Imaging prices at Texas County Memorial Hospital

Houston, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $317.10 $453 3.0×
Acute gastrointestinal blood loss imaging (78278) $676.90 $967 1.7×
Angiography extremity bilateral rs&i (75716) $145 $145 0.0×
Angiography extremity unilateral rs&i (75710) $130 $130 0.0×
Ankle 2 views (73600) $207.90 $297 2.4×
Antegrade urography radiological supvj & interpj (74425) $375.20 $536 1.1×
Arthrogram shoulder (73040) $623 $890 1.8×
Bone &/Joint Imaging Limited Area (78300) $1,365 $1,950 3.4×
Bone &/Joint Imaging Multiple Areas (78305) $1,575.70 $2,251 3.9×
Bone &/joint imaging whole body (78306) $1,041.60 $1,488 2.6×
Bone age studies (77072) $158.90 $227 1.5×
Bone Imaging 3 Phase (78315) $1,796.90 $2,567 4.5×
Bone survey complete (77075) $281.40 $402 2.7×
Brain image w/flow 4 + views (78606) $963.90 $1,377 1.8×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $641.20 $916 1.6×
Cervical spine 2 or 3 views (72040) $213.30 $279 2.4×
Chest 1 view (71045) $106.25 $132.50 1.2×
Chest 3 views (71047) $245 $350 2.8×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $355.60 $508 2.0×
Clavicle complete (73000) $220.50 $315 2.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,961.40 $2,802 18.7×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $490 $700 2.8×
CT abdomen and pelvis without and with contrast (74178) $3,392.20 $4,846 9.7×
CT abdomen and pelvis without contrast (74176) $2,482.20 $3,546 10.4×
CT abdomen w contrast (74160) $1,961.40 $2,802 11.2×
CT abdomen w wo contrast (74170) $2,262.40 $3,232 12.9×
CT abdomen w/o contrast (74150) $1,654.80 $2,364 15.8×
CT angiography upper extremity lt (73206) $2,403.80 $3,434 13.7×
CT c-spine w/o contrast (72125) $1,961.40 $2,802 18.7×
CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) $115.50 $165 0.7×
CT cervical spine w&w/o contrast (72127) $2,565.50 $3,665 14.6×
CT cervical spine with contrast (72126) $2,262.40 $3,232 6.5×
CT chest w/wo contrast (71270) $2,565.50 $3,665 14.6×
CT chest with contrast (71260) $2,262.40 $3,232 12.9×
CT head/brain with contrast (70460) $1,961.40 $2,802 11.2×
CT head/brain without and with contrast (70470) $2,262.40 $3,232 12.9×
CT iac w contrast (70481) $2,109.80 $3,014 12.0×
CT limited/localized follow up study (76380) $1,129.10 $1,613 13.0×
CT lower ext w/o (73700) $1,809.50 $2,585 17.3×
CT lower extremity w wo contrast (73702) $2,413.60 $3,448 13.7×
CT lower extremity with contrast (73701) $2,109.80 $3,014 12.0×
CT lumbar spine w & w/o contrast (72133) $2,565.50 $3,665 14.6×
CT lumbar spine w/o contrast (72131) $1,961.40 $2,802 18.7×
CT lumbar spine with contrast (72132) $2,262.40 $3,232 6.5×
CT maxillofacial w contrast (70487) $2,109.80 $3,014 12.0×
CT maxillofacial w/o contrast (70486) $1,809.50 $2,585 17.3×
CT maxillofacial w/wo contrast (70488) $2,413.60 $3,448 13.7×
CT neck soft tissue w contrast (70491) $1,961.40 $2,802 11.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,413.60 $3,448 13.7×
CT orbits w/o contrast (70480) $1,809.50 $2,585 17.3×
CT pelvis w & w/o contrast (72194) $2,262.40 $3,232 12.9×
CT pelvis w/o contrast (72192) $1,654.80 $2,364 15.8×
CT soft tissue neck w/o & w/contrast material (70492) $2,262.40 $3,232 12.9×
CT soft tissue neck w/o contrast (70490) $1,654.80 $2,364 15.8×
CT thoracic spine w/contrast (72129) $2,262.40 $3,232 12.9×
CT thoracic spine w/o contrast (72128) $1,961.40 $2,802 18.7×
CT thoracic spine w/wo contrast (72130) $2,565.50 $3,665 14.6×
CT thorax w/o contrast (71250) $1,961.40 $2,802 18.7×
CT upper extremity w/o & w/contrast material (73202) $2,262.40 $3,232 12.9×
CT upper extremity w/o contrast rt (73200) $1,654.80 $2,364 15.8×
CT upper extremity with contrast (73201) $1,961.40 $2,802 5.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,403.80 $3,434 13.7×
Cta Abdomen (74175) $2,403.80 $3,434 13.7×
CTA abdomen pelvis (74174) $2,286.90 $3,267 6.5×
CTA chest (71275) $2,746.10 $3,923 15.6×
Cta Head (70496) $2,403.80 $3,434 13.7×
CTA lwr ext w&w/o contrast (73706) $2,572.50 $3,675 14.6×
Cta Neck (70498) $2,403.80 $3,434 13.7×
Cta Pelvis (72191) $2,403.80 $3,434 13.7×
Cystography minimum 3 views rs&i (74430) $203.70 $291 0.6×
Dxa bone density study 1/> sites axial skel (77080) $296.10 $423 2.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $158.90 $227 1.8×
Echoencephalography real time imaging (76506) $343 $490 3.3×
Esophagus (74220) $214.90 $307 1.2×
Fetal biophysical profile non-stress testing (76818) $662.20 $946 6.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $405.30 $579 3.9×
Fluoroscopy up to 1 hr (76000) $65 $65 0.3×
Foot 2 views (73620) $220.50 $315 2.5×
Forearm 2 views (73090) $220.50 $315 2.5×
Hand 2 views (73120) $220.50 $315 2.1×
Hand 3 views (73130) $229.60 $328 2.6×
Heart Infarct Image (78466) $856.80 $1,224 2.1×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,541.40 $2,202 2.8×
Hepatobiliary syst imaging including gallbladder (78226) $1,379 $1,970 3.4×
Ht muscle image spect sing (78451) $2,030 $2,900 1.6×
Humerus Min 2 Views Left (73060) $220.50 $315 2.5×
Hysterosalpingogram (74740) $467.60 $668 2.0×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $130.20 $186 1.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $852.25 $1,217.50 1.6×
Kidney img morphology vascular flow 1 w/rx (78708) $1,134 $1,620 2.1×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,320.55 $1,886.50 2.4×
Knee 3 views (73562) $341.60 $488 3.9×
Liver & spleen imaging static only (78215) $865.90 $1,237 2.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $962.50 $1,375 2.4×
Lung Ventilation Imaging (78579) $411.60 $588 1.0×
Manual appl stress pfrmd phys/qhp joint films (77071) $130.20 $186 1.5×
Meckels Diverticulum (78290) $815.50 $1,165 2.0×
MRA head w & w/o contrast (70546) $2,117.50 $3,025 6.1×
MRA head w/o contrast (70544) $1,463 $2,090 6.1×
MRA head with contrast (70545) $1,568 $2,240 4.5×
MRA neck w contrast (70548) $1,568 $2,240 4.5×
Mra Neck W/O &W/Contrast Material (70549) $2,117.50 $3,025 6.1×
MRA neck w/o contrast (70547) $1,463 $2,090 6.1×
MRI abdomen w contrast (74182) $3,157 $4,510 9.0×
MRI abdomen w/o & w/contrast material (74183) $3,591 $5,130 10.3×
MRI abdomen w/o contrast (74181) $2,884 $4,120 12.1×
MRI any jnt lwr ext with con lt (73722) $3,157 $4,510 4.0×
MRI any jt upper extremity w/contrast matrl (73222) $3,157 $4,510 4.0×
MRI c-spine with contrast (72142) $3,157 $4,510 9.0×
MRI cervical spine w/o contrast (72141) $2,884 $4,120 12.1×
MRI chest w/o & w/contrast material (71552) $3,591 $5,130 10.3×
MRI chest w/o contrast (71550) $2,884 $4,120 12.1×
MRI chest with contrast (71551) $3,157 $4,510 4.0×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $3,157 $4,510 9.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,157 $4,510 9.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,884 $4,120 12.1×
MRI orbit face &/neck w/o contrast (70540) $2,884 $4,120 12.1×
MRI orbit/face/neck w&w/o cont (70543) $3,591 $5,130 10.3×
MRI orbit/face/neck w/contrast (70542) $3,157 $4,510 9.0×
MRI pelvis w contrast (72196) $3,157 $4,510 9.0×
MRI pelvis w/o & w/contrast material (72197) $3,591 $5,130 10.3×
MRI pelvis w/o contrast (72195) $2,884 $4,120 12.1×
MRI scan of arm joint before and after contrast (73223) $3,591 $5,130 10.3×
MRI scan of leg joint before and after contrast (73723) $3,591 $5,130 10.3×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,591 $5,130 10.3×
MRI spinal canal lumbar w/contrast material (72149) $3,157 $4,510 9.0×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,591 $5,130 10.3×
MRI spinal canal thoracic w/contrast matrl (72147) $3,157 $4,510 9.0×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,591 $5,130 10.3×
MRI thoracic spine w/o contrast (72146) $2,884 $4,120 12.1×
MRI tmj (70336) $1,774.50 $2,535 7.4×
MRI upper ext joint w/o contrast (73221) $2,884 $4,120 12.1×
MRI upper extrem other than jt w/o & w/contras (73220) $3,591 $5,130 10.3×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,884 $4,120 12.1×
Myocardial Spect Multiple Studies (78452) $2,792.30 $3,989 2.2×
Neck soft tissue (70360) $45 $45 0.5×
Nm gastric emptying study (78264) $892.50 $1,275 2.2×
Nuclear medicine study to assess blood clot in vein of side (78457) $816.90 $1,167 1.5×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $662.90 $947 6.3×
Osseous survey infant (77076) $158.90 $227 1.5×
Osseous survey limited (77074) $281.40 $402 2.7×
Parathyroid imaging (78070) $653.80 $934 1.6×
Pelvis 1 or 2 views (72170) $115 $115 1.1×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $3,591 $5,130 10.3×
Pulmonary Perfusion Imaging Particulate (78580) $647.50 $925 1.6×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,030.40 $1,472 1.9×
Radex abscess/fistula/sinus tract rs&i (76080) $333.20 $476 0.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $108.50 $155 1.2×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $233.10 $333 2.2×
Radex hips bilateral with pelvis 2 views (73521) $399 $570 3.8×
Radex mastoids compl minimum 3 views pr side (70130) $305.90 $437 2.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $388.50 $555 3.7×
Radiolog exam mandible compl minimum 4 views (70110) $415.10 $593 4.0×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $155.25 $202.50 1.8×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $464.10 $663 4.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $123.50 $155 1.4×
Radiologic exam colon single contrast study (74270) $292.60 $418 1.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $220.50 $315 2.5×
Radiologic Examination Salivary Gland Calculus (70380) $102.90 $147 1.2×
Radiological examination surgical specimen (76098) $152.60 $218 0.3×
Ribs bilateral 3 views (71110) $227.50 $325 2.2×
Rp loclzj tum plnr whole body single day imaging (78802) $993.30 $1,419 1.8×
Scanogram (77073) $158.90 $227 1.5×
Scapula complete (73010) $120 $120 1.1×
Screening digital breast tomosynthesis (77063) $33.88 $48.39 1.4×
Sella turcica (70240) $102.90 $147 1.2×
Sialogram (70390) $391.30 $559 1.6×
Small bowel series (74250) $559.30 $799 3.2×
Spine thoracic 3 views (72072) $317.10 $453 3.0×
Tbs Technical Calculation Only (77091) $108.50 $155 1.2×
Testicular Imaging With Vascular Flow (78761) $815.50 $1,165 2.0×
Thoracolumbar 2 views (72080) $173.60 $248 2.0×
Thyroid Imaging With Vascular Flow (78013) $401.80 $574 1.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,321.60 $1,888 3.3×
Tomogram (76100) $424.20 $606 4.1×
Ultrasound, abdomen limited (76705) $688.80 $984 6.6×
Umbilical-artery Doppler (OB) (76820) $557.20 $796 5.3×
Unlisted Ultrasound Procedure (76999) $454.30 $649 5.2×
Upper Extremity Infant (73092) $135.10 $193 1.3×
Urethrocystography retrograde rs&i (74450) $349.30 $499 1.5×
Urethrocystography voiding (74455) $803.60 $1,148 3.4×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $655.20 $936 3.7×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $924.70 $1,321 5.3×
Us abdl aorta screen aaa (76706) $305.20 $436 2.9×
Us breast unilateral complete (76641) $155 $155 1.5×
Us breast unilateral limited (76642) $211.27 $301.82 2.4×
Us chest (76604) $653.80 $934 6.2×
Us compl joint r-t w/image documentation (76881) $292.60 $418 2.8×
Us fetal nuchal translucency 1st gestation (76813) $364.70 $521 3.5×
Us kidney transplant (76776) $403.90 $577 3.9×
Us ob transvaginal (76817) $563.85 $805.50 5.4×
Us pelvic non ob complete (76856) $688.80 $984 6.6×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $347.20 $496 3.3×
Us pregnancy ltd (76815) $205 $205 2.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $574 $820 5.5×
Us retroperitoneal complete (76770) $155 $155 1.5×
Us retroperitoneal limited (76775) $378.70 $541 3.6×
Us scrotum and contents (76870) $651.70 $931 6.2×
Us soft tissue head/neck (76536) $637.35 $910.50 6.1×
Us xtr non-vasc lmtd (76882) $201.95 $288.50 1.9×
Venogram extremity bilateral (75822) $857.50 $1,225 0.5×
Venography extremity unilateral rs&i (75820) $437.50 $625 0.3×
Wrist 2 views (73100) $207.90 $297 2.4×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $438.90 $627 4.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $259 $370 3.0×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $220.50 $315 2.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $855.40 $1,222 4.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $220.50 $315 2.5×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $317.10 $453 3.6×
X-ray exam entire spi 4/5 vw (72083) $347.90 $497 3.3×
X-ray exam hip uni 1 view (73501) $172.90 $247 2.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $242.90 $347 2.8×
X-ray exam hip uni 4/> views (73503) $399 $570 3.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $502.25 $717.50 4.8×
X-Ray Exam Hips Bi 5/> Views (73523) $606.20 $866 5.8×
X-ray exam of femur 1 (73551) $156.80 $224 1.8×
X-ray eye for foreign body (70030) $163.80 $234 1.9×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $389.90 $557 3.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $317.10 $453 3.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $229.60 $328 2.6×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $80 $80 0.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $341.60 $488 3.9×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $366.80 $524 3.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $207.20 $296 2.4×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $135.10 $193 1.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $242.35 $313 2.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $303.10 $433 2.9×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $313.60 $448 3.0×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $159.40 $209.50 1.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $72.80 $104 0.8×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $116.80 $154 1.1×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $227.50 $325 2.2×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $281.40 $402 0.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $169.40 $242 1.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $307.30 $439 2.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $401.10 $573 3.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $389.90 $557 3.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $120 $120 1.4×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $220.50 $315 2.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $329.70 $471 3.8×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $145.60 $208 1.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $335.30 $479 3.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $371 $530 3.5×
X-Ray Spine One View - Xr Spine (72020) $172.20 $246 2.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $114.10 $163 1.3×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $269.50 $385 3.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $205.95 $268.50 2.0×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $393.40 $562 3.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $220.50 $315 2.5×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $220.50 $315 2.5×
Xr c-spine 6 or more views (72052) $385 $550 3.7×
Xr chest 4+ views (71048) $292.60 $418 2.8×
Xr Cholecystography Oral Contrast (74290) $263.20 $376 1.5×
Xr finger(s) 2+ views (73140) $220.50 $315 2.5×
Xr internal auditory meati complete (70134) $161.70 $231 0.3×
XR Mastoids < 3 Views Bilateral (70120) $72.80 $104 0.7×
Xr optic foramina (70190) $106.40 $152 1.2×
Xr shoulder 1 view (73020) $183.40 $262 2.1×
Xr spine cervical 4 or 5 views (72050) $264.60 $340.50 2.5×
Xr tibia/fibula 2 views (73590) $220.50 $315 2.5×
Xr tmj bilateral (70330) $490 $700 5.6×
Xray knee 1 or 2 views rt (73560) $220.50 $315 2.5×