Imaging prices at Tyler County Hospital

Woodville, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $129 $172 1.5×
Abdomen 2 views (74019) $129 $172 1.2×
Ankle 2 views (73600) $129 $172 1.5×
Bone age studies (77072) $129 $172 1.2×
Chest 1 view (71045) $129 $172 1.5×
Chest 2 views (71046) $129 $172 1.5×
Chest 3 views (71047) $129 $172 1.5×
Chest 4 or more views (71048) $129 $172 1.2×
Clavicle complete (73000) $129 $172 1.5×
CT abdomen and pelvis without and with contrast (74178) $964 $1,285 2.8×
CT abdomen and pelvis without contrast (74176) $561 $748 2.3×
CT abdomen w contrast (74160) $884 $1,179 5.0×
CT abdomen w wo contrast (74170) $101 $135 0.6×
CT abdomen w/o contrast (74150) $558 $744 5.3×
CT Angio Chest (71275) $1,010 $1,347 5.7×
CT bone density (77078) $209 $278 2.4×
CT cervical spine w/ contrast (72126) $864 $1,152 2.5×
CT cervical spine w/o contrast (72125) $558 $744 5.3×
CT chest w contrast (71260) $884 $1,179 5.0×
CT chest w/wo contrast (71270) $101 $135 0.6×
CT head/brain with contrast (70460) $74 $99 0.4×
CT head/brain without and with contrast (70470) $101 $135 0.6×
CT iac w contrast (70481)
range across 3 matching MRF lines		 $558–$884 $744–$1,179 varies
CT lower ext w/o (73700) $558 $744 5.3×
CT lower extremity w/contrast material (73701) $864 $1,152 4.9×
CT lumbar spine w contrast (72132) $864 $1,152 2.5×
CT lumbar spine w/o contrast (72131) $558 $744 5.3×
CT maxillofacial w contrast (70487) $884 $1,179 5.0×
CT maxillofacial wo contrast (70486) $558 $744 5.3×
CT neck tissue combo (70492) $101 $135 0.6×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482)
range across 3 matching MRF lines		 $558–$864 $744–$1,152 varies
CT orbits w/o contrast (70480) $558 $744 5.3×
CT pelvis w&w/o contrast (72194) $9 $12 0.1×
CT pelvis w/o contrast (72192) $558 $744 5.3×
CT scan of leg combo (73702) $101 $135 0.6×
CT scans face/jaw combo (70488)
range across 2 matching MRF lines		 $101–$884 $135–$1,179 varies
CT soft tissue neck w contrast (70491) $884 $1,179 5.0×
CT soft tissue neck w/o contrast (70490) $558 $744 5.3×
CT thoracic spine w contrast (72129) $864 $1,152 4.9×
CT thoracic spine w/o contrast (72128) $558 $744 5.3×
CT thorax w/o contrast (71250) $558 $744 5.3×
CT upper ext wo (73200) $558 $744 5.3×
CT upper extremity w/o & w/contrast material (73202) $101 $135 0.6×
CT upper extremity with contrast (73201) $864 $1,152 2.5×
Esophagram (74220) $254 $338 1.4×
Fluoroscopy up to 1 hr (76000) $243 $324 1.0×
Foot 2 views (73620) $129 $172 1.5×
Forearm 2 views (73090) $129 $172 1.5×
Hand 2 views (73120) $129 $172 1.2×
Joint Survey Single View (77077) $129 $172 1.2×
Knee 3 Views (73562) $129 $172 1.5×
Neck soft tissue (70360) $129 $172 1.5×
Nm whole blood volume (78122)
range across 2 matching MRF lines		 $3–$20 $4–$26 varies
Pelvis 1 or 2 views (72170) $129 $172 1.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $215 $286 2.0×
Radex Ankle Complete Minimum 3 Views (73610) $129 $172 1.5×
Radex Calcaneus Minimum 2 Views (73650) $129 $172 1.5×
Radex elbow complete minimum 3 views (73080) $129 $172 1.5×
Radex Facial Bones Complete Minimum 3 Views (70150)
range across 4 matching MRF lines		 $128–$129 $170–$172 varies
Radex fingr minimum 2 views (73140) $129 $172 1.5×
Radex foot complete minimum 3 views (73630) $129 $172 1.5×
Radex Hand Minimum 3 Views (73130) $129 $172 1.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $129 $172 1.5×
Radex Ribs Unilateral 2 Views (71100) $129 $172 1.5×
Radex shoulder complete minimum 2 views (73030) $129 $172 1.5×
Radex Sinuses Paransl < 3 Views (70210) $129 $172 1.5×
Radex Spine 1 View Specify Level (72020) $129 $172 1.5×
Radex Sternum Minimum 2 Views (71120) $129 $172 1.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $129 $172 1.5×
Radex Toe Minimum 2 Views (73660) $129 $172 1.5×
Radex Wrist Complete Minimum 3 Views (73110) $129 $172 1.5×
Radiolog exam mandible compl minimum 4 views (70110) $129 $172 1.2×
Radiologic exam colon double contrast study (74280) $411 $548 2.3×
Radiologic exam colon single contrast study (74270) $254 $338 1.4×
Radiologic exam knee complete 4/more views (73564) $129 $172 1.2×
Radiologic exam pelvis compl minimum 3 views (72190) $129 $172 1.2×
Radiologic Exam Small Int Single Contrast Study (74250) $254 $338 1.4×
Radiologic exam swallow function contrast study (74230) $254 $338 1.4×
Radiologic examination femur minimum 2 views (73552) $129 $172 1.5×
Radiologic examination knee 1/2 views (73560) $129 $172 1.5×
Radiologic examination tibia & fibula 2 views (73590) $129 $172 1.5×
Red Cell Volume Determination Spx 1 Sampling (78120) $44 $59 0.1×
Red Cell Volume Determination Spx Mult Samplings (78121)
range across 2 matching MRF lines		 $4–$7 $5–$9 varies
Ribs bilateral 3 views (71110) $129 $172 1.2×
Scapula (73010) $129 $172 1.2×
Shoulder 1 view (73020) $129 $172 1.5×
Skull less than 4 views (70250) $129 $172 1.2×
Sternoclavicular joints (71130) $129 $172 1.5×
Thoracic spine 2 views (72070) $129 $172 1.2×
Thoracic spine 3 views (72072) $129 $172 1.2×
Thoracolumbar 2 views (72080) $129 $172 1.5×
Ultrasound Breast Limited (76642) $180 $240 2.1×
Ultrasound, abdomen limited (76705) $281 $374 2.7×
Urethrocystogram voiding (74455) $500 $666 2.1×
Us breast unilateral complete (76641) $180 $240 1.7×
Us complete joint (76881) $281 $374 2.7×
Us exam, pelvic, limited (76857) $180 $240 1.7×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $281 $374 2.7×
Us ob limited 1 or more fetuses (76815) $180 $240 1.7×
Us pelvic non ob complete (76856) $281 $374 2.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $180 $240 1.7×
Us retroperitoneal complete (76770) $281 $374 2.7×
Us retroperitoneal limited (76775) $281 $374 2.7×
Us scrotum and contents (76870) $281 $374 2.7×
Us thyroid (76536) $281 $374 2.7×
Wrist 2 views (73100) $129 $172 1.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $129 $172 1.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $129 $172 1.5×
X-Ray Exam Entire Spi 2/3 Vw (72082) $129 $172 1.2×
X-Ray Exam Hip Uni 1 View (73501) $129 $172 1.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $129 $172 1.5×
X-Ray Exam Hips Bi 2 Views (73521) $215 $286 2.0×
X-Ray Exam L-S Spine Bending (72114) $129 $172 1.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $129 $172 1.5×
X-Ray Exam Neck Spine 6/>Vws (72052) $215 $286 2.0×
X-Ray Exam Unilat Ribs/Chest (71101)
range across 3 matching MRF lines		 $129–$215 $172–$286 varies
X-ray eye for foreign body (70030) $129 $172 1.5×
X-ray humerus (73060) $129 $172 1.5×
X-ray IV pyelogram (ivp) (74400) $500 $666 2.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $129 $172 1.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $129 $172 1.2×
X-ray nose-rectum child f.b. (76010) $129 $172 1.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $215 $286 2.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $129 $172 1.2×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $129 $172 1.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $129 $172 1.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $129 $172 1.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $215 $286 2.0×
X-Rays Bone Survey Complete (77075) $129 $172 1.2×
Xr c-spine 4 or 5 views (72050) $215 $286 2.0×
Xr facial bones less than 3 views (70140) $129 $172 1.5×
XR Mastoids < 3 Views Bilateral (70120) $129 $172 1.2×
Xr orbits complete 4 views (70200) $129 $172 1.2×

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.