202) $900 $900 5.7×
CT upper extremity with contrast (73201) $1,237 $1,237 3.9×
Cta Abdomen (74175) $590 $590 3.7×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,100 $1,100 3.5×
Esophagram (74220) $590 $590 3.7×
Fluoroscopy up to 1 hr (76000) $755 $755 3.5×
Foot 2 views (73620) $259 $259 3.3×
Forearm 2 views (73090) $259 $259 3.3×
Gastric emptying imaging study (78264) $1,192 $1,192 3.3×
Gated Heart Planar Single (78472) $1,192 $1,192 3.3×
Gated Heart, Multiple (78473) $1,656 $1,656 4.6×
Hand 2 views (73120) $363 $363 3.8×
Heart first pass single,planar (78481) $1,529 $1,529 3.1×
Hepatobil Syst Image W/Drug (78227) $1,529 $1,529 3.1×
Hepatobiliary System Imaging (78226) $1,192 $1,192 3.3×
Infusion Ivp (74410) $590 $590 3.7×
K Flow/Funct Image W/Drug (78708) $1,529 $1,529 3.1×
K Flow/Funct Image W/O Drug (78707) $1,529 $1,529 3.1×
Kidney Imaging Morphol (78700) $1,192 $1,192 3.3×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,192 $1,192 3.3×
Knee 3 Views (73562) $259 $259 3.3×
Liver & Spleen Imaging Static Only (78215) $1,192 $1,192 3.3×
Lymphangiography, pelvic/abdominal, unilateral (75805) $5,284 $5,284 1.8×
Magnetic Image Jaw Joint (70336) $2,164.80 $2,164.80 10.0×
Mra Head W/O & W/Contrast Material (70546) $2,626.80 $2,626.80 8.3×
MRA head w/o contrast (70544) $2,164.80 $2,164.80 10.0×
MRA head with contrast (70545) $2,389.20 $2,389.20 7.6×
MRA neck w contrast (70548) $2,172 $2,172 6.9×
Mra Neck W/O &W/Contrast Material (70549) $2,626.80 $2,626.80 8.3×
MRA neck w/o contrast (70547) $2,164.80 $2,164.80 10.0×
MRI abdomen w contrast (74182) $2,172 $2,172 6.9×
MRI abdomen w/o contrast (74181) $1,968 $1,968 9.1×
MRI any jt lower extrem w/contrast material (73722) $2,205 $2,205 3.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,388 $2,388 7.6×
MRI any jt upper extremity w/contrast matrl (73222) $2,205 $2,205 3.1×
MRI cervical spine w contrast (72142) $2,172 $2,172 6.9×
MRI cervical spine w/o cont (72141) $1,968 $1,968 9.1×
MRI chest w/o contrast (71550) $1,968 $1,968 9.1×
MRI chest with contrast (71551) $2,205 $2,205 3.1×
MRI chest wo w contrast (71552) $2,388 $2,388 7.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 6 matching MRF lines		 $2,172–$2,388 $2,172–$2,388 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,388 $2,388 7.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 6 matching MRF lines		 $1,968–$2,172 $1,968–$2,172 varies
MRI lumbar spine w contrast (72149) $2,172 $2,172 6.9×
Mri Neck Spine W/O & W/Dye (72156) $2,388 $2,388 7.6×
MRI orbit face &/neck w/o contrast (70540)
range across 2 matching MRF lines		 $1,400–$2,164.80 $1,400–$2,164.80 varies
MRI orbit face neck w contrast (70542) $2,389.20 $2,389.20 7.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,626.80 $2,626.80 8.3×
MRI pelvis w contrast (72196) $2,172 $2,172 6.9×
MRI pelvis w/o & w contrast (72197) $2,388 $2,388 7.6×
MRI pelvis w/o contrast (72195) $1,968 $1,968 9.1×
MRI spectroscopy (76390) $2,388 $2,388 30.3×
MRI thoracic spine w/o contrast (72146) $1,968 $1,968 9.1×
MRI upper extremity oth than jt w/contr matrl (73219) $2,172 $2,172 6.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,968 $1,968 9.1×
Mri Uppr Extremity W/O&W/Dye (73220) $2,388 $2,388 7.6×
MRI, abdomen, combo (74183) $2,388 $2,388 7.6×
MRI, dorsal spine combo (72157) $2,388 $2,388 7.6×
MRI, dorsal spine contrast (72147) $2,172 $2,172 6.9×
MRI, joint upper extrem (73221) $1,968 $1,968 9.1×
MRI, joint upper extrem combo (73223) $2,388 $2,388 7.6×
MRI, lumbar spine combo (72158) $2,388 $2,388 7.6×
Myocardial Spect Multiple Studies (78452) $4,121 $4,121 3.5×
Neck soft tissue (70360) $259 $259 3.3×
Pelvis 1 or 2 views (72170) $363 $363 3.8×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $363 $363 3.8×
Radex Ankle Complete Minimum 3 Views (73610) $259 $259 3.3×
Radex Calcaneus Minimum 2 Views (73650) $259 $259 3.3×
Radex elbow complete minimum 3 views (73080) $259 $259 3.3×
Radex Facial Bones Complete Minimum 3 Views (70150) $363 $363 3.8×
Radex fingr minimum 2 views (73140) $259 $259 3.3×
Radex foot complete minimum 3 views (73630) $259 $259 3.3×
Radex Hand Minimum 3 Views (73130) $259 $259 3.3×
Radex lower extremity infant minimum 2 views (73592) $259 $259 3.3×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $363 $363 3.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $259 $259 3.3×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $259 $259 3.3×
Radex Ribs Unilateral 2 Views (71100) $259 $259 3.3×
Radex shoulder complete minimum 2 views (73030) $259 $259 3.3×
Radex Sinuses Paransl < 3 Views (70210) $259 $259 3.3×
Radex Spine 1 View Specify Level (72020) $259 $259 3.3×
Radex Sternum Minimum 2 Views (71120) $259 $259 3.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $303.60 $303.60 3.9×
Radex Toe Minimum 2 Views (73660) $259 $259 3.3×
Radex upper extremity infant minimum 2 views (73092) $363 $363 3.8×
Radex Wrist Complete Minimum 3 Views (73110) $259 $259 3.3×
Radiolog exam mandible compl minimum 4 views (70110) $363 $363 3.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $363 $363 3.8×
Radiologic exam colon double contrast study (74280) $590 $590 3.7×
Radiologic exam colon single contrast study (74270) $590 $590 3.7×
Radiologic exam knee complete 4/more views (73564) $363 $363 3.8×
Radiologic exam pelvis compl minimum 3 views (72190) $363 $363 3.8×
Radiologic Exam Small Int Single Contrast Study (74250) $590 $590 3.7×
Radiologic exam swallow function contrast study (74230) $590 $590 3.7×
Radiologic exam upr gi trc double contrast study (74246) $590 $590 3.7×
Radiologic examination femur 1 view (73551) $259 $259 3.3×
Radiologic examination femur minimum 2 views (73552) $259 $259 3.3×
Radiologic examination knee 1/2 views (73560) $259 $259 3.3×
Radiologic Examination Osseous Survey Limited (77074) $363 $363 3.8×
Radiologic Examination Salivary Gland Calculus (70380) $259 $259 3.3×
Radiologic examination tibia & fibula 2 views (73590) $259 $259 3.3×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $1,560 $1,560 3.2×
Ribs bilateral 3 views (71110) $363 $363 3.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $4,121 $4,121 8.4×
Scapula (73010) $363 $363 3.8×
Screening Digital Breast Tomosynthesis Bi (77063) $72 $72 3.1×
Sella turcica (70240) $259 $259 3.3×
Shoulder 1 view (73020) $259 $259 3.3×
Shoulder Arthrography (73040) $1,237 $1,237 3.9×
Sialogram (70390) $755 $755 3.5×
Skull less than 4 views (70250) $363 $363 3.8×
Speech evaluation, complex (70371) $755 $755 3.5×
Sternoclavicular joints (71130) $259 $259 3.3×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $590 $590 3.7×
Thoracic spine 2 views (72070) $363 $363 3.8×
Thoracic spine 3 views (72072) $363 $363 3.8×
Thoracolumbar 2 views (72080) $298.58 $298.58 3.8×
Thyroid Imaging With Vascular Flow (78013) $1,192 $1,192 3.3×
Thyroid Uptake Measurement (78012) $1,192 $1,192 3.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,192 $1,192 3.3×
Ultrasound Breast Limited (76642) $320 $320 4.1×
Ultrasound Elastography Parenchyma (76981) $534.80 $534.80 5.6×
Ultrasound Exam Aaa Screen (76706) $422.40 $422.40 4.5×
Ultrasound, abdomen limited (76705) $534.80 $534.80 5.6×
Unlisted us procedure (76999) $259 $259 3.3×
Upper gi w/o kub (74240) $590 $590 3.7×
Urethrocystogram voiding (74455) $755 $755 3.5×
Us breast unilateral complete (76641) $365 $365 3.9×
Us exam, pelvic, limited (76857) $363 $363 3.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $363 $363 3.8×
Us ob limited 1 or more fetuses (76815) $363 $363 3.8×
Us ob transvaginal (76817) $385 $385 4.1×
Us pelvic non ob complete (76856) $500.63 $500.63 5.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $440 $440 4.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $363 $363 3.8×
Us retroperitoneal complete (76770) $363 $363 3.8×
Us scrotum and contents (76870) $527.49 $527.49 5.6×
Us thyroid (76536) $394.29 $394.29 4.2×
Venography extremity unilateral rs&i (75820) $2,042 $2,042 1.4×
Wrist 2 views (73100) $259 $259 3.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $259 $259 3.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $259 $259 3.3×
X-Ray Exam Entire Spi 1 Vw (72081)
range across 2 matching MRF lines		 $259–$343.20 $259–$343.20 varies
X-Ray Exam Hip Uni 1 View (73501) $259 $259 3.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $259 $259 3.3×
X-Ray Exam Hips Bi 2 Views (73521) $363 $363 3.8×
X-Ray Exam L-S Spine Bending (72114) $363 $363 3.8×
X-Ray Exam Neck Spine 2-3 Vw (72040) $258.49 $258.49 3.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $413.46 $413.46 4.4×
X-Ray Exam Unilat Ribs/Chest (71101) $363 $363 3.8×
X-ray eye for foreign body (70030) $259 $259 3.3×
X-ray humerus (73060) $259 $259 3.3×
X-ray IV pyelogram (ivp) (74400) $590 $590 3.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $259 $259 3.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $259 $259 3.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $363 $363 3.8×
X-ray nose-rectum child f.b. (76010) $259 $259 3.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $363 $363 3.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $363 $363 3.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $363 $363 3.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $259 $259 3.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $291.94 $291.94 3.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $363 $363 3.8×
X-ray thoracic spine 4 vw (72074) $363 $363 3.8×
X-Ray Tmj Unilat (70328) $259 $259 3.3×
X-Rays Bone Survey Complete (77075) $462 $462 4.9×
Xr c-spine 4 or 5 views (72050) $463.07 $463.07 4.9×
Xr facial bones less than 3 views (70140) $259 $259 3.3×
XR Mastoids < 3 Views Bilateral (70120) $363 $363 3.8×
Xr orbits complete 4 views (70200) $363 $363 3.8×

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.