Imaging prices at Stonewall Memorial Hospital District
Aspermont, TX · every code in this section with a posted price and a Medicare benchmark.
156 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) | $92.25 | $123 | 1.1× |
| Abdomen 2 views (74019) | $131.25 | $175 | 1.2× |
| Ankle 2 views (73600) | $92.25 | $123 | 1.1× |
| Chest 1 view (71045) | $92.25 | $123 | 1.1× |
| Chest 2 views (71046) | $99.75 | $133 | 1.1× |
| Clavicle complete (73000) | $92.25 | $123 | 1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $208.50 | $278 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $1,914 | $2,552 | 5.5× |
| CT abdomen and pelvis without contrast (74176) | $1,707 | $2,276 | 7.1× |
| CT abdomen w contrast (74160) | $1,344 | $1,792 | 7.6× |
| CT abdomen w wo contrast (74170) | $1,680 | $2,240 | 9.5× |
| CT abdomen w/o contrast (74150) | $1,080 | $1,440 | 10.3× |
| CT Angio Abdomen and Pelvis (74174) | $1,312.50 | $1,750 | 3.7× |
| CT Angio Chest (71275) | $1,500 | $2,000 | 8.5× |
| CT Angio Head (70496) | $1,500 | $2,000 | 8.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,500 | $2,000 | 8.5× |
| CT Angio Neck (70498) | $1,500 | $2,000 | 8.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,500 | $2,000 | 8.5× |
| CT bone density (77078) | $324.75 | $433 | 3.7× |
| CT cervical spine w/o contrast (72125) | $1,152 | $1,536 | 11.0× |
| CT chest w contrast (71260) | $1,362 | $1,816 | 7.7× |
| CT chest w/wo contrast (71270) | $1,698 | $2,264 | 9.6× |
| CT head/brain with contrast (70460) | $1,134 | $1,512 | 6.4× |
| CT head/brain without and with contrast (70470) | $1,452 | $1,936 | 8.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,134–$1,320 | $1,512–$1,760 | varies |
| CT l-spine w&w/o contrast (72133) | $1,728 | $2,304 | 9.8× |
| CT lower ext w/o (73700) | $1,020 | $1,360 | 9.7× |
| CT lower extremity w/contrast material (73701) | $1,170 | $1,560 | 6.6× |
| CT lumbar spine w contrast (72132) | $1,380 | $1,840 | 3.9× |
| CT lumbar spine w/o contrast (72131) | $1,152 | $1,536 | 11.0× |
| CT maxillofacial w contrast (70487) | $1,134 | $1,512 | 6.4× |
| CT maxillofacial wo contrast (70486) | $978 | $1,304 | 9.3× |
| CT neck tissue combo (70492) | $1,452 | $1,936 | 8.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,452 | $1,936 | 8.2× |
| CT orbits w/o contrast (70480) | $978 | $1,304 | 9.3× |
| CT pelvis w&w/o contrast (72194) | $1,650 | $2,200 | 9.4× |
| CT pelvis w/o contrast (72192) | $1,170 | $1,560 | 11.1× |
| CT scan of leg combo (73702) | $1,470 | $1,960 | 8.3× |
| CT scans face/jaw combo (70488) | $1,452 | $1,936 | 8.2× |
| CT soft tissue neck w contrast (70491) | $1,134 | $1,512 | 6.4× |
| CT soft tissue neck w/o contrast (70490) | $978 | $1,304 | 9.3× |
| CT thoracic spine w/o contrast (72128) | $1,152 | $1,536 | 11.0× |
| CT thorax w/o contrast (71250) | $1,164 | $1,552 | 11.1× |
| CT upper ext wo (73200) | $1,020 | $1,360 | 9.7× |
| CT upper extremity w/o & w/contrast material (73202) | $1,470 | $1,960 | 8.3× |
| CT upper extremity with contrast (73201) | $1,170 | $1,560 | 3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,500 | $2,000 | 8.5× |
| Cta Abdomen (74175) | $1,500 | $2,000 | 8.5× |
| CTA pelvis (72191) | $1,500 | $2,000 | 8.5× |
| Foot 2 views (73620) | $92.25 | $123 | 1.1× |
| Forearm 2 views (73090) | $92.25 | $123 | 1.1× |
| Hand 2 views (73120) | $92.25 | $123 | 0.9× |
| Knee 3 Views (73562) | $94.50 | $126 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $2,887.50 | $3,850 | 8.2× |
| MRA head w/o contrast (70544) | $2,362.50 | $3,150 | 9.9× |
| MRA head with contrast (70545) | $2,625 | $3,500 | 7.5× |
| MRA neck w contrast (70548) | $2,625 | $3,500 | 7.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,887.50 | $3,850 | 8.2× |
| MRA neck w/o contrast (70547) | $2,362.50 | $3,150 | 9.9× |
| MRI abdomen w contrast (74182) | $2,625 | $3,500 | 7.5× |
| MRI abdomen w/o contrast (74181) | $2,362.50 | $3,150 | 9.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,625 | $3,500 | 3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,887.50 | $3,850 | 8.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,625 | $3,500 | 3.3× |
| MRI cervical spine w contrast (72142) | $2,625 | $3,500 | 7.5× |
| MRI cervical spine w/o cont (72141) | $2,362.50 | $3,150 | 9.9× |
| MRI chest w/o contrast (71550) | $2,362.50 | $3,150 | 9.9× |
| MRI chest with contrast (71551) | $2,625 | $3,500 | 3.3× |
| MRI chest wo w contrast (71552) | $2,887.50 | $3,850 | 8.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,625 | $3,500 | 7.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,887.50 | $3,850 | 8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,362.50 | $3,150 | 9.9× |
| MRI lumbar spine w contrast (72149) | $2,625 | $3,500 | 7.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,887.50 | $3,850 | 8.2× |
| MRI orbit face &/neck w/o contrast (70540) | $2,362.50 | $3,150 | 9.9× |
| MRI orbit face neck w contrast (70542) | $2,625 | $3,500 | 7.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,887.50 | $3,850 | 8.2× |
| MRI pelvis w contrast (72196) | $2,625 | $3,500 | 7.5× |
| MRI pelvis w/o & w contrast (72197) | $2,887.50 | $3,850 | 8.2× |
| MRI pelvis w/o contrast (72195) | $2,362.50 | $3,150 | 9.9× |
| MRI thoracic spine w/o contrast (72146) | $2,362.50 | $3,150 | 9.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,625 | $3,500 | 7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,362.50 | $3,150 | 9.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,887.50 | $3,850 | 8.2× |
| MRI, abdomen, combo (74183) | $2,887.50 | $3,850 | 8.2× |
| MRI, dorsal spine combo (72157) | $2,887.50 | $3,850 | 8.2× |
| MRI, dorsal spine contrast (72147) | $2,625 | $3,500 | 7.5× |
| MRI, joint upper extrem (73221) | $2,362.50 | $3,150 | 9.9× |
| MRI, joint upper extrem combo (73223) | $2,887.50 | $3,850 | 8.2× |
| MRI, lumbar spine combo (72158) | $2,887.50 | $3,850 | 8.2× |
| Neck soft tissue (70360) | $92.25 | $123 | 1.1× |
| Pelvis 1 or 2 views (72170) | $105 | $140 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $153.75 | $205 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $94.50 | $126 | 1.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $92.25 | $123 | 1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $136.50 | $182 | 1.3× |
| Radex fingr minimum 2 views (73140) | $92.25 | $123 | 1.1× |
| Radex foot complete minimum 3 views (73630) | $95.25 | $127 | 1.1× |
| Radex Hand Minimum 3 Views (73130) | $94.50 | $126 | 1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $131.25 | $175 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $105 | $140 | 1.2× |
| Radex Ribs Unilateral 2 Views (71100) | $105 | $140 | 1.2× |
| Radex shoulder complete minimum 2 views (73030) | $92.25 | $123 | 1.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $105 | $140 | 1.2× |
| Radex Spine 1 View Specify Level (72020) | $92.25 | $123 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $105 | $140 | 1.2× |
| Radex Toe Minimum 2 Views (73660) | $92.25 | $123 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $155.25 | $207 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $147 | $196 | 1.7× |
| Radiologic examination knee 1/2 views (73560) | $92.25 | $123 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $92.25 | $123 | 1.1× |
| Ribs bilateral 3 views (71110) | $204.75 | $273 | 1.9× |
| Scapula (73010) | $92.25 | $123 | 0.9× |
| Shoulder 1 view (73020) | $92.25 | $123 | 1.1× |
| Skull less than 4 views (70250) | $94.50 | $126 | 0.9× |
| Thoracic spine 2 views (72070) | $105 | $140 | 1.0× |
| Thoracic spine 3 views (72072) | $131.25 | $175 | 1.2× |
| Ultrasound Breast Limited (76642) | $90 | $120 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) | $220.50 | $294 | 2.1× |
| Ultrasound, abdomen limited (76705) | $220.50 | $294 | 2.1× |
| Us breast unilateral complete (76641) | $183.75 | $245 | 1.7× |
| Us chest (76604) | $210 | $280 | 2.0× |
| Us exam, pelvic, limited (76857) | $210.75 | $281 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $172.50 | $230 | 1.6× |
| Us ob limited 1 or more fetuses (76815) | $225.75 | $301 | 2.1× |
| Us ob transvaginal (76817) | $204.75 | $273 | 1.9× |
| Us pelvic non ob complete (76856) | $262.50 | $350 | 2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $288.75 | $385 | 2.7× |
| Us retroperitoneal complete (76770) | $294 | $392 | 2.8× |
| Us retroperitoneal limited (76775) | $220.50 | $294 | 2.1× |
| Us scrotum and contents (76870) | $236.25 | $315 | 2.2× |
| Us thyroid (76536) range across 2 matching MRF lines |
$210–$300 | $280–$400 | varies |
| Wrist 2 views (73100) | $92.25 | $123 | 1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $92.25 | $123 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $182.25 | $243 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $131.25 | $175 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $157.50 | $210 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $157.50 | $210 | 1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $157.50 | $210 | 1.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $105 | $140 | 1.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $208.50 | $278 | 2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $120.75 | $161 | 1.1× |
| X-ray eye for foreign body (70030) | $187.50 | $250 | 2.1× |
| X-ray humerus (73060) | $94.50 | $126 | 1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $105 | $140 | 1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $105 | $140 | 1.0× |
| X-ray nose-rectum child f.b. (76010) | $152.25 | $203 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $250.50 | $334 | 2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $92.25 | $123 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $92.25 | $123 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $120.75 | $161 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $157.50 | $210 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $208.50 | $278 | 2.0× |
| Xr c-spine 4 or 5 views (72050) | $162.75 | $217 | 1.5× |
| Xr facial bones less than 3 views (70140) | $94.50 | $126 | 1.1× |
| Xr orbits complete 4 views (70200) | $136.50 | $182 | 1.3× |
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.