Imaging prices at TriStar Horizon Medical Center

Dickson, TN · every code in this section with a posted price and a Medicare benchmark.

246 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) $12,459.44 $12,459.44 9.4×
Abdomen 2 views (74019) $1,661.05 $1,661.05 16.6×
Acute gastrointestinal blood loss imaging (78278) $2,085.94 $2,085.94 5.4×
Angiography extremity bilateral rs&i (75716) $11,756.06 $11,756.06 3.9×
Angiography extremity unilateral rs&i (75710) $12,070.86 $12,070.86 4.0×
Angiography visceral slctv/supraslctv rs&i (75726) $15,776.39 $15,776.39 3.0×
Ankle 2 views (73600) $715.32 $715.32 8.6×
Aortogram thoracic (75605) $16,224.17 $16,224.17 3.0×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $12,464.16 $12,464.16 4.1×
Aortography abdominal serialography rs&i (75625) $12,464.16 $12,464.16 4.1×
Arthrogram shoulder (73040) $3,150.63 $3,150.63 9.4×
Basic radiation dosimetry calculation (77300) $1,741.51 $1,741.51 13.5×
Bone &/Joint Imaging Limited Area (78300) $4,939.88 $4,939.88 12.9×
Bone &/Joint Imaging Multiple Areas (78305) $7,121.70 $7,121.70 18.6×
Bone &/joint imaging whole body (78306) $5,024.30 $5,024.30 13.1×
Bone age studies (77072) $1,077.59 $1,077.59 10.7×
Bone Imaging 3 Phase (78315) $6,756.79 $6,756.79 17.6×
Bone survey complete (77075) $1,166.47 $1,166.47 11.6×
Brain image w/flow 4 + views (78606) $1,506.73 $1,506.73 2.9×
Brain Imaging Pet Metabolic Evaluation (78608) $7,027.80 $7,027.80 5.1×
Cervical spine 2 or 3 views (72040) $1,157 $1,157 13.9×
Chest 1 view (71045) $623.81 $623.81 7.5×
Chest 3 views (71047) $1,815.56 $1,815.56 21.7×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $522.22 $522.22 3.1×
Clavicle complete (73000) $1,006 $1,006 12.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $272.85 $272.85 2.7×
Continuing medical physics consltj pr wk (77336) $2,320.32 $2,320.32 18.0×
CT abdomen and pelvis without and with contrast (74178) $32,173.97 $32,173.97 96.1×
CT abdomen and pelvis without contrast (74176) $20,102.28 $20,102.28 87.8×
CT abdomen w contrast (74160) $11,011.47 $11,011.47 65.4×
CT abdomen w wo contrast (74170) $11,484.15 $11,484.15 68.2×
CT abdomen w/o contrast (74150) $11,011.47 $11,011.47 109.8×
CT angiography upper extremity lt (73206) $11,757.66 $11,757.66 69.9×
CT c-spine w/o contrast (72125) $6,857.75 $6,857.75 68.4×
CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) $14,458.27 $14,458.27 85.9×
CT cervical spine w&w/o contrast (72127) $6,857.75 $6,857.75 40.8×
CT cervical spine with contrast (72126) $7,849.16 $7,849.16 23.5×
CT chest w/wo contrast (71270) $9,309.38 $9,309.38 55.3×
CT chest with contrast (71260) $8,326.30 $8,326.30 49.5×
CT head/brain with contrast (70460) $9,833.09 $9,833.09 58.4×
CT head/brain without and with contrast (70470) $11,067.49 $11,067.49 65.8×
CT heart no contrast quant eval coronry calcium (75571) $56.63 $56.63 0.7×
CT iac w contrast (70481) $7,397.56 $7,397.56 44.0×
CT limited/localized follow up study (76380) $3,935.66 $3,935.66 47.1×
CT lower ext w/o (73700) $4,110.39 $4,110.39 41.0×
CT lower extremity w wo contrast (73702) $4,434.97 $4,434.97 26.4×
CT lower extremity with contrast (73701) $4,110.39 $4,110.39 24.4×
CT lumbar spine w & w/o contrast (72133) $10,770.15 $10,770.15 64.0×
CT lumbar spine w/o contrast (72131) $8,861.63 $8,861.63 88.4×
CT lumbar spine with contrast (72132) $8,861.63 $8,861.63 26.5×
CT maxillofacial w contrast (70487) $6,079.92 $6,079.92 36.1×
CT maxillofacial w/o contrast (70486) $8,761.23 $8,761.23 87.4×
CT neck soft tissue w contrast (70491) $10,086.08 $10,086.08 59.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $10,810.07 $10,810.07 64.2×
CT orbits w/o contrast (70480) $7,397.56 $7,397.56 73.8×
CT pelvis w & w/o contrast (72194) $9,207.82 $9,207.82 54.7×
CT pelvis w/o contrast (72192) $9,093.55 $9,093.55 90.7×
CT soft tissue neck w/o & w/contrast material (70492) $10,828.93 $10,828.93 64.4×
CT soft tissue neck w/o contrast (70490) $10,086.08 $10,086.08 100.6×
CT thoracic spine w/contrast (72129) $9,890.22 $9,890.22 58.8×
CT thoracic spine w/o contrast (72128) $9,890.22 $9,890.22 98.6×
CT thoracic spine w/wo contrast (72130) $8,496.91 $8,496.91 50.5×
CT thorax w/o contrast (71250) $8,326.30 $8,326.30 83.0×
CT upper extremity w/o & w/contrast material (73202) $10,150.98 $10,150.98 60.3×
CT upper extremity w/o contrast rt (73200) $9,042 $9,042 90.1×
CT upper extremity with contrast (73201) $8,761.23 $8,761.23 26.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $11,872.52 $11,872.52 70.6×
Cta Abdomen (74175) $13,091.93 $13,091.93 77.8×
CTA abdomen pelvis (74174) $4,102.09 $4,102.09 12.3×
CTA chest (71275) $10,913.26 $10,913.26 64.9×
Cta Head (70496) $12,673.63 $12,673.63 75.3×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $25,347.26 $25,347.26 75.7×
CTA lwr ext w&w/o contrast (73706) $11,757.66 $11,757.66 69.9×
Cta Neck (70498) $12,673.63 $12,673.63 75.3×
Cystography minimum 3 views rs&i (74430) $867.19 $867.19 2.6×
Dxa bone density study 1/> sites axial skel (77080) $526.14 $526.14 5.2×
Echoencephalography real time imaging (76506) $2,278.63 $2,278.63 22.7×
Esophagus (74220) $2,159.05 $2,159.05 12.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $2,505.33 $2,505.33 25.0×
Fluoroscopy up to 1 hr (76000) $2,449 $2,449 10.7×
Foot 2 views (73620) $1,066 $1,066 12.8×
Forearm 2 views (73090) $791 $791 9.5×
Gated Heart Planar Single (78472) $4,201.94 $4,201.94 11.0×
Hand 2 views (73120) $929.63 $929.63 9.3×
Hand 3 views (73130) $1,008 $1,008 12.1×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,798.29 $1,798.29 3.5×
Hepatobiliary syst imaging including gallbladder (78226) $1,798.29 $1,798.29 4.7×
Ht muscle image spect sing (78451) $5,612.91 $5,612.91 4.5×
Humerus Min 2 Views Left (73060) $1,060 $1,060 12.7×
Hysterosalpingogram (74740) $2,468.52 $2,468.52 10.8×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $4,968.96 $4,968.96 9.5×
Knee 3 views (73562) $1,349 $1,349 16.2×
Lung perf&ventilat diferentl (78598) $1,937.11 $1,937.11 3.7×
Lymphoscintigraphy (78195) $4,983.27 $4,983.27 9.6×
Mlc imrt design & construction per imrt plan (77338) $1,485.69 $1,485.69 4.1×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $65.82 $65.82 2.4×
MRA head w/o contrast (70544) $10,094.98 $10,094.98 44.1×
Mra Neck W/O &W/Contrast Material (70549) $18,610.14 $18,610.14 55.6×
MRA neck w/o contrast (70547) $10,094.98 $10,094.98 44.1×
MRI abdomen w/o & w/contrast material (74183) $12,897.95 $12,897.95 38.5×
MRI abdomen w/o contrast (74181) $10,094.98 $10,094.98 44.1×
MRI any jnt lwr ext with con lt (73722) $12,479.09 $12,479.09 16.6×
MRI any jt upper extremity w/contrast matrl (73222) $12,479.09 $12,479.09 16.6×
MRI c-spine with contrast (72142) $12,479.09 $12,479.09 37.3×
MRI cervical spine w/o contrast (72141) $9,675.22 $9,675.22 42.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $13,384.04 $13,384.04 40.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $9,675.22 $9,675.22 42.3×
MRI orbit face &/neck w/o contrast (70540) $13,177.64 $13,177.64 57.6×
MRI orbit/face/neck w&w/o cont (70543) $15,982.01 $15,982.01 47.8×
MRI pelvis w/o & w/contrast material (72197) $15,313.61 $15,313.61 45.8×
MRI pelvis w/o contrast (72195) $14,294.58 $14,294.58 62.4×
MRI scan of arm joint before and after contrast (73223) $14,462.48 $14,462.48 43.2×
MRI scan of leg joint before and after contrast (73723) $12,479.09 $12,479.09 37.3×
MRI spinal canal cervical w/o & w/contr matrl (72156) $12,479.09 $12,479.09 37.3×
MRI spinal canal lumbar w/contrast material (72149) $13,771.84 $13,771.84 41.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $12,479.09 $12,479.09 37.3×
MRI spinal canal thoracic w/contrast matrl (72147) $13,724.98 $13,724.98 41.0×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $12,479.09 $12,479.09 37.3×
MRI thoracic spine w/o contrast (72146) $9,675.22 $9,675.22 42.3×
MRI tmj (70336) $14,129.91 $14,129.91 61.7×
MRI upper ext joint w/o contrast (73221) $9,675.22 $9,675.22 42.3×
MRI upper extrem other than jt w/o & w/contras (73220) $14,462.48 $14,462.48 43.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $11,077.16 $11,077.16 48.4×
Myocardial Spect Multiple Studies (78452) $5,612.91 $5,612.91 4.5×
Neck soft tissue (70360) $923.39 $923.39 11.1×
Nm cisternogram (78630) $1,512.89 $1,512.89 2.9×
Nm gastric emptying study (78264) $3,228.85 $3,228.85 8.4×
Ntsty modul radthx pln dose-vol histos (77301) $10,142.67 $10,142.67 7.6×
Osseous survey infant (77076) $462.52 $462.52 4.6×
Parathyrd planar w/wo subtrj (78071) $1,262.76 $1,262.76 3.3×
Parathyroid imaging (78070) $2,990.81 $2,990.81 7.8×
Pelvis 1 or 2 views (72170) $1,098 $1,098 10.9×
PET image w/CT, skull-thigh (78815) $5,052.48 $5,052.48 3.7×
PET imaging for CT attenuation whole body (78816) $5,052.48 $5,052.48 3.7×
PET whole body (78813) $5,052.48 $5,052.48 3.7×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $12,479.09 $12,479.09 37.3×
Pulmonary Perfusion Imaging Particulate (78580) $4,151.37 $4,151.37 10.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,937.11 $1,937.11 3.7×
Radex abscess/fistula/sinus tract rs&i (76080) $1,800.35 $1,800.35 3.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $278.65 $278.65 3.3×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $461.47 $461.47 4.6×
Radex hips bilateral with pelvis 2 views (73521) $461.47 $461.47 4.6×
Radiation treatment delivery 1 mev >= complex (77412) $2,900.67 $2,900.67 5.5×
Radiation treatment delivery 1 mev >= simple (77402) $2,139.60 $2,139.60 21.9×
Radiation tx delivery 1 mev >= intermediate (77407) $4,523.29 $4,523.29 12.2×
Radiolog exam mandible compl minimum 4 views (70110) $1,095.23 $1,095.23 10.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $1,186.86 $1,186.86 14.2×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $1,364.22 $1,364.22 16.3×
Radiologic exam colon single contrast study (74270) $2,572.24 $2,572.24 15.3×
Radiologic Exam Esophagus Double Contrast Study (74221) $625.41 $625.41 3.7×
Radiologic exam upr gi trc double contrast study (74246) $3,854.88 $3,854.88 22.9×
Radiologic exam upr gi trc single contrast study (74240) $3,041.09 $3,041.09 18.1×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $278.65 $278.65 3.3×
Radiological examination surgical specimen (76098) $920.64 $920.64 1.8×
Ribs bilateral 3 views (71110) $1,937.01 $1,937.01 19.3×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $4,744.77 $4,744.77 12.4×
Rp loclzj tum spect 1 area single day imaging (78803) $6,596.49 $6,596.49 12.7×
Sacroiliac Joints < 3 Views (72200) $1,151.40 $1,151.40 11.5×
Scanogram (77073) $812.30 $812.30 8.1×
Scapula complete (73010) $419.50 $419.50 4.2×
Screening digital breast tomosynthesis (77063) $83.47 $83.47 3.6×
Small bowel series (74250) $2,999.31 $2,999.31 17.8×
Spec medical radj physics consltj (77370) $4,206.96 $4,206.96 32.6×
Spec telethx port pln parts hemibdy tot bdy (77321) $5,364.57 $5,364.57 14.9×
Special dosimetry (77331) $2,174.21 $2,174.21 16.9×
Special treatment procedure (77470) $5,652.69 $5,652.69 10.7×
Spine thoracic 3 views (72072) $1,730 $1,730 17.2×
Stereotactic body radiation delivery (77373) $6,095.65 $6,095.65 3.6×
Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) $95.40 $95.40 2.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $12,183.11 $12,183.11 33.9×
Ther rad simulaj-aided field setting complex (77290) $6,522.19 $6,522.19 18.2×
Ther rad simulaj-aided field setting simple (77280) $3,332.84 $3,332.84 25.8×
Thoracolumbar 2 views (72080) $949.78 $949.78 11.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,307.94 $1,307.94 3.4×
Tmj unilateral (70328) $1,261.21 $1,261.21 15.1×
Tx devices design & construction complex (77334) $4,491.50 $4,491.50 12.5×
Ultrasound, abdomen limited (76705) $2,858.40 $2,858.40 28.5×
Upper Extremity Infant (73092) $992 $992 9.9×
Us abdl aorta screen aaa (76706) $501.32 $501.32 5.0×
Us breast unilateral complete (76641) $183.04 $183.04 1.8×
Us breast unilateral limited (76642) $183.04 $183.04 2.2×
Us chest (76604) $899.85 $899.85 9.0×
Us compl joint r-t w/image documentation (76881) $2,185.26 $2,185.26 21.8×
Us guided compression repair (76936) $2,364.53 $2,364.53 11.4×
Us kidney transplant (76776) $788.49 $788.49 7.9×
Us ob transvaginal (76817) $2,962.75 $2,962.75 29.5×
Us pelvic non ob complete (76856) $3,409.72 $3,409.72 34.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $1,243.42 $1,243.42 12.4×
Us pregnancy ltd (76815) $1,553.04 $1,553.04 15.5×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $2,474.90 $2,474.90 24.7×
Us retroperitoneal complete (76770) $3,036.19 $3,036.19 30.3×
Us retroperitoneal limited (76775) $2,567.28 $2,567.28 25.6×
Us scrotum and contents (76870) $3,041.19 $3,041.19 30.3×
Us soft tissue head/neck (76536) $2,424.95 $2,424.95 24.2×
Us spinal canal and contents (76800) $788.49 $788.49 7.9×
Us xtr non-vasc lmtd (76882) $1,844.16 $1,844.16 18.4×
Venography caval inferior serialography rs&i (75825) $3,345.32 $3,345.32 1.1×
Venography caval superior serialography rs&i (75827) $4,613.99 $4,613.99 3.1×
Venography extremity unilateral rs&i (75820) $4,149.16 $4,149.16 2.7×
Wrist 2 views (73100) $944 $944 11.3×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $1,377.38 $1,377.38 13.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $945 $945 11.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $793 $793 9.5×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $1,296.68 $1,296.68 15.5×
X-ray exam entire spi 4/5 vw (72083) $417.08 $417.08 4.2×
X-ray exam hip uni 1 view (73501) $278.65 $278.65 3.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $278.65 $278.65 3.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $461.47 $461.47 4.6×
X-Ray Exam Hips Bi 5/> Views (73523) $879.83 $879.83 8.8×
X-ray exam of femur 1 (73551) $278.65 $278.65 3.3×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $905 $905 9.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $988.16 $988.16 11.8×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $1,143 $1,143 13.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $1,145 $1,145 13.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $1,533 $1,533 15.3×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $637 $637 7.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $1,308 $1,308 13.0×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $2,389 $2,389 23.8×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $1,501.71 $1,501.71 15.0×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $989 $989 11.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $620.39 $620.39 7.4×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $1,584.79 $1,584.79 15.8×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $1,908.36 $1,908.36 19.0×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $1,644.06 $1,644.06 4.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $1,371.99 $1,371.99 16.4×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $1,379 $1,379 13.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $2,485 $2,485 24.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $1,113 $1,113 11.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $1,093 $1,093 13.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $1,155 $1,155 13.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $1,747.30 $1,747.30 20.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,222.60 $1,222.60 12.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $844.86 $844.86 8.4×
X-Ray Spine One View - Xr Spine (72020) $754.48 $754.48 9.0×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $1,104.28 $1,104.28 13.2×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $1,677 $1,677 16.7×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $1,608.84 $1,608.84 16.0×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $856 $856 10.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $1,060 $1,060 12.7×
Xr c-spine 6 or more views (72052) $2,625 $2,625 26.2×
Xr finger(s) 2+ views (73140) $837.02 $837.02 10.0×
Xr shoulder 1 view (73020) $604.86 $604.86 7.2×
Xr spine cervical 4 or 5 views (72050) $1,253 $1,253 12.5×
Xr tibia/fibula 2 views (73590) $1,053 $1,053 12.6×
Xr tmj bilateral (70330) $1,613.42 $1,613.42 19.3×
Xray knee 1 or 2 views rt (73560) $694 $694 8.3×