Imaging prices at University of Texas M D Anderson Cancer Center

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

336 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) $6,543
Abdomen 2 views (74019) $587
Angiography Adrenal Bilateral Slctv Rs&I (75733) $4,636
Angiography extremity bilateral rs&i (75716) $3,885
Angiography extremity unilateral rs&i (75710) $3,639
Angiography internal mammary rs&i (75756) $3,292
Angiography pelvic slctv/supraslctv rs&i (75736) $3,709
Angiography pulmonary bilateral slctv rs&i (75743) $5,013
Angiography pulmonary unilateral slctv rs&i (75741) $4,011
Angiography Spinal Selective Rs&I (75705) $6,002
Angiography visceral slctv/supraslctv rs&i (75726) $7,718
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $1,200
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $198
Ankle 2 views (73600) $243
Antegrade urography radiological supvj & interpj (74425) $1,095
Aortogram thoracic (75605) $3,639
Aortography abdl bi iliofem low extrem cath rs&i (75630) $7,521
Aortography abdominal serialography rs&i (75625) $3,639
Artery X-Rays Adrenal Gland (75731) $3,709
Arthrogram hip (73525) $1,655
Arthrogram shoulder (73040) $1,295
Basic radiation dosimetry calculation (77300) $891
Bone age studies (77072) $356
Bone survey complete (77075) $1,142
Brachytx isodose complex (77318) $4,287
Brachytx isodose intermed (77317) $3,283
Brachytx isodose pln smpl w/dosimetry cal (77316) $2,363
Brain Imaging Pet Metabolic Evaluation (78608) $8,814
Cardiac MRI w/w/o contrast & further seq (75561) $3,285
Cervical spine 2 or 3 views (72040) $405
Chest 1 view (71045) $564
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $690
Clavicle complete (73000) $328
Complete single session course of cranial lesion surgery using radiation (77371) $71,624
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,470
Continuing medical physics consltj pr wk (77336) $1,011
CT abdomen and pelvis without and with contrast (74178) $7,944
CT abdomen and pelvis without contrast (74176) $5,606
CT abdomen w contrast (74160) $3,884
CT abdomen w wo contrast (74170) $4,628
CT abdomen w/o contrast (74150) $2,857
CT angio hrt w/3d image (75574) $3,885
CT angiography upper extremity lt (73206) $2,970
CT c-spine w/o contrast (72125) $3,407
CT cervical spine w&w/o contrast (72127) $4,087
CT cervical spine with contrast (72126) $3,749
CT chest w/wo contrast (71270) $4,371
CT chest with contrast (71260) $3,704
CT colonography screening (74263) $2,578
CT colonography w/dye (74262) $2,483
CT colonography w/o cntrst (74261) $2,488
CT head/brain with contrast (70460) $3,406
CT head/brain without and with contrast (70470) $3,599
CT heart contrast eval cardiac structure&morph (75572) $3,332
CT heart no contrast quant eval coronry calcium (75571) $1,004
CT iac w contrast (70481) $3,413
CT limited/localized follow up study (76380) $1,060
CT lower ext w/o (73700) $2,754
CT lower extremity w wo contrast (73702) $3,315
CT lower extremity with contrast (73701) $3,173
CT lumbar spine w & w/o contrast (72133) $4,498
CT lumbar spine w/o contrast (72131) $3,408
CT lumbar spine with contrast (72132) $3,885
CT maxillofacial w contrast (70487) $3,702
CT maxillofacial w/o contrast (70486) $3,045
CT maxillofacial w/wo contrast (70488) $4,072
CT neck soft tissue w contrast (70491) $3,701
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $3,753
CT orbits w/o contrast (70480) $3,084
CT pelvis w & w/o contrast (72194) $3,725
CT pelvis w/o contrast (72192) $3,035
CT soft tissue neck w/o & w/contrast material (70492) $3,935
CT soft tissue neck w/o contrast (70490) $3,142
CT thoracic spine w/contrast (72129) $3,885
CT thoracic spine w/o contrast (72128) $3,408
CT thoracic spine w/wo contrast (72130) $4,087
CT thorax w/o contrast (71250) $3,125
CT upper extremity w/o & w/contrast material (73202) $3,277
CT upper extremity w/o contrast rt (73200) $2,843
CT upper extremity with contrast (73201) $3,123
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,643
Cta Abdomen (74175) $4,503
CTA abdomen pelvis (74174) $7,103
CTA chest (71275) $4,164
Cta Head (70496) $4,240
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $5,485
CTA lwr ext w&w/o contrast (73706) $3,447
Cta Neck (70498) $4,095
Cta Pelvis (72191) $4,082
Cystography minimum 3 views rs&i (74430) $995
Diskogram cervical (72285) $4,628
Diskography lumbar (72295) $4,775
Dx ophthalmic us ant segment immersion uni/bi (76513) $441
Dxa bone density study 1/> sites axial skel (77080) $657
Dxa bone density study 1/>sites appendiclr skel (77081) $312
Dxa bone density study axial skeleton (77085) $826
Esophagus (74220) $641
Fluoroscopy up to 1 hr (76000) $495
Foot 2 views (73620) $237
Forearm 2 views (73090) $484
Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) $218
Functional MRI brain by phys/psych (70555) $4,560
Functional MRI brain by tech (70554) $4,982
Hand 3 views (73130) $302
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $6,394
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $8,146
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $9,148
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $3,639
Humerus Min 2 Views Left (73060) $328
Hysterosalpingogram (74740) $1,251
Interstitial radiation source applic complex (77778) $2,567
Intracavitary Radiation Source Applic Complex (77763) $2,709
Intracavitary Radiation Source Applic Intermed (77762) $2,329
Knee 3 views (73562) $371
Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) $1,699
Lymphangio extrem unilat - ir lymphangiogram extremity (75801) $1,504
Lymphangiography extremity only bilateral rs&i (75803) $154
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $1,048
Mammary ductogram or galactogram multiple (77054) $789
Mammary ductogram or galactogram single (77053) $668
Mlc imrt design & construction per imrt plan (77338) $4,989
Mr elastography (76391) $4,942
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $93
Mr safety med physics xm customization plng&mntr (76017) $387
MRA head w & w/o contrast (70546) $3,764
MRA head w/o contrast (70544) $2,976
MRA head with contrast (70545) $3,326
MRA neck w contrast (70548) $3,327
Mra Neck W/O &W/Contrast Material (70549) $3,730
MRA neck w/o contrast (70547) $2,976
MRI abdomen w contrast (74182) $5,362
MRI abdomen w/o & w/contrast material (74183) $6,781
MRI abdomen w/o contrast (74181) $4,719
MRI any jt upper extremity w/contrast matrl (73222) $4,667
MRI bone marrow blood supply (77084) $10,617
MRI breast w/o contrast bilateral (77047) $4,856
MRI breast w/o contrast unilat (77046) $4,670
MRI c-spine with contrast (72142) $5,480
MRI cardiac w/o contrast (75557) $2,149
MRI cervical spine w/o contrast (72141) $4,971
MRI chest w/o & w/contrast material (71552) $6,553
MRI chest w/o contrast (71550) $4,268
MRI chest with contrast (71551) $4,766
MRI lower extrem oth/thn jt w/contrast matrl (73719) $4,758
MRI lower extrem oth/thn jt w/o contr matrl (73718) $4,495
MRI orbit face &/neck w/o contrast (70540) $4,603
MRI orbit/face/neck w&w/o cont (70543) $6,564
MRI orbit/face/neck w/contrast (70542) $4,814
MRI pelvis w contrast (72196) $5,786
MRI pelvis w/o & w/contrast material (72197) $6,469
MRI pelvis w/o contrast (72195) $4,715
MRI scan of arm joint before and after contrast (73223) $6,193
MRI scan of leg joint before and after contrast (73723) $6,427
MRI spectroscopy (76390) $3,585
MRI spinal canal cervical w/o & w/contr matrl (72156) $7,004
MRI spinal canal lumbar w/contrast material (72149) $5,277
MRI spinal canal lumbar w/o & w/contr matrl (72158) $6,878
MRI spinal canal thoracic w/contrast matrl (72147) $5,050
MRI spinal canal thoracic w/o & w/contr matrl (72157) $7,079
MRI thoracic spine w/o contrast (72146) $4,459
MRI tmj (70336) $4,294
MRI upper ext joint w/o contrast (73221) $4,317
MRI upper extrem other than jt w/o & w/contras (73220) $5,932
MRI upper extremity oth than jt w/o contr matrl (73218) $4,248
Myelogram Cervical (72240) $2,609
Myelogram Lumbar (72265) $2,526
Myelogram thoracic (72255) $2,955
Myelography 2 or more regions (72270) $3,788
Myocardial Imaging Pet Metabolic Evaluation (78459) $6,970
Neck soft tissue (70360) $353
Ntsty modul radthx pln dose-vol histos (77301) $10,147
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $8,185
Nuclear medicine study from skull base to mid-thigh (78812) $8,715
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $3,230
Ophthalmic us dx quantitative a-scan only (76511) $571
Orthopantogram (70355) $338
Osseous survey infant (77076) $400
Osseous survey limited (77074) $723
Pelvis 1 or 2 views (72170) $385
Peritoneogram rs&i (74190) $292
PET image w/CT, skull-thigh (78815) $9,085
PET imaging CT for attenuation limited area (78814) $8,109
PET imaging for CT attenuation whole body (78816) $9,085
PET imaging limited area chest head/neck (78811) $8,109
PET whole body (78813) $9,291
Pr MRI brain w/ dye (70558) $5,528
Pr MRI brain w/o & w/ dye (70559) $6,950
Pr MRI brain w/o dye (70557) $4,510
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $6,176
Proton trmt simple w/comp (77522) $5,331
Proton tx delivery complex (77525) $7,535
Proton tx delivery intermediate (77523) $6,380
Proton tx delivery simple w/o compensation (77520) $4,531
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $4,841
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $3,547
Radex abscess/fistula/sinus tract rs&i (76080) $971
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $577
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $650
Radex hips bilateral with pelvis 2 views (73521) $513
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $802
Radiation Delivery Stereotactic Cranial Linear (77372) $31,182
Radiation treatment delivery 1 mev >= complex (77412) $4,730
Radiation treatment delivery 1 mev >= simple (77402) $2,713
Radiation tx delivery 1 mev >= intermediate (77407) $4,178
Radiolog exam mandible compl minimum 4 views (70110) $411
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $565
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $616
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $591
Radiologic exam colon single contrast study (74270) $881
Radiologic Exam Esophagus Double Contrast Study (74221) $797
Radiologic exam teeth prtl exam < full mouth (70310) $130
Radiologic exam upr gi trc double contrast study (74246) $878
Radiologic exam upr gi trc single contrast study (74240) $669
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $432
Radiological examination surgical specimen (76098) $326
Review by radiologist of adrenal gland vein image (75840) $3,333
Review by radiologist of liver vein image with assessment of blood flow (75889) $3,639
Ribs bilateral 3 views (71110) $497
Sacroiliac Joints < 3 Views (72200) $231
Saline Infus Sonohysterography W/Color Doppler (76831) $251
Scanogram (77073) $531
Scapula complete (73010) $341
Screening digital breast tomosynthesis (77063) $180
Simulation intermediate (77285) $2,185
Small bowel series (74250) $790
Spec medical radj physics consltj (77370) $1,431
Spec telethx port pln parts hemibdy tot bdy (77321) $1,684
Special dosimetry (77331) $1,007
Special treatment procedure (77470) $3,582
Spine thoracic 3 views (72072) $452
Splenoportograpy rs&i (75810) $193
Stereotactic body radiation delivery (77373) $18,191
Superior sagittal sinus venogram (75870) $212
Surface Applic Low Dose Rate Radionuclide Source (77789) $124
Tbs Technical Calculation Only (77091) $67
Telethx isodose pln cplx w/basic dosimetry (77307) $4,129
Telethx isodose pln smpl w/dosimetry calculation (77306) $3,900
Ther rad simulaj-aided field setting complex (77290) $3,026
Ther rad simulaj-aided field setting simple (77280) $1,443
Thoracolumbar 2 views (72080) $315
Treatment device intermediate (77333) $1,059
Treatment devices simple (77332) $700
Tx devices design & construction complex (77334) $1,358
Ultrasound elastography first target lesion (76982) $1,390
Ultrasound scan of cornea to determine thickness (76514) $64
Ultrasound scan to determine eye length and lens power (76519) $501
Ultrasound trgt dynamic microbubble 1st lesion (76978) $1,776
Ultrasound, abdomen limited (76705) $795
Unlisted Diagnostic Radiographic Procedure (76499) $547
Unlisted fluoroscopic procedure (76496) $454
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine UNSCHEDULED (78199) $2,864
Unlisted magnetic resonance procedure (76498) $7,835.50
Upper Extremity Infant (73092) $264
Urethrocystography retrograde rs&i (74450) $189
Urethrocystography voiding (74455) $792
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $1,231
Us breast unilateral complete (76641) $1,401
Us breast unilateral limited (76642) $1,124
Us chest (76604) $642
Us compl joint r-t w/image documentation (76881) $774
Us elastography parenchyma (76981) $1,390
Us guided compression repair (76936) $1,133
Us kidney transplant (76776) $979
Us ob transvaginal (76817) $668
Us pelvic non ob complete (76856) $1,082
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $627
Us pregnancy ltd (76815) $126
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $519
Us retroperitoneal complete (76770) $812
Us retroperitoneal limited (76775) $719
Us scrotum and contents (76870) $894
Us soft tissue head/neck (76536) $911
Us transrectal (76872) $756
Us transrectal prostate volume (76873) $582
Us xtr non-vasc lmtd (76882) $593
Us, eye b-scan (76512) $635
Venogram extremity bilateral (75822) $1,177
Venography caval inferior serialography rs&i (75825) $3,639
Venography caval superior serialography rs&i (75827) $1,177
Venography epidural rs&i (75872) $210
Venography extremity unilateral rs&i (75820) $1,153
Venography Renal Bilateral (75833) $4,548
Venography renal unilateral selective rs&i (75831) $3,639
Venography venous sinus/jugular cath rs&i (75860) $263
Venous sampling thru cath w/wo angiography rs& (75893) $3,639
Vertebral fracture assessment via dxa (77086) $826
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $580
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $311
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $313
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,040
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $319
X-ray exam entire spi 4/5 vw (72083) $779
X-ray exam hip uni 1 view (73501) $379
X-Ray Exam Hip Uni 2-3 Views (73502) $420
X-ray exam hip uni 4/> views (73503) $520
X-Ray Exam Hips Bi 3-4 Views (73522) $578
X-Ray Exam Hips Bi 5/> Views (73523) $641
X-ray exam of femur 1 (73551) $390
X-ray eye for foreign body (70030) $470
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $375
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $292
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $342
X-ray guide gu dilation - ir nephrostomy dilation (74485) $1,250
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $289
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $295
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $369
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $297
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $350
X-Ray Nasal Bones - Xr Nasal Bones (70160) $272
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $363
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $505
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $1,231
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $233
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $254
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $422
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $387
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $356
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $289
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $510
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $312
X-Ray Spine One View - Xr Spine (72020) $267
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $353
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $358
X-Ray Teeth Single - Xr Teeth 1 View (70300) $98
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $387
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $561
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $225
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $337
Xr chest 4+ views (71048) $616
Xr finger(s) 2+ views (73140) $237
Xr myelogram posterior fossa (70010) $645
Xr shoulder 1 view (73020) $285
Xr spine cervical 4 or 5 views (72050) $551
Xr tibia/fibula 2 views (73590) $346
Xr tmj bilateral (70330) $434
Xray knee 1 or 2 views rt (73560) $300