Imaging prices at Savoy Medical Center

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

236 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) $1,973.29 $3,288.81 1.6×
Abdomen 2 views (74019) $368.61 $614.34 3.9×
Acute gastrointestinal blood loss imaging (78278) $1,391.81 $2,319.69 3.8×
Ankle 2 views (73600) $245.15 $408.59 3.1×
Basic radiation dosimetry calculation (77300) $387.16 $645.27 3.2×
Bone &/Joint Imaging Limited Area (78300) $848.32 $1,413.87 2.3×
Bone &/joint imaging whole body (78306) $1,132.16 $1,886.94 3.1×
Bone age studies (77072) $605.62 $1,009.37 6.4×
Bone Imaging 3 Phase (78315) $1,196.35 $1,993.92 3.3×
Bone survey complete (77075) $637.49 $1,062.48 6.7×
Cervical spine 2 or 3 views (72040) $229.96 $383.27 2.9×
Chest 1 view (71045) $249.85 $416.42 3.2×
Chest 3 views (71047) $319.09 $531.81 4.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $926.33 $1,543.88 5.8×
Clavicle complete (73000) $214.78 $357.97 2.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $630 $1,050 6.7×
Continuing medical physics consltj pr wk (77336) $302.50 $504.17 2.5×
CT abdomen and pelvis without and with contrast (74178) $3,521.69 $5,869.48 11.1×
CT abdomen and pelvis without contrast (74176) $3,080.05 $5,133.42 14.3×
CT abdomen w contrast (74160) $1,758.78 $2,931.30 11.1×
CT abdomen w wo contrast (74170) $1,878.74 $3,131.24 11.8×
CT abdomen w/o contrast (74150) $1,643.11 $2,738.52 17.4×
CT c-spine w/o contrast (72125) $1,766.44 $2,944.06 18.7×
CT cervical spine w&w/o contrast (72127) $1,813.43 $3,022.38 11.4×
CT cervical spine with contrast (72126) $1,813.43 $3,022.38 5.7×
CT chest w/wo contrast (71270) $1,878.74 $3,131.24 11.8×
CT chest with contrast (71260) $1,758.78 $2,931.30 11.1×
CT head/brain with contrast (70460) $1,839.02 $3,065.04 11.6×
CT head/brain without and with contrast (70470) $1,829.59 $3,049.32 11.5×
CT heart no contrast quant eval coronry calcium (75571) $60 $100 0.8×
CT iac w contrast (70481) $2,161.24 $3,602.07 13.6×
CT lower ext w/o (73700) $1,562.69 $2,604.49 16.5×
CT lower extremity w wo contrast (73702) $1,758.78 $2,931.30 11.1×
CT lower extremity with contrast (73701) $1,643.11 $2,738.52 10.3×
CT lumbar spine w & w/o contrast (72133) $2,005 $3,341.66 12.6×
CT lumbar spine w/o contrast (72131) $1,997.88 $3,329.80 21.1×
CT lumbar spine with contrast (72132) $2,158.05 $3,596.75 6.8×
CT maxillofacial w contrast (70487) $1,776.02 $2,960.03 11.2×
CT maxillofacial w/o contrast (70486) $1,730.22 $2,883.70 18.3×
CT maxillofacial w/wo contrast (70488) $1,685.62 $2,809.37 10.6×
CT neck soft tissue w contrast (70491) $1,813.43 $3,022.38 11.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,314.04 $3,856.73 14.6×
CT orbits w/o contrast (70480) $1,625.01 $2,708.35 17.2×
CT pelvis w & w/o contrast (72194) $1,642.94 $2,738.24 10.3×
CT pelvis w/o contrast (72192) $1,436.77 $2,394.62 15.2×
CT soft tissue neck w/o & w/contrast material (70492) $1,730.22 $2,883.70 10.9×
CT soft tissue neck w/o contrast (70490) $1,605.70 $2,676.17 17.0×
CT thoracic spine w/contrast (72129) $1,652.54 $2,754.23 10.4×
CT thoracic spine w/o contrast (72128) $1,362.92 $2,271.53 14.4×
CT thoracic spine w/wo contrast (72130) $2,005 $3,341.66 12.6×
CT thorax w/o contrast (71250) $1,643.11 $2,738.52 17.4×
CT upper extremity w/o & w/contrast material (73202) $1,758.78 $2,931.30 11.1×
CT upper extremity w/o contrast rt (73200) $1,562.69 $2,604.49 16.5×
CT upper extremity with contrast (73201) $1,643.11 $2,738.52 5.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,733.13 $2,888.55 10.9×
Cta Abdomen (74175) $1,540.36 $2,567.26 9.7×
CTA abdomen pelvis (74174) $2,602.01 $4,336.69 8.2×
CTA chest (71275) $1,636.83 $2,728.05 10.3×
Cta Head (70496) $1,654.49 $2,757.49 10.4×
Cta Neck (70498) $1,567.54 $2,612.56 9.9×
Cta Pelvis (72191) $1,636.83 $2,728.05 10.3×
Cystography minimum 3 views rs&i (74430) $280.83 $468.05 0.9×
Dxa bone density study 1/> sites axial skel (77080) $379.80 $633 4.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $379.80 $633 4.8×
Esophagus (74220) $280.83 $468.05 1.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $841.93 $1,403.22 8.9×
Fluoroscopy up to 1 hr (76000) $341.37 $568.95 1.6×
Forearm 2 views (73090) $214.78 $357.97 2.7×
Gated Heart Planar Single (78472) $1,394.08 $2,323.47 3.9×
Hand 3 views (73130) $214.78 $357.97 2.7×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,603.42 $2,672.37 3.3×
Hepatobiliary syst imaging including gallbladder (78226) $1,603.42 $2,672.37 4.4×
Humerus Min 2 Views Left (73060) $214.78 $357.97 2.7×
Hysterosalpingogram (74740) $655.11 $1,091.85 3.0×
Kidney img morphology vascular flow 1 w/rx (78708) $1,637.29 $2,728.81 3.3×
Knee 3 views (73562) $242.25 $403.75 3.1×
Liver & spleen imaging static only (78215) $990.73 $1,651.21 2.7×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,389.40 $2,315.67 3.8×
Lung Ventilation Imaging (78579) $1,183.45 $1,972.41 3.3×
Lymphoscintigraphy (78195) $2,647.36 $4,412.27 5.4×
Meckels Diverticulum (78290) $788.48 $1,314.14 2.2×
Mlc imrt design & construction per imrt plan (77338) $1,369.67 $2,282.78 4.0×
MRA head w/o contrast (70544) $1,923.92 $3,206.54 8.9×
MRA neck w/o contrast (70547) $1,849.60 $3,082.66 8.6×
MRI abdomen w contrast (74182) $1,699.41 $2,832.35 5.4×
MRI abdomen w/o & w/contrast material (74183) $2,299.83 $3,833.05 7.3×
MRI abdomen w/o contrast (74181) $1,451.74 $2,419.57 6.7×
MRI any jnt lwr ext with con lt (73722) $1,930.70 $3,217.84 2.7×
MRI any jt upper extremity w/contrast matrl (73222) $2,240.13 $3,733.55 3.2×
MRI c-spine with contrast (72142) $2,578.01 $4,296.69 8.2×
MRI cervical spine w/o contrast (72141) $2,365.56 $3,942.60 10.9×
MRI chest w/o & w/contrast material (71552) $2,421.11 $4,035.19 7.7×
MRI chest w/o contrast (71550) $1,528.51 $2,547.51 7.1×
MRI chest with contrast (71551) $1,788.11 $2,980.18 2.5×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,785.38 $2,975.64 5.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,699.41 $2,832.35 5.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,451.74 $2,419.57 6.7×
MRI orbit face &/neck w/o contrast (70540) $1,941.41 $3,235.69 9.0×
MRI orbit/face/neck w&w/o cont (70543) $3,076.49 $5,127.48 9.7×
MRI orbit/face/neck w/contrast (70542) $2,272.93 $3,788.22 7.2×
MRI pelvis w contrast (72196) $1,699.41 $2,832.35 5.4×
MRI pelvis w/o & w/contrast material (72197) $2,299.83 $3,833.05 7.3×
MRI pelvis w/o contrast (72195) $1,451.74 $2,419.57 6.7×
MRI scan of arm joint before and after contrast (73223) $2,416.84 $4,028.07 7.7×
MRI scan of leg joint before and after contrast (73723) $1,967.04 $3,278.40 6.2×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,778.96 $4,631.60 8.8×
MRI spinal canal lumbar w/contrast material (72149) $2,212.49 $3,687.48 7.0×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,384.95 $3,974.92 7.5×
MRI spinal canal thoracic w/contrast matrl (72147) $2,212.49 $3,687.48 7.0×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,384.95 $3,974.92 7.5×
MRI thoracic spine w/o contrast (72146) $2,030.16 $3,383.60 9.4×
MRI tmj (70336) $1,699.41 $2,832.35 7.9×
MRI upper ext joint w/o contrast (73221) $2,055.74 $3,426.23 9.5×
MRI upper extrem other than jt w/o & w/contras (73220) $2,416.84 $4,028.07 7.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,525.60 $2,542.67 7.1×
Myelogram Cervical (72240) $1,211.14 $2,018.57 1.7×
Myelogram Lumbar (72265) $1,211.14 $2,018.57 1.7×
Myelogram thoracic (72255) $1,211.14 $2,018.57 1.7×
Myocardial Spect Multiple Studies (78452) $3,355.37 $5,592.28 2.9×
Neck soft tissue (70360) $215.59 $359.31 2.7×
Nm gastric emptying study (78264) $1,256.68 $2,094.46 3.5×
Ntsty modul radthx pln dose-vol histos (77301) $5,220.22 $8,700.37 4.2×
Nuclear medicine study of kidney and blood flow (78701) $1,263.61 $2,106.02 3.5×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $131.41 $219.02 1.4×
Osseous survey infant (77076) $637.49 $1,062.48 6.7×
Parathyroid imaging (78070) $1,417.79 $2,362.98 3.9×
Pelvis 1 or 2 views (72170) $275.68 $459.47 2.9×
Pr heart first pass single,planar (78481) $817.84 $1,363.07 1.7×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $2,299.83 $3,833.05 7.3×
Pulmonary Perfusion Imaging Particulate (78580) $1,088.78 $1,814.63 3.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,570.60 $4,284.33 5.2×
Radex abscess/fistula/sinus tract rs&i (76080) $396.19 $660.31 0.8×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $242.25 $403.75 3.1×
Radex hips bilateral with pelvis 2 views (73521) $289.51 $482.51 3.1×
Radex mastoids compl minimum 3 views pr side (70130) $334.19 $556.99 3.5×
Radiation treatment delivery 1 mev >= complex (77412) $1,289.32 $2,148.86 2.6×
Radiation treatment delivery 1 mev >= simple (77402) $1,150.11 $1,916.85 12.4×
Radiation tx delivery 1 mev >= intermediate (77407) $1,283.46 $2,139.10 3.7×
Radiolog exam mandible compl minimum 4 views (70110) $275.68 $459.47 2.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $167.53 $279.21 2.1×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $294.03 $490.05 3.7×
Radiologic exam colon single contrast study (74270) $640.76 $1,067.94 4.0×
Radiologic exam upr gi trc single contrast study (74240) $499.88 $833.13 3.1×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $242.25 $403.75 3.1×
Radiologic Examination Salivary Gland Calculus (70380) $288.55 $480.92 3.7×
Radiological examination surgical specimen (76098) $205.40 $342.33 0.4×
Rp loclzj tum plnr whole body single day imaging (78802) $1,503.43 $2,505.71 3.1×
Rp loclzj tum spect 1 area single day imaging (78803) $1,327.31 $2,212.18 2.7×
Scanogram (77073) $637.49 $1,062.48 6.7×
Scapula complete (73010) $214.78 $357.97 2.3×
Screening digital breast tomosynthesis (77063) $41.58 $69.30 1.8×
Sella turcica (70240) $169.06 $281.77 2.1×
Shuntogram indwelling nonvascular shunt rs&i (75809) $637.49 $1,062.48 6.7×
Simulation intermediate (77285) $1,403.05 $2,338.42 4.1×
Small bowel series (74250) $277.36 $462.27 1.7×
Spec medical radj physics consltj (77370) $605.51 $1,009.18 5.0×
Special dosimetry (77331) $99.80 $166.33 0.8×
Special treatment procedure (77470) $1,130.84 $1,884.73 2.3×
Spine thoracic 3 views (72072) $290.02 $483.36 3.1×
Telethx isodose pln cplx w/basic dosimetry (77307) $438.01 $730.01 1.3×
Telethx isodose pln smpl w/dosimetry calculation (77306) $438.01 $730.01 1.3×
Testicular Imaging With Vascular Flow (78761) $720.26 $1,200.44 2.0×
Ther rad simulaj-aided field setting complex (77290) $2,247.39 $3,745.65 6.6×
Ther rad simulaj-aided field setting simple (77280) $781.88 $1,303.13 6.4×
Thoracolumbar 2 views (72080) $290.02 $483.36 3.7×
Thyroid uptake measurement (78012) $976.37 $1,627.28 2.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,261.03 $2,101.71 3.5×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,503.43 $2,505.71 4.2×
Tx devices design & construction complex (77334) $482.14 $803.57 1.4×
Ultrasound, abdomen limited (76705) $654.92 $1,091.53 6.9×
Upper Extremity Infant (73092) $214.78 $357.97 2.3×
Urethrocystography voiding (74455) $276.89 $461.49 1.3×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $582.30 $970.50 3.7×
Us abdl aorta screen aaa (76706) $857.88 $1,429.80 9.1×
Us breast unilateral complete (76641) $419.90 $699.84 4.4×
Us breast unilateral limited (76642) $870.18 $1,450.31 11.0×
Us chest (76604) $555.87 $926.45 5.9×
Us compl joint r-t w/image documentation (76881) $307.64 $512.73 3.2×
Us kidney transplant (76776) $722.98 $1,204.96 7.6×
Us ob transvaginal (76817) $496.78 $827.96 5.2×
Us pelvic non ob complete (76856) $569.54 $949.23 6.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $916.22 $1,527.02 9.7×
Us pregnancy ltd (76815) $516.68 $861.13 5.5×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $442.09 $736.81 4.7×
Us retroperitoneal complete (76770) $722.98 $1,204.96 7.6×
Us scrotum and contents (76870) $614.66 $1,024.44 6.5×
Us soft tissue head/neck (76536) $322.98 $538.30 3.4×
Us xtr non-vasc lmtd (76882) $307.64 $512.73 3.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $214.78 $357.97 2.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $245.15 $408.59 3.1×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $641.41 $1,069.01 4.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $245.15 $408.59 3.1×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $245.15 $408.59 3.1×
X-ray exam hip uni 1 view (73501) $212.90 $354.84 2.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $275.68 $459.47 3.5×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $275.68 $459.47 2.9×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $232.19 $386.98 2.9×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $214.78 $357.97 2.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $214.78 $357.97 2.7×
X-ray IV pyelogram+drip infusn (74410) $582.30 $970.50 3.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $275.68 $459.47 3.5×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $242.25 $403.75 2.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $242.25 $403.75 3.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $228.52 $380.86 2.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $233.38 $388.96 2.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $600.67 $1,001.12 6.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $327.72 $546.20 3.5×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $181.34 $302.23 2.3×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $182.81 $304.68 2.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $334.19 $556.99 3.5×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $275.68 $459.47 2.9×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $392.24 $653.74 1.2×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $389.13 $648.55 4.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $442.53 $737.55 4.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $275.68 $459.47 2.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $275.68 $459.47 3.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $260.50 $434.16 3.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $275.68 $459.47 3.5×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $275.68 $459.47 3.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $514.86 $858.10 5.4×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $514.86 $858.10 5.4×
X-Ray Spine One View - Xr Spine (72020) $227.92 $379.86 2.9×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $214.78 $357.97 2.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $214.78 $357.97 2.7×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $280.97 $468.29 3.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $181.34 $302.23 2.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $214.78 $357.97 2.7×
Xr c-spine 6 or more views (72052) $554.95 $924.92 5.9×
Xr chest 4+ views (71048) $319.09 $531.81 3.4×
Xr Cholecystography Oral Contrast (74290) $277.36 $462.27 1.7×
Xr finger(s) 2+ views (73140) $181.34 $302.23 2.3×
Xr shoulder 1 view (73020) $214.78 $357.97 2.7×
Xr spine cervical 4 or 5 views (72050) $334.19 $556.99 3.5×
Xr tibia/fibula 2 views (73590) $214.78 $357.97 2.7×
Xr tmj bilateral (70330) $334.19 $556.99 4.2×
Xray knee 1 or 2 views rt (73560) $214.78 $357.97 2.7×