Imaging prices at Thibodaux Regional Health System

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

265 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) $8,994 $8,994 7.2×
Abdomen 2 views (74019) $971 $971 10.3×
Acute gastrointestinal blood loss imaging (78278) $3,360 $3,360 9.3×
Angiography extremity bilateral rs&i (75716) $7,305 $7,305 2.6×
Angiography extremity unilateral rs&i (75710) $25,497 $25,497 8.9×
Angiography pulmonary bilateral slctv rs&i (75743) $8,258 $8,258 2.9×
Angiography visceral slctv/supraslctv rs&i (75726) $42,504 $42,504 8.4×
Ankle 2 views (73600) $782 $782 9.9×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $7,464 $7,464 2.6×
Aortography abdominal serialography rs&i (75625) $16,500 $16,500 5.8×
Basic radiation dosimetry calculation (77300) $567 $567 4.7×
Bone &/Joint Imaging Limited Area (78300) $3,360 $3,360 9.3×
Bone &/Joint Imaging Multiple Areas (78305) $3,360 $3,360 9.3×
Bone &/joint imaging whole body (78306) $3,360 $3,360 9.3×
Bone age studies (77072) $971 $971 10.3×
Bone Imaging 3 Phase (78315) $3,360 $3,360 9.3×
Bone survey complete (77075) $971 $971 10.3×
Brain Imaging Pet Metabolic Evaluation (78608) $5,578 $5,578 4.3×
Cervical spine 2 or 3 views (72040) $721 $721 9.1×
Chest 1 view (71045) $721 $721 9.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $1,591 $1,591 10.0×
Clavicle complete (73000) $721 $721 9.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $297 $297 3.1×
Continuing medical physics consltj pr wk (77336) $1,482 $1,482 12.2×
CT abdomen and pelvis without and with contrast (74178) $6,296 $6,296 19.9×
CT abdomen and pelvis without contrast (74176) $3,589 $3,589 16.6×
CT abdomen w contrast (74160) $2,784 $2,784 17.5×
CT abdomen w wo contrast (74170) $2,970 $2,970 18.7×
CT abdomen w/o contrast (74150) $1,699 $1,699 17.9×
CT angio hrt w/3d image (75574) $2,932 $2,932 9.3×
CT angiography upper extremity lt (73206) $2,784 $2,784 17.5×
CT c-spine w/o contrast (72125) $1,699 $1,699 17.9×
CT cervical spine w&w/o contrast (72127) $4,487 $4,487 28.3×
CT cervical spine with contrast (72126) $5,740 $5,740 18.2×
CT chest w/wo contrast (71270) $2,784 $2,784 17.5×
CT chest with contrast (71260) $2,784 $2,784 17.5×
CT head/brain with contrast (70460) $2,784 $2,784 17.5×
CT head/brain without and with contrast (70470) $2,970 $2,970 18.7×
CT heart no contrast quant eval coronry calcium (75571) $297 $297 3.8×
CT iac w contrast (70481) $2,784 $2,784 17.5×
CT lower ext w/o (73700) $1,699 $1,699 17.9×
CT lower extremity w wo contrast (73702) $2,970 $2,970 18.7×
CT lower extremity with contrast (73701) $2,784 $2,784 17.5×
CT lumbar spine w & w/o contrast (72133) $4,084 $4,084 25.7×
CT lumbar spine w/o contrast (72131) $1,699 $1,699 17.9×
CT lumbar spine with contrast (72132) $5,740 $5,740 18.2×
CT maxillofacial w contrast (70487) $2,784 $2,784 17.5×
CT maxillofacial w/o contrast (70486) $1,699 $1,699 17.9×
CT maxillofacial w/wo contrast (70488) $3,465 $3,465 21.8×
CT neck soft tissue w contrast (70491) $2,784 $2,784 17.5×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,970 $2,970 18.7×
CT orbits w/o contrast (70480) $1,699 $1,699 17.9×
CT pelvis w & w/o contrast (72194) $3,465 $3,465 21.8×
CT pelvis w/o contrast (72192) $1,699 $1,699 17.9×
CT soft tissue neck w/o & w/contrast material (70492) $3,242 $3,242 20.4×
CT soft tissue neck w/o contrast (70490) $1,699 $1,699 17.9×
CT thoracic spine w/contrast (72129) $2,784 $2,784 17.5×
CT thoracic spine w/o contrast (72128) $1,699 $1,699 17.9×
CT thoracic spine w/wo contrast (72130) $2,784 $2,784 17.5×
CT thorax w/o contrast (71250) $1,699 $1,699 17.9×
CT upper extremity w/o & w/contrast material (73202) $3,168 $3,168 19.9×
CT upper extremity w/o contrast rt (73200) $1,699 $1,699 17.9×
CT upper extremity with contrast (73201) $5,740 $5,740 18.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,784 $2,784 17.5×
Cta Abdomen (74175) $2,784 $2,784 17.5×
CTA abdomen pelvis (74174) $5,740 $5,740 18.2×
CTA chest (71275) $2,784 $2,784 17.5×
Cta Head (70496) $2,784 $2,784 17.5×
CTA lwr ext w&w/o contrast (73706) $2,784 $2,784 17.5×
Cta Neck (70498) $2,784 $2,784 17.5×
Cta Pelvis (72191) $2,784 $2,784 17.5×
Cystography minimum 3 views rs&i (74430) $1,695.50 $1,695.50 5.4×
Doppler Fetal Mid Cerebral Artery (76821) $830 $830 8.8×
Dxa bone density study 1/> sites axial skel (77080) $971 $971 10.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $455 $455 5.8×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $1,539 $1,539 7.1×
Esophagus (74220) $1,591 $1,591 10.0×
Fetal biophysical profile non-stress testing (76818) $830 $830 8.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $830 $830 8.8×
Fluoroscopy up to 1 hr (76000) $2,050 $2,050 9.5×
Foot 2 views (73620) $866 $866 11.0×
Forearm 2 views (73090) $1,188 $1,188 15.1×
Gated Heart Planar Single (78472) $3,360 $3,360 9.3×
Hand 2 views (73120) $1,337 $1,337 14.1×
Hand 3 views (73130) $1,238 $1,238 15.7×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $4,361 $4,361 8.9×
Hepatobiliary syst imaging including gallbladder (78226) $3,360 $3,360 9.3×
Ht muscle image spect sing (78451) $7,067 $7,067 6.0×
Humerus Min 2 Views Left (73060) $1,188 $1,188 15.1×
Hysterosalpingogram (74740) $2,050 $2,050 9.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $4,361 $4,361 8.9×
Kidney Img Morphology Vascular Flow Multiple (78709) $4,361 $4,361 8.9×
Knee 3 views (73562) $842 $842 10.7×
Lymphoscintigraphy (78195) $4,361 $4,361 8.9×
Manual appl stress pfrmd phys/qhp joint films (77071) $455 $455 5.8×
Mlc imrt design & construction per imrt plan (77338) $1,767 $1,767 5.2×
MRA head w/o contrast (70544) $3,076 $3,076 14.2×
MRA head with contrast (70545) $5,165 $5,165 16.4×
MRA neck w contrast (70548) $4,920 $4,920 15.6×
MRA neck w/o contrast (70547) $3,076 $3,076 14.2×
MRI abdomen w contrast (74182) $4,920 $4,920 15.6×
MRI abdomen w/o & w/contrast material (74183) $4,920 $4,920 15.6×
MRI abdomen w/o contrast (74181) $3,076 $3,076 14.2×
MRI any jnt lwr ext with con lt (73722) $6,373 $6,373 9.0×
MRI any jt upper extremity w/contrast matrl (73222) $6,373 $6,373 9.0×
MRI breast w/o contrast bilateral (77047) $3,076 $3,076 14.2×
MRI c-spine with contrast (72142) $4,920 $4,920 15.6×
MRI cervical spine w/o contrast (72141) $3,076 $3,076 14.2×
MRI chest w/o & w/contrast material (71552) $4,920 $4,920 15.6×
MRI chest w/o contrast (71550) $3,076 $3,076 14.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $4,920 $4,920 15.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,076 $3,076 14.2×
MRI orbit face &/neck w/o contrast (70540) $3,076 $3,076 14.2×
MRI orbit/face/neck w&w/o cont (70543) $4,920 $4,920 15.6×
MRI orbit/face/neck w/contrast (70542) $4,920 $4,920 15.6×
MRI pelvis w contrast (72196) $4,920 $4,920 15.6×
MRI pelvis w/o & w/contrast material (72197) $4,920 $4,920 15.6×
MRI pelvis w/o contrast (72195) $3,076 $3,076 14.2×
MRI scan of arm joint before and after contrast (73223) $5,742 $5,742 18.2×
MRI scan of leg joint before and after contrast (73723) $5,346 $5,346 16.9×
MRI spinal canal cervical w/o & w/contr matrl (72156) $4,920 $4,920 15.6×
MRI spinal canal lumbar w/contrast material (72149) $4,920 $4,920 15.6×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,920 $4,920 15.6×
MRI spinal canal thoracic w/contrast matrl (72147) $4,920 $4,920 15.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $4,920 $4,920 15.6×
MRI thoracic spine w/o contrast (72146) $3,076 $3,076 14.2×
MRI tmj (70336) $5,893 $5,893 27.3×
MRI upper ext joint w/o contrast (73221) $3,076 $3,076 14.2×
MRI upper extrem other than jt w/o & w/contras (73220) $5,445 $5,445 17.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,076 $3,076 14.2×
Myocardial Spect Multiple Studies (78452) $8,727 $8,727 7.4×
Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) $12,532 $12,532 6.3×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $2,606 $2,606 3.4×
Neck soft tissue (70360) $721 $721 9.1×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $3,360 $3,360 9.3×
Nm gastric emptying study (78264) $3,360 $3,360 9.3×
Ntsty modul radthx pln dose-vol histos (77301) $5,867 $5,867 4.7×
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $10,687 $10,687 8.3×
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $10,687 $10,687 8.3×
Nuclear Rx Oral Admin (79005) $2,225 $2,225 10.5×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $830 $830 8.8×
Osseous survey infant (77076) $971 $971 10.3×
Parathyroid imaging (78070) $3,360 $3,360 9.3×
Pelvis 1 or 2 views (72170) $971 $971 10.3×
Perineogram (74775) $2,050 $2,050 9.5×
PET image w/CT, skull-thigh (78815) $10,687 $10,687 8.3×
PET imaging CT for attenuation limited area (78814) $10,687 $10,687 8.3×
PET imaging for CT attenuation whole body (78816) $10,687 $10,687 8.3×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $5,148 $5,148 16.3×
Pulmonary Perfusion Imaging Particulate (78580) $3,360 $3,360 9.3×
Pulmonary Ventilation & Perfusion Imaging (78582) $4,361 $4,361 8.9×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $2,238 $2,238 2.7×
Radex abscess/fistula/sinus tract rs&i (76080) $4,303 $4,303 8.7×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $971 $971 10.3×
Radex hips bilateral with pelvis 2 views (73521) $971 $971 10.3×
Radiation Delivery Stereotactic Cranial Linear (77372) $28,044 $28,044 4.2×
Radiation treatment delivery 1 mev >= complex (77412) $1,405 $1,405 2.8×
Radiation treatment delivery 1 mev >= simple (77402) $424 $424 4.6×
Radiation tx delivery 1 mev >= intermediate (77407) $816 $816 2.3×
Radiolog exam mandible compl minimum 4 views (70110) $971 $971 10.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $721 $721 9.1×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $721 $721 9.1×
Radiologic exam colon single contrast study (74270) $1,591 $1,591 10.0×
Radiologic exam upr gi trc double contrast study (74246) $1,591 $1,591 10.0×
Radiologic exam upr gi trc single contrast study (74240) $1,591 $1,591 10.0×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $1,089 $1,089 13.8×
Ribs bilateral 3 views (71110) $971 $971 10.3×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $3,360 $3,360 9.3×
Rp loclzj tum plnr whole body single day imaging (78802) $8,727 $8,727 17.8×
Rp loclzj tum spect 1 area single day imaging (78803) $2,929.03 $2,929.03 6.0×
Sacroiliac Joints < 3 Views (72200) $971 $971 10.3×
Saline Infus Sonohysterography W/Color Doppler (76831) $1,294 $1,294 6.0×
Scanogram (77073) $971 $971 10.3×
Scapula complete (73010) $971 $971 10.3×
Screening digital breast tomosynthesis (77063) $149 $149 6.4×
Shuntogram indwelling nonvascular shunt rs&i (75809) $971 $971 10.3×
Small bowel series (74250) $1,591 $1,591 10.0×
Spec medical radj physics consltj (77370) $2,119 $2,119 17.4×
Spec telethx port pln parts hemibdy tot bdy (77321) $845 $845 2.5×
Special dosimetry (77331) $1,048 $1,048 8.6×
Special treatment procedure (77470) $5,171 $5,171 10.3×
Stereotactic body radiation delivery (77373) $25,591 $25,591 15.8×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,413 $1,413 4.2×
Ther rad simulaj-aided field setting complex (77290) $2,121 $2,121 6.3×
Ther rad simulaj-aided field setting simple (77280) $935 $935 7.7×
Thyroid carcinoma metastases img whole body (78018) $4,361 $4,361 8.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,360 $3,360 9.3×
Treatment devices simple (77332) $719 $719 5.9×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $5,151 $5,151 10.5×
Tx devices design & construction complex (77334) $1,641 $1,641 4.8×
Ultrasound, abdomen limited (76705) $830 $830 8.8×
Umbilical-artery Doppler (OB) (76820) $830 $830 8.8×
Upper Extremity Infant (73092) $75 $75 0.8×
Urethrocystography retrograde rs&i (74450) $2,050 $2,050 9.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $1,591 $1,591 10.0×
Us abdl aorta screen aaa (76706) $830 $830 8.8×
Us breast unilateral complete (76641) $830 $830 8.8×
Us breast unilateral limited (76642) $591 $591 7.5×
Us compl joint r-t w/image documentation (76881) $830 $830 8.8×
Us guided compression repair (76936) $1,801.50 $1,801.50 9.2×
Us kidney transplant (76776) $607 $607 6.4×
Us ob detailed single fetus (76811) $1,726 $1,726 8.0×
Us ob transvaginal (76817) $830 $830 8.8×
Us pelvic non ob complete (76856) $830 $830 8.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $830 $830 8.8×
Us pregnancy ltd (76815) $8 $8 0.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $830 $830 8.8×
Us retroperitoneal complete (76770) $830 $830 8.8×
Us retroperitoneal limited (76775) $830 $830 8.8×
Us scrotum and contents (76870) $830 $830 8.8×
Us soft tissue head/neck (76536) $830 $830 8.8×
Us spinal canal and contents (76800) $830 $830 8.8×
Us transrectal (76872) $613 $613 6.5×
Us xtr non-vasc lmtd (76882) $613 $613 6.5×
Venogram extremity bilateral (75822) $3,329 $3,329 2.3×
Venography caval inferior serialography rs&i (75825) $5,657 $5,657 2.0×
Venography caval superior serialography rs&i (75827) $2,665 $2,665 1.9×
Venography extremity unilateral rs&i (75820) $7,346.50 $7,346.50 5.2×
Wrist 2 views (73100) $990 $990 12.6×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $1,089 $1,089 11.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $67 $67 0.9×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $842 $842 10.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,591 $1,591 10.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $1,089 $1,089 13.8×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $1,287 $1,287 16.3×
X-ray exam hip uni 1 view (73501) $721 $721 9.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $721 $721 9.1×
X-ray exam of femur 1 (73551) $69 $69 0.9×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $971 $971 10.3×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $597.50 $597.50 7.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $812 $812 10.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $817 $817 10.4×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $1,139 $1,139 12.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $721 $721 9.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $721 $721 9.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $971 $971 10.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $971 $971 10.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $613 $613 6.5×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $721 $721 9.1×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $721 $721 9.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $971 $971 10.3×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $83.50 $83.50 0.9×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $1,772 $1,772 5.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $721 $721 9.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $971 $971 10.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $971 $971 10.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $792 $792 10.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $1,163 $1,163 14.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $721 $721 9.1×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $76 $76 1.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $971 $971 10.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $971 $971 10.3×
X-Ray Spine One View - Xr Spine (72020) $721 $721 9.1×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $721 $721 9.1×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $721 $721 9.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $971 $971 10.3×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $721 $721 9.1×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $1,188 $1,188 15.1×
Xr c-spine 6 or more views (72052) $971 $971 10.3×
Xr finger(s) 2+ views (73140) $721 $721 9.1×
Xr shoulder 1 view (73020) $471 $471 6.0×
Xr spine cervical 4 or 5 views (72050) $971 $971 10.3×
Xr tibia/fibula 2 views (73590) $941 $941 11.9×
Xr tmj bilateral (70330) $721 $721 9.1×
Xray knee 1 or 2 views rt (73560) $891 $891 11.3×