Imaging prices at The Hospitals of Providence Horizon City Campus
Horizon City, TX · every code in this section with a posted price and a Medicare benchmark.
139 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $1,211.31 | $1,514.14 | 11.5× |
| Ankle 2 views (73600) | $1,038.03 | $1,297.54 | 11.9× |
| Bone age studies (77072) | $997.01 | $1,246.26 | 9.5× |
| Cervical spine 2 or 3 views (72040) | $1,211.31 | $1,514.14 | 13.9× |
| Chest 1 view (71045) | $1,283.30 | $1,604.13 | 14.7× |
| Chest 3 views (71047) | $856.38 | $1,070.47 | 9.8× |
| Clavicle complete (73000) | $1,240.61 | $1,550.76 | 14.2× |
| CT abdomen and pelvis without and with contrast (74178) | $6,530.30 | $8,162.87 | 18.6× |
| CT abdomen and pelvis without contrast (74176) | $10,228.47 | $12,785.59 | 42.7× |
| CT abdomen w contrast (74160) | $4,291.36 | $5,364.20 | 24.4× |
| CT abdomen w wo contrast (74170) | $4,663.38 | $5,829.22 | 26.5× |
| CT abdomen w/o contrast (74150) | $3,073.36 | $3,841.70 | 29.3× |
| CT angiography upper extremity lt (73206) | $8,965.98 | $11,207.48 | 50.9× |
| CT c-spine w/o contrast (72125) | $7,255.94 | $9,069.93 | 69.1× |
| CT cervical spine w&w/o contrast (72127) | $6,102.17 | $7,627.71 | 34.6× |
| CT cervical spine with contrast (72126) | $4,683.35 | $5,854.19 | 13.4× |
| CT chest w/wo contrast (71270) | $4,075.52 | $5,094.40 | 23.1× |
| CT chest with contrast (71260) | $3,972.36 | $4,965.45 | 22.5× |
| CT head/brain with contrast (70460) | $5,701.44 | $7,126.80 | 32.4× |
| CT head/brain without and with contrast (70470) | $4,734.14 | $5,917.68 | 26.9× |
| CT iac w contrast (70481) | $4,146.14 | $5,182.68 | 23.5× |
| CT lower ext w/o (73700) | $3,085.21 | $3,856.51 | 29.4× |
| CT lower extremity w wo contrast (73702) | $2,676.54 | $3,345.68 | 15.2× |
| CT lower extremity with contrast (73701) | $2,131.39 | $2,664.24 | 12.1× |
| CT lumbar spine w & w/o contrast (72133) | $3,166.94 | $3,958.67 | 18.0× |
| CT lumbar spine w/o contrast (72131) | $3,650.98 | $4,563.73 | 34.8× |
| CT lumbar spine with contrast (72132) | $3,506.57 | $4,383.21 | 10.0× |
| CT maxillofacial w contrast (70487) | $6,674.30 | $8,342.87 | 37.9× |
| CT maxillofacial w/o contrast (70486) | $3,290.73 | $4,113.41 | 31.3× |
| CT maxillofacial w/wo contrast (70488) | $4,584.17 | $5,730.21 | 26.0× |
| CT neck soft tissue w contrast (70491) | $4,562.74 | $5,703.43 | 25.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $2,532.91 | $3,166.14 | 14.4× |
| CT orbits w/o contrast (70480) | $3,900.94 | $4,876.18 | 37.1× |
| CT pelvis w & w/o contrast (72194) | $3,578.78 | $4,473.47 | 20.3× |
| CT pelvis w/o contrast (72192) | $4,158.05 | $5,197.56 | 39.6× |
| CT soft tissue neck w/o & w/contrast material (70492) | $3,206.62 | $4,008.27 | 18.2× |
| CT soft tissue neck w/o contrast (70490) | $3,316.12 | $4,145.15 | 31.6× |
| CT thoracic spine w/contrast (72129) | $4,432.60 | $5,540.75 | 25.2× |
| CT thoracic spine w/o contrast (72128) | $3,789.85 | $4,737.31 | 36.1× |
| CT thoracic spine w/wo contrast (72130) | $4,808.73 | $6,010.91 | 27.3× |
| CT thorax w/o contrast (71250) | $3,179.63 | $3,974.54 | 30.3× |
| CT upper extremity w/o & w/contrast material (73202) | $4,742.87 | $5,928.59 | 26.9× |
| CT upper extremity w/o contrast rt (73200) | $3,689.07 | $4,611.34 | 35.1× |
| CT upper extremity with contrast (73201) | $3,817.62 | $4,772.03 | 10.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,701.44 | $7,126.80 | 32.4× |
| Cta Abdomen (74175) | $3,285.97 | $4,107.46 | 18.6× |
| CTA abdomen pelvis (74174) | $9,127.06 | $11,408.83 | 26.0× |
| CTA chest (71275) | $6,382.28 | $7,977.85 | 36.2× |
| Cta Head (70496) | $10,726.01 | $13,407.51 | 60.9× |
| CTA lwr ext w&w/o contrast (73706) | $3,985.06 | $4,981.32 | 22.6× |
| Cta Neck (70498) | $6,402.12 | $8,002.65 | 36.3× |
| Cta Pelvis (72191) | $9,200.86 | $11,501.08 | 52.2× |
| Foot 2 views (73620) | $1,038.03 | $1,297.54 | 11.9× |
| Forearm 2 views (73090) | $1,254.01 | $1,567.51 | 14.3× |
| Hand 2 views (73120) | $1,084.90 | $1,356.13 | 10.3× |
| Hand 3 views (73130) | $1,272.42 | $1,590.53 | 14.6× |
| Humerus Min 2 Views Left (73060) | $1,236.42 | $1,545.53 | 14.1× |
| Knee 3 views (73562) | $1,144.34 | $1,430.43 | 13.1× |
| Neck soft tissue (70360) | $1,310.93 | $1,638.66 | 15.0× |
| Pelvis 1 or 2 views (72170) | $426.93 | $533.66 | 4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $1,868.45 | $2,335.56 | 17.8× |
| Radex hips bilateral with pelvis 2 views (73521) | $873.95 | $1,092.44 | 8.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,703.54 | $2,129.42 | 16.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $979.43 | $1,224.29 | 11.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,205.46 | $1,506.82 | 11.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) | $1,160.25 | $1,450.31 | 13.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) | $847.17 | $1,058.96 | 9.7× |
| Sacroiliac Joints < 3 Views (72200) | $837.45 | $1,046.81 | 8.0× |
| Scapula complete (73010) | $1,139.32 | $1,424.15 | 10.8× |
| Spine thoracic 3 views (72072) | $2,256.04 | $2,820.05 | 21.5× |
| Thoracolumbar 2 views (72080) | $1,475.84 | $1,844.80 | 16.9× |
| Ultrasound, abdomen limited (76705) | $2,252.01 | $2,815.01 | 21.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) | $1,285.14 | $1,606.43 | 14.7× |
| Unlisted Ultrasound Procedure (76999) | $1,722.90 | $2,153.63 | 19.7× |
| Upper Extremity Infant (73092) | $606.91 | $758.64 | 5.8× |
| Us abdl aorta screen aaa (76706) | $860.18 | $1,075.22 | 8.2× |
| Us breast unilateral complete (76641) | $859.38 | $1,074.23 | 8.2× |
| Us breast unilateral limited (76642) | $549.91 | $687.39 | 6.3× |
| Us chest (76604) | $1,285.50 | $1,606.88 | 12.2× |
| Us compl joint r-t w/image documentation (76881) | $1,238.69 | $1,548.36 | 11.8× |
| Us fetal nuchal translucency 1st gestation (76813) | $780.03 | $975.04 | 7.4× |
| Us infant hips dynamic (76885) | $694.33 | $867.91 | 7.9× |
| Us infant hips limited static (76886) | $631.64 | $789.55 | 7.2× |
| Us ob detailed single fetus (76811) | $1,225.22 | $1,531.53 | 5.1× |
| Us ob transvaginal (76817) | $1,030.78 | $1,288.48 | 9.8× |
| Us pelvic non ob complete (76856) | $1,990.15 | $2,487.69 | 19.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $1,328.35 | $1,660.44 | 12.6× |
| Us pregnancy ltd (76815) | $945.87 | $1,182.34 | 9.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) | $2,774.14 | $3,467.68 | 26.4× |
| Us retroperitoneal complete (76770) | $2,013.95 | $2,517.44 | 19.2× |
| Us retroperitoneal limited (76775) | $2,089.34 | $2,611.67 | 19.9× |
| Us scrotum and contents (76870) | $1,177.58 | $1,471.98 | 11.2× |
| Us soft tissue head/neck (76536) | $1,482.30 | $1,852.87 | 14.1× |
| Us xtr non-vasc lmtd (76882) | $657.03 | $821.29 | 6.3× |
| Wrist 2 views (73100) | $1,070.68 | $1,338.35 | 12.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $2,242.65 | $2,803.31 | 21.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) | $1,253.17 | $1,566.46 | 14.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $1,089.93 | $1,362.41 | 12.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) | $1,274.94 | $1,593.67 | 14.6× |
| X-ray exam hip uni 1 view (73501) | $873.95 | $1,092.44 | 10.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $917.48 | $1,146.85 | 10.5× |
| X-ray exam hip uni 4/> views (73503) | $557.52 | $696.90 | 5.3× |
| X-ray exam of femur 1 (73551) | $416.05 | $520.06 | 4.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) | $1,969.74 | $2,462.18 | 18.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $1,331.02 | $1,663.78 | 15.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) | $1,290.84 | $1,613.55 | 14.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) | $1,013.75 | $1,267.19 | 11.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $1,247.90 | $1,559.88 | 14.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) | $2,041.74 | $2,552.17 | 19.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) | $409.35 | $511.69 | 4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $917.48 | $1,146.85 | 8.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $1,551.18 | $1,938.98 | 14.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) | $1,253.17 | $1,566.46 | 14.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) | $1,089.93 | $1,362.41 | 12.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $1,581.32 | $1,976.65 | 15.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) | $2,617.44 | $3,271.80 | 24.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $1,794.78 | $2,243.48 | 20.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $1,877.66 | $2,347.08 | 17.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $951.81 | $1,189.76 | 9.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,020.45 | $1,275.56 | 11.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) | $1,296.70 | $1,620.87 | 14.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $2,057.64 | $2,572.05 | 23.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) | $788.57 | $985.71 | 9.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,803.99 | $2,254.99 | 17.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $1,269.07 | $1,586.34 | 12.1× |
| X-Ray Spine One View - Xr Spine (72020) | $1,088.26 | $1,360.32 | 12.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $848.84 | $1,061.05 | 9.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $765.97 | $957.46 | 8.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $1,612.30 | $2,015.37 | 15.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $704.86 | $881.07 | 6.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) | $1,131.78 | $1,414.73 | 12.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) | $1,209.64 | $1,512.05 | 13.8× |
| Xr c-spine 6 or more views (72052) | $1,187.87 | $1,484.84 | 11.3× |
| Xr finger(s) 2+ views (73140) | $1,108.34 | $1,385.43 | 12.7× |
| Xr shoulder 1 view (73020) | $1,161.09 | $1,451.36 | 13.3× |
| Xr spine cervical 4 or 5 views (72050) | $2,233.44 | $2,791.80 | 21.3× |
| Xr tibia/fibula 2 views (73590) | $1,211.31 | $1,514.14 | 13.9× |
| Xr tmj bilateral (70330) | $954.32 | $1,192.90 | 10.9× |
| Xray knee 1 or 2 views rt (73560) | $1,002.87 | $1,253.59 | 11.5× |