Imaging prices at West Tennessee Healthcare Henry County Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $408 $408 4.3×
Acute gastrointestinal blood loss imaging (78278) $1,158 $1,158 3.2×
Angiography extremity bilateral rs&i (75716) $6,346 $6,346 2.2×
Angiography extremity unilateral rs&i (75710) $6,238 $6,238 2.2×
Angiography visceral slctv/supraslctv rs&i (75726) $3,296 $3,296 0.7×
Ankle 2 views (73600) $254 $254 3.2×
Antegrade urography radiological supvj & interpj (74425) $381 $381 1.2×
Aortogram thoracic (75605) $4,181 $4,181 0.8×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $3,703 $3,703 1.3×
Aortography abdominal serialography rs&i (75625) $6,058 $6,058 2.1×
Basic radiation dosimetry calculation (77300) $356 $356 2.9×
Bone &/Joint Imaging Limited Area (78300) $1,132 $1,132 3.1×
Bone &/joint imaging whole body (78306) $1,760 $1,760 4.9×
Bone age studies (77072) $198 $198 2.1×
Bone Imaging 3 Phase (78315) $1,809 $1,809 5.0×
Bone survey complete (77075) $537 $537 5.7×
Brachytx isodose complex (77318) $2,219 $2,219 6.5×
Cervical spine 2 or 3 views (72040) $295 $295 3.7×
Chest 1 view (71045) $254 $254 3.2×
Chest 3 views (71047) $386 $386 4.9×
Clavicle complete (73000) $243 $243 3.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $550 $550 5.8×
Continuing medical physics consltj pr wk (77336) $356 $356 2.9×
CT abdomen and pelvis without and with contrast (74178) $4,547 $4,547 14.4×
CT abdomen and pelvis without contrast (74176) $3,751 $3,751 17.3×
CT abdomen w contrast (74160) $2,013 $2,013 12.6×
CT abdomen w wo contrast (74170) $2,273 $2,273 14.3×
CT abdomen w/o contrast (74150) $2,013 $2,013 21.2×
CT angiography upper extremity lt (73206) $1,906 $1,906 12.0×
CT c-spine w/o contrast (72125) $1,821 $1,821 19.2×
CT cervical spine w&w/o contrast (72127) $2,273 $2,273 14.3×
CT cervical spine with contrast (72126) $2,013 $2,013 6.4×
CT chest w/wo contrast (71270) $2,190 $2,190 13.8×
CT chest with contrast (71260) $1,906 $1,906 12.0×
CT head/brain with contrast (70460) $1,916 $1,916 12.0×
CT head/brain without and with contrast (70470) $2,190 $2,190 13.8×
CT heart no contrast quant eval coronry calcium (75571) $99 $99 1.3×
CT iac w contrast (70481) $1,366 $1,366 8.6×
CT limited/localized follow up study (76380) $1,320.50 $1,320.50 16.7×
CT lower ext w/o (73700) $1,489 $1,489 15.7×
CT lower extremity w wo contrast (73702) $1,898 $1,898 11.9×
CT lower extremity with contrast (73701) $1,591 $1,591 10.0×
CT lumbar spine w & w/o contrast (72133) $2,273 $2,273 14.3×
CT lumbar spine w/o contrast (72131) $1,966 $1,966 20.7×
CT lumbar spine with contrast (72132) $1,966 $1,966 6.2×
CT maxillofacial w contrast (70487) $1,841 $1,841 11.6×
CT maxillofacial w/o contrast (70486) $1,841 $1,841 19.4×
CT maxillofacial w/wo contrast (70488) $2,190 $2,190 13.8×
CT neck soft tissue w contrast (70491) $1,547 $1,547 9.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,867 $1,867 11.7×
CT orbits w/o contrast (70480) $1,366 $1,366 14.4×
CT pelvis w & w/o contrast (72194) $2,098 $2,098 13.2×
CT pelvis w/o contrast (72192) $1,922 $1,922 20.3×
CT soft tissue neck w/o & w/contrast material (70492) $1,821 $1,821 11.4×
CT soft tissue neck w/o contrast (70490) $1,547 $1,547 16.3×
CT thoracic spine w/contrast (72129) $1,906 $1,906 12.0×
CT thoracic spine w/o contrast (72128) $1,821 $1,821 19.2×
CT thoracic spine w/wo contrast (72130) $2,273 $2,273 14.3×
CT thorax w/o contrast (71250) $1,906 $1,906 20.1×
CT upper extremity w/o & w/contrast material (73202) $1,873 $1,873 11.8×
CT upper extremity w/o contrast rt (73200) $1,489 $1,489 15.7×
CT upper extremity with contrast (73201) $1,591 $1,591 5.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,561 $2,561 16.1×
Cta Abdomen (74175) $1,906 $1,906 12.0×
CTA abdomen pelvis (74174) $3,811 $3,811 12.0×
CTA chest (71275) $1,906 $1,906 12.0×
Cta Head (70496) $1,906 $1,906 12.0×
CTA lwr ext w&w/o contrast (73706) $1,906 $1,906 12.0×
Cta Neck (70498) $1,906 $1,906 12.0×
Cta Pelvis (72191) $1,906 $1,906 12.0×
Cystography minimum 3 views rs&i (74430) $796 $796 2.5×
Dxa bone density study 1/> sites axial skel (77080) $583 $583 6.1×
Echoencephalography real time imaging (76506) $1,102 $1,102 11.6×
Esophagus (74220) $401 $401 2.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $373 $373 3.9×
Fluoroscopy up to 1 hr (76000) $341 $341 1.6×
Foot 2 views (73620) $195 $195 2.5×
Forearm 2 views (73090) $254 $254 3.2×
Gated Heart Planar Single (78472) $1,511 $1,511 4.2×
Hand 2 views (73120) $254 $254 2.7×
Hand 3 views (73130) $279 $279 3.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,693 $1,693 3.4×
Hepatobiliary syst imaging including gallbladder (78226) $1,556 $1,556 4.3×
Ht muscle image spect sing (78451) $1,693 $1,693 1.4×
Humerus Min 2 Views Left (73060) $254 $254 3.2×
Hysterosalpingogram (74740) $362 $362 1.7×
Interstitial radiation source applic complex (77778) $2,685 $2,685 4.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,333 $1,333 2.7×
Kidney img morphology vascular flow 1 w/rx (78708) $1,548 $1,548 3.1×
Knee 3 views (73562) $299 $299 3.8×
Liver & spleen imaging static only (78215) $1,898 $1,898 5.2×
Liver imaging static only (78201) $995 $995 2.0×
Lung perf&ventilat diferentl (78598) $1,459 $1,459 3.0×
Lung perfusion differential (78597) $730 $730 2.0×
Lung Ventilation Imaging (78579) $1,140 $1,140 3.1×
Lymphoscintigraphy (78195) $1,254 $1,254 2.5×
Manual appl stress pfrmd phys/qhp joint films (77071) $198 $198 2.5×
Meckels Diverticulum (78290) $1,158 $1,158 3.2×
MRA head w/o contrast (70544) $2,694 $2,694 12.4×
MRA head with contrast (70545) $2,833 $2,833 9.0×
MRA neck w contrast (70548) $2,833 $2,833 9.0×
MRA neck w/o contrast (70547) $2,694 $2,694 12.4×
MRI abdomen w contrast (74182) $1,472 $1,472 4.7×
MRI abdomen w/o & w/contrast material (74183) $1,779 $1,779 5.6×
MRI abdomen w/o contrast (74181) $1,096 $1,096 5.1×
MRI any jnt lwr ext with con lt (73722) $2,833 $2,833 4.0×
MRI any jt upper extremity w/contrast matrl (73222) $2,833 $2,833 4.0×
MRI c-spine with contrast (72142) $2,833 $2,833 9.0×
MRI cervical spine w/o contrast (72141) $2,833 $2,833 13.1×
MRI chest w/o & w/contrast material (71552) $3,040 $3,040 9.6×
MRI chest w/o contrast (71550) $2,694 $2,694 12.4×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $2,833 $2,833 9.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,833 $2,833 9.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,694 $2,694 12.4×
MRI orbit face &/neck w/o contrast (70540) $2,694 $2,694 12.4×
MRI orbit/face/neck w&w/o cont (70543) $3,040 $3,040 9.6×
MRI orbit/face/neck w/contrast (70542) $2,833 $2,833 9.0×
MRI pelvis w contrast (72196) $1,472 $1,472 4.7×
MRI pelvis w/o & w/contrast material (72197) $2,263.50 $2,263.50 7.2×
MRI pelvis w/o contrast (72195) $1,895 $1,895 8.8×
MRI scan of arm joint before and after contrast (73223) $3,040 $3,040 9.6×
MRI scan of leg joint before and after contrast (73723) $3,040 $3,040 9.6×
MRI spinal canal cervical w/o & w/contr matrl (72156) $3,040 $3,040 9.6×
MRI spinal canal lumbar w/contrast material (72149) $2,694 $2,694 8.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $3,040 $3,040 9.6×
MRI spinal canal thoracic w/contrast matrl (72147) $2,833 $2,833 9.0×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $3,040 $3,040 9.6×
MRI thoracic spine w/o contrast (72146) $2,694 $2,694 12.4×
MRI tmj (70336) $1,808 $1,808 8.4×
MRI upper ext joint w/o contrast (73221) $2,694 $2,694 12.4×
MRI upper extrem other than jt w/o & w/contras (73220) $3,040 $3,040 9.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,694 $2,694 12.4×
Myelogram Lumbar (72265) $1,475 $1,475 2.1×
Myelography 2 or more regions (72270) $1,475 $1,475 2.1×
Myocardial Spect Multiple Studies (78452) $4,950 $4,950 4.2×
Neck soft tissue (70360) $188 $188 2.4×
Nm gastric emptying study (78264) $1,403 $1,403 3.9×
Nm gastroesophageal reflux study (78262) $1,094 $1,094 3.0×
Nuclear Rx Oral Admin (79005) $903 $903 4.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $519 $519 5.5×
Osseous survey infant (77076) $315 $315 3.3×
Parathyrd planar w/wo subtrj (78071) $1,292 $1,292 3.6×
Parathyroid imaging (78070) $780 $780 2.2×
Pelvis 1 or 2 views (72170) $269 $269 2.8×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $4,578 $4,578 14.5×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,896 $1,896 3.8×
Radex abscess/fistula/sinus tract rs&i (76080) $620 $620 1.3×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $172 $172 2.2×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $242 $242 2.6×
Radex hips bilateral with pelvis 2 views (73521) $423 $423 4.5×
Radex mastoids compl minimum 3 views pr side (70130) $287 $287 3.0×
Radiolog exam mandible compl minimum 4 views (70110) $262 $262 2.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $269 $269 3.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $408 $408 4.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $346 $346 4.4×
Radiologic exam colon single contrast study (74270) $718 $718 4.5×
Radiologic Exam Esophagus Double Contrast Study (74221) $400 $400 2.5×
Radiologic exam upr gi trc double contrast study (74246) $909 $909 5.7×
Radiologic exam upr gi trc single contrast study (74240) $909 $909 5.7×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $198 $198 2.5×
Rp loclzj tum plnr whole body single day imaging (78802) $2,198.50 $2,198.50 4.5×
Rp loclzj tum spect 1 area single day imaging (78803) $2,753 $2,753 5.6×
Rp Therapy Intravenous Administration (79101) $716 $716 3.4×
Sacroiliac Joints < 3 Views (72200) $148 $148 1.6×
Saline Infus Sonohysterography W/Color Doppler (76831) $743 $743 3.4×
Scapula complete (73010) $245 $245 2.6×
Screening digital breast tomosynthesis (77063) $130 $130 5.6×
Simulation intermediate (77285) $793 $793 2.3×
Small bowel series (74250) $510 $510 3.2×
Spec medical radj physics consltj (77370) $470 $470 3.9×
Special dosimetry (77331) $356 $356 2.9×
Special treatment procedure (77470) $1,186 $1,186 2.4×
Spine thoracic 3 views (72072) $302 $302 3.2×
Ther rad simulaj-aided field setting complex (77290) $546.50 $546.50 1.6×
Ther rad simulaj-aided field setting simple (77280) $240 $240 2.0×
Thyroid carcinoma metastases img whole body (78018) $1,637 $1,637 3.3×
Thyroid Imaging With Vascular Flow (78013) $722 $722 2.0×
Thyroid uptake measurement (78012) $549 $549 1.5×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $801 $801 2.2×
Treatment device intermediate (77333) $584 $584 4.8×
Treatment devices simple (77332) $584 $584 4.8×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,886 $1,886 5.2×
Tx devices design & construction complex (77334) $584 $584 1.7×
Ultrasound, abdomen limited (76705) $458 $458 4.8×
Umbilical-artery Doppler (OB) (76820) $260 $260 2.7×
Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) $1,367 $1,367 3.8×
Unlisted miscellaneous px dx nuclear medicine (78999) $1,367 $1,367 3.8×
Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) $1,367 $1,367 3.8×
Upper Extremity Infant (73092) $198 $198 2.1×
Urethrocystography retrograde rs&i (74450) $729 $729 3.4×
Urethrocystography voiding (74455) $713 $713 3.3×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $729 $729 4.6×
Us abdl aorta screen aaa (76706) $169 $169 1.8×
Us breast unilateral limited (76642) $320 $320 4.1×
Us chest (76604) $420 $420 4.4×
Us compl joint r-t w/image documentation (76881) $454 $454 4.8×
Us ob detailed single fetus (76811) $706 $706 3.3×
Us ob transvaginal (76817) $504 $504 5.3×
Us pelvic non ob complete (76856) $787 $787 8.3×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $494 $494 5.2×
Us pregnancy ltd (76815) $342 $342 3.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $532 $532 5.6×
Us retroperitoneal complete (76770) $816 $816 8.6×
Us retroperitoneal limited (76775) $816 $816 8.6×
Us scrotum and contents (76870) $518 $518 5.5×
Us soft tissue head/neck (76536) $463.50 $463.50 4.9×
Us spinal canal and contents (76800) $462 $462 4.9×
Us transrectal (76872) $768 $768 8.1×
Us transrectal prostate volume (76873) $759 $759 8.0×
Us xtr non-vasc lmtd (76882) $613 $613 6.5×
Venography caval inferior serialography rs&i (75825) $6,058 $6,058 2.1×
Venography caval superior serialography rs&i (75827) $2,858 $2,858 2.0×
Venography extremity unilateral rs&i (75820) $2,117 $2,117 1.5×
Wrist 2 views (73100) $247 $247 3.1×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $537 $537 5.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $254 $254 3.2×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $279 $279 3.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $778 $778 4.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $224 $224 2.8×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $304 $304 3.9×
X-ray exam entire spi 4/5 vw (72083) $252 $252 2.7×
X-ray exam hip uni 1 view (73501) $198 $198 2.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $210 $210 2.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $455 $455 4.8×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $346 $346 3.6×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $241 $241 3.1×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $279 $279 3.5×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $217 $217 2.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $334 $334 3.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $254 $254 3.2×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $198 $198 2.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $302 $302 3.2×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $473 $473 5.0×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $222 $222 2.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $210 $210 2.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $222 $222 2.3×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $729 $729 2.3×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $304 $304 3.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $298 $298 3.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $541 $541 5.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $279 $279 3.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $254 $254 3.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $329 $329 4.2×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $166 $166 2.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $351 $351 3.7×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $174 $174 1.8×
X-Ray Spine One View - Xr Spine (72020) $188 $188 2.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $254 $254 3.2×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $302 $302 3.2×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $189 $189 2.4×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $286 $286 3.6×
Xr c-spine 6 or more views (72052) $401 $401 4.2×
Xr chest 4+ views (71048) $397 $397 4.2×
Xr finger(s) 2+ views (73140) $189 $189 2.4×
Xr shoulder 1 view (73020) $188 $188 2.4×
Xr spine cervical 4 or 5 views (72050) $382 $382 4.0×
Xr tibia/fibula 2 views (73590) $276 $276 3.5×
Xr tmj bilateral (70330) $300 $300 3.8×
Xray knee 1 or 2 views rt (73560) $254 $254 3.2×