Imaging prices at Woman's Hospital

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

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $3,923 $3,923 3.1×
Abdomen 1 View (74018) $331 $331 4.2×
Abdomen 2 views (74019) $430 $430 4.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,137 $1,137 3.1×
Adrenal Cortex & Medulla Img (78075) $594 $594 0.5×
Artery X-Rays Pelvis (75736) $6,166 $6,166 1.2×
Arthrogram hip (73525) $1,112 $1,112 3.5×
Arthrogram Wrist (73115) $1,115 $1,115 3.5×
Basic radiation dosimetry calculation (77300) $598 $598 4.9×
Bone age studies (77072) $340 $340 3.6×
Bone Imaging 3 Phase (78315) $1,110 $1,110 3.1×
Bone Imaging Limited Area (78300) $1,106 $1,106 3.1×
Bone Imaging Whole Body (78306) $1,853 $1,853 5.1×
Bone marrow imaging limited area (78102) $408 $408 1.1×
Bone marrow imaging; multiple areas (78103) $325 $325 0.9×
Bone marrow imaging; whole body (78104) $325 $325 0.9×
Bone survey infant (77076) $309 $309 3.3×
Brachytx isodose complex (77318) $883 $883 2.6×
Brachytx isodose intermed (77317) $883 $883 2.6×
Brachytx Isodose Plan Simple (77316) $883 $883 2.6×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,480 $1,480 3.0×
Brain Imaging Pet Metabolic Evaluation (78608) $4,263 $4,263 3.3×
Cat Scan Follow-Up Study (76380) $745 $745 9.5×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $962 $962 2.0×
Cerebrospinal Fluid Scan (78630) $1,147 $1,147 2.3×
Chest 1 view (71045)
range across 3 matching MRF lines		 $299–$10,741.79 $299–$10,741.79 varies
Chest 2 views (71046)
range across 2 matching MRF lines		 $348–$376 $348–$376 varies
Chest 4 or more views (71048) $373 $373 3.9×
Clavicle complete (73000) $536 $536 6.8×
Continuing medical physics consltj pr wk (77336) $414 $414 3.4×
Contrast X-Ray Bladder (74430) $712 $712 2.3×
Contrast X-Ray Of Elbow (73085) $1,357 $1,357 4.3×
Contrast X-Ray Of Knee Joint (73580) $1,370 $1,370 4.3×
CT abdomen and pelvis without and with contrast (74178) $4,845 $4,845 15.3×
CT abdomen and pelvis without contrast (74176) $3,467 $3,467 16.0×
CT abdomen w contrast (74160) $2,542 $2,542 16.0×
CT abdomen w wo contrast (74170) $2,938 $2,938 18.5×
CT abdomen w/o contrast (74150) $2,189 $2,189 23.1×
CT Angio Abdomen and Pelvis (74174) $4,026 $4,026 12.7×
CT Angio Chest (71275) $2,765 $2,765 17.4×
CT Angio Head (70496) $2,605 $2,605 16.4×
CT Angio Neck (70498) $2,412 $2,412 15.2×
CT cervical spine w/ contrast (72126) $2,259 $2,259 7.2×
CT cervical spine w/o contrast (72125) $2,251 $2,251 23.8×
CT cervical spine w/wo cont (72127) $2,295 $2,295 14.5×
CT chest w contrast (71260) $2,399 $2,399 15.1×
CT chest w/wo contrast (71270) $2,917 $2,917 18.4×
CT head/brain with contrast (70460) $2,068 $2,068 13.0×
CT head/brain without and with contrast (70470) $2,916 $2,916 18.4×
CT heart no contrast quant eval coronry calcium (75571) $99 $99 1.3×
CT iac w contrast (70481) $2,085 $2,085 13.1×
CT l-spine w&w/o contrast (72133) $2,373 $2,373 14.9×
CT lower ext w/o (73700)
range across 12 matching MRF lines		 $1,704–$1,773 $1,704–$1,773 varies
CT lower extremity w/contrast material (73701) $1,950 $1,950 12.3×
CT lumbar spine w contrast (72132) $2,306 $2,306 7.3×
CT lumbar spine w/o contrast (72131) $2,177 $2,177 23.0×
CT maxillofacial w contrast (70487) $2,280 $2,280 14.4×
CT maxillofacial wo contrast (70486) $1,813 $1,813 19.2×
CT neck tissue combo (70492) $2,786 $2,786 17.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,409 $2,409 15.2×
CT orbits w/o contrast (70480)
range across 2 matching MRF lines		 $1,729–$1,901 $1,729–$1,901 varies
CT pelvis w&w/o contrast (72194) $2,779 $2,779 17.5×
CT pelvis w/o contrast (72192) $2,049 $2,049 21.6×
CT scan of leg combo (73702) $2,363 $2,363 14.9×
CT scans face/jaw combo (70488) $2,435 $2,435 15.3×
CT soft tissue neck w contrast (70491) $2,277 $2,277 14.3×
CT soft tissue neck w/o contrast (70490) $1,972 $1,972 20.8×
CT thoracic spine w contrast (72129) $2,103 $2,103 13.2×
CT thoracic spine w/o contrast (72128) $2,067 $2,067 21.8×
CT thoracic spine w/wo cont (72130) $2,327 $2,327 14.7×
CT thorax w/o contrast (71250) $1,958 $1,958 20.7×
CT upper ext wo (73200) $2,893 $2,893 30.6×
CT upper extremity w/o & w/contrast material (73202) $2,396 $2,396 15.1×
CT upper extremity with contrast (73201) $2,118 $2,118 6.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,710 $2,710 17.1×
Cta Abdomen (74175) $2,894 $2,894 18.2×
CTA pelvis (72191) $3,172 $3,172 20.0×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828)
range across 2 matching MRF lines		 $164–$610 $164–$610 varies
Doppler Echo Fetal Spectral Display Complete (76827)
range across 2 matching MRF lines		 $252–$647 $252–$647 varies
Doppler Fetal Mid Cerebral Artery (76821) $490 $490 5.2×
Dxa Bone Density Axial (77080) $516 $516 5.5×
Dxa bone density study (77085) $613 $613 6.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $230 $230 2.9×
Echo exam of fetal heart (76825)
range across 3 matching MRF lines		 $659–$1,578 $659–$1,578 varies
Echo exam uterus (76831)
range across 2 matching MRF lines		 $516–$801 $516–$801 varies
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826)
range across 3 matching MRF lines		 $828–$1,042 $828–$1,042 varies
Esophageal Motility Study (78258) $561 $561 1.5×
Esophagram (74220) $606 $606 3.8×
Fetal Biophys Profile W/Nst (76818) $891 $891 9.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines		 $548–$687 $548–$687 varies
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $2,820 $2,820 13.1×
Fluoroscopy up to 1 hr (76000) $586 $586 2.7×
Forearm 2 views (73090)
range across 3 matching MRF lines		 $346–$440 $346–$440 varies
Gastric emptying imaging study (78264) $1,710 $1,710 4.7×
Gastroesophageal Reflux Exam (78262) $979 $979 2.7×
Gated Heart Planar Single (78472) $1,649 $1,649 4.6×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $1,951 $1,951 3.1×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $2,468 $2,468 3.9×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $2,468 $2,468 3.9×
Hepatobil Syst Image W/Drug (78227) $1,900 $1,900 3.9×
Hepatobiliary System Imaging (78226) $2,079 $2,079 5.7×
Hyperthermia external generated superficial (77600) $600 $600 1.7×
Hysterosalpingogram (74740) $1,360 $1,360 6.3×
Image fusion (77399) $342 $342 2.8×
Infant hip ultrasound with hip movement (dynamic) (76885) $765 $765 9.7×
Infant hip ultrasound, limited static exam (76886) $563 $563 7.1×
Interstitial radiation source applic complex (77778) $1,951 $1,951 3.1×
Intracavitary Radiation Source Applic Complex (77763) $1,951 $1,951 3.1×
Intracavitary Radiation Source Applic Intermed (77762) $1,428 $1,428 2.9×
Intracavitary radiation source applic simple (77761) $1,428 $1,428 2.9×
K Flow/Funct Image W/Drug (78708) $1,799 $1,799 3.7×
Kidney Imaging Morphol (78700) $981 $981 2.7×
Liver & Spleen Imaging Static Only (78215) $1,106 $1,106 3.1×
Lymph System Imaging (78195) $1,618 $1,618 3.3×
Mammary ductogram or galactogram single (77053) $681 $681 3.2×
Meckels Divert Exam (78290) $1,035 $1,035 2.9×
Mlc imrt design & construction per imrt plan (77338) $1,068 $1,068 3.1×
Mra Head W/O & W/Contrast Material (70546) $2,921 $2,921 9.2×
MRA head w/o contrast (70544) $2,946 $2,946 13.6×
Mra Neck W/O &W/Contrast Material (70549) $3,336 $3,336 10.6×
MRI abdomen w contrast (74182) $2,370 $2,370 7.5×
MRI abdomen w/o contrast (74181) $2,608 $2,608 12.1×
MRI any jt lower extrem w/contrast material (73722) $2,631 $2,631 3.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 8 matching MRF lines		 $3,564–$3,707 $3,564–$3,707 varies
MRI any jt upper extremity w/contrast matrl (73222) $2,908 $2,908 4.1×
MRI Breast W/O Contrast Bilateral (77047) $3,660 $3,660 16.9×
MRI Breast Without Contrast Material Unilateral (77046) $2,567 $2,567 11.9×
MRI cervical spine w contrast (72142) $2,549 $2,549 8.1×
MRI cervical spine w/o cont (72141) $2,879 $2,879 13.3×
MRI chest w/o contrast (71550) $3,163 $3,163 14.6×
MRI chest with contrast (71551) $3,025 $3,025 4.3×
MRI chest wo w contrast (71552) $3,684 $3,684 11.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,663 $2,663 8.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 7 matching MRF lines		 $3,508–$3,648 $3,508–$3,648 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,751 $2,751 12.7×
MRI lumbar spine w contrast (72149) $2,820 $2,820 8.9×
Mri Neck Spine W/O & W/Dye (72156) $4,390 $4,390 13.9×
MRI orbit face &/neck w/o contrast (70540) $2,425 $2,425 11.2×
MRI orbit face neck w contrast (70542) $1,912 $1,912 6.1×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,503 $3,503 11.1×
MRI pelvis w contrast (72196) $3,071 $3,071 9.7×
MRI pelvis w/o & w contrast (72197) $3,788 $3,788 12.0×
MRI pelvis w/o contrast (72195) $2,582 $2,582 12.0×
MRI thoracic spine w/o contrast (72146) $2,776 $2,776 12.8×
MRI upper extremity oth than jt w/contr matrl (73219) $1,646 $1,646 5.2×
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 6 matching MRF lines		 $2,337–$2,570 $2,337–$2,570 varies
Mri Uppr Extremity W/O&W/Dye (73220) $3,461 $3,461 11.0×
MRI, abdomen, combo (74183) $3,971 $3,971 12.6×
MRI, dorsal spine combo (72157) $4,052 $4,052 12.8×
MRI, dorsal spine contrast (72147) $4,413 $4,413 14.0×
MRI, joint upper extrem (73221) $2,619 $2,619 12.1×
MRI, joint upper extrem combo (73223) $3,922 $3,922 12.4×
MRI, lumbar spine combo (72158) $4,049 $4,049 12.8×
Neck soft tissue (70360) $327 $327 4.1×
Ntsty modul radthx pln dose-vol histos (77301) $3,923 $3,923 3.1×
Nuclear Rx Oral Admin (79005) $1,173 $1,173 5.6×
Optic foramina (70190) $177 $177 2.2×
Parathyroid Planar Imaging (78070) $1,395 $1,395 3.9×
Pelvis 1 or 2 views (72170) $339 $339 3.6×
Pet Image W/Ct Lmtd (78814) $5,342 $5,342 4.1×
PET image w/CT, full body (78816) $6,545 $6,545 5.1×
PET imaging CT attenuation skull base mid-thigh (78815) $6,947 $6,947 5.4×
Pulmonary Perfusion Imaging Particulate (78580) $157 $157 0.4×
Radex abscess/fistula/sinus tract rs&i (76080) $638 $638 1.3×
Radex Ankle Complete Minimum 3 Views (73610) $389 $389 4.9×
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines		 $287–$359 $287–$359 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines		 $377–$485 $377–$485 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $505 $505 5.3×
Radex fingr minimum 2 views (73140) $291 $291 3.7×
Radex foot complete minimum 3 views (73630) $512 $512 6.5×
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $371–$490 $371–$490 varies
Radex lower extremity infant minimum 2 views (73592) $313 $313 4.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $359 $359 4.6×
Radex shoulder complete minimum 2 views (73030) $631 $631 8.0×
Radex Sinuses Paransl < 3 Views (70210) $224 $224 2.8×
Radex Spine 1 View Specify Level (72020) $307 $307 3.9×
Radex Sternum Minimum 2 Views (71120) $377 $377 4.8×
Radex Toe Minimum 2 Views (73660) $297 $297 3.8×
Radex upper extremity infant minimum 2 views (73092) $312 $312 3.3×
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines		 $356–$371 $356–$371 varies
Radiation treatment delivery level 1 (77402) $341 $341 3.7×
Radiation treatment delivery level 2 (77407) $341 $341 1.0×
Radiation treatment delivery level 3 (77412) $727 $727 1.5×
Radiolog exam mandible compl minimum 4 views (70110) $384 $384 4.1×
Radiologic exam colon double contrast study (74280) $872 $872 5.5×
Radiologic exam colon single contrast study (74270) $836 $836 5.3×
Radiologic exam knee complete 4/more views (73564) $418 $418 4.4×
Radiologic exam pelvis compl minimum 3 views (72190) $384 $384 4.1×
Radiologic Exam Small Int Single Contrast Study (74250) $677 $677 4.3×
Radiologic exam swallow function contrast study (74230) $611 $611 3.8×
Radiologic examination femur minimum 2 views (73552) $497 $497 6.3×
Radiologic examination knee 1/2 views (73560) $339 $339 4.3×
Radiologic Examination Osseous Survey Limited (77074) $548 $548 5.8×
Radiologic examination tibia & fibula 2 views (73590) $636 $636 8.1×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $600 $600 1.7×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $600 $600 1.7×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,020 $1,020 2.8×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,778 $1,778 4.9×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,690 $1,690 3.4×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 3 matching MRF lines		 $1,122–$1,583 $1,122–$1,583 varies
Scapula (73010) $312 $312 3.3×
Screening Digital Breast Tomosynthesis Bi (77063)
range across 3 matching MRF lines		 $69–$79 $69–$79 varies
Shoulder Arthrography (73040) $1,023 $1,023 3.2×
Skull less than 4 views (70250) $377 $377 4.0×
Special dosimetry (77331) $342 $342 2.8×
Special Physics Consult (77370) $414 $414 3.4×
Special teletherapy port plan (77321) $1,391 $1,391 4.1×
Special treatment procedure (77470) $1,727 $1,727 3.5×
Stereotactic Body Radiation Delivery (77373) $5,004 $5,004 3.1×
Sternoclavicular joints (71130) $233 $233 3.0×
Surface Applic Low Dose Rate Radionuclide Source (77789) $341 $341 3.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,836 $1,836 5.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,765 $1,765 5.2×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,100 $1,100 3.2×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,117 $1,117 3.3×
Ther rad simulaj-aided field setting simple (77280) $414 $414 3.4×
Thoracic spine 2 views (72070) $399 $399 4.2×
Thoracolumbar 2 views (72080) $253 $253 3.2×
Thyroid Met Imaging Body (78018) $1,745 $1,745 3.5×
Thyroid Uptake Measurement (78012) $892 $892 2.5×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,411 $1,411 3.9×
Tx Devices Design & Construction Complex (77334) $1,251 $1,251 3.7×
Tx devices design & construction intermediate (77333) $342 $342 2.8×
Tx devices design & construction simple (77332) $342 $342 2.8×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines		 $466–$727 $466–$727 varies
Ultrasound Exam Aaa Screen (76706) $528 $528 5.6×
Ultrasound, abdomen limited (76705)
range across 5 matching MRF lines		 $673–$740 $673–$740 varies
Umbilical-artery Doppler (OB) (76820)
range across 2 matching MRF lines		 $278–$523 $278–$523 varies
Unlisted Dx Radiographic Procedure (76499) $210 $210 2.7×
Upper gi w/o kub (74240) $708 $708 4.5×
Ureteral Reflux Study (78740) $1,058 $1,058 2.9×
Urethrocystogram voiding (74455) $948 $948 4.4×
Urethrocystography retrograde (74450) $523 $523 2.4×
Us breast unilateral complete (76641)
range across 3 matching MRF lines		 $488–$754 $488–$754 varies
Us chest (76604) $530 $530 5.6×
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines		 $507–$657 $507–$657 varies
Us head (76506) $643 $643 6.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $534 $534 5.6×
Us ob detailed single fetus (76811)
range across 2 matching MRF lines		 $861–$1,161 $861–$1,161 varies
Us ob limited 1 or more fetuses (76815) $541 $541 5.7×
Us ob transvaginal (76817)
range across 2 matching MRF lines		 $579–$666 $579–$666 varies
Us pelvic non ob complete (76856) $903 $903 9.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines		 $642–$766 $642–$766 varies
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $246–$490 $246–$490 varies
Us retroperitoneal complete (76770) $836 $836 8.8×
Us retroperitoneal limited (76775) $324 $324 3.4×
Us scrotum and contents (76870) $719 $719 7.6×
Us spinal canal and contents (76800) $549 $549 5.8×
Us thyroid (76536) $730 $730 7.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $276 $276 3.5×
X-Ray Bend Only L-S Spine (72120) $590 $590 6.2×
X-Ray Exam Breast Specimen (76098) $367 $367 0.7×
X-Ray Exam Entire Spi 1 Vw (72081) $349 $349 4.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $424 $424 4.5×
X-Ray Exam Entire Spi 4/5 Vw (72083) $661 $661 7.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $365 $365 4.6×
X-Ray Exam Hips Bi 2 Views (73521) $441 $441 4.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $443 $443 5.6×
X-Ray Exam Neck Spine 6/>Vws (72052) $640 $640 6.8×
X-Ray Exam Unilat Ribs/Chest (71101) $431 $431 4.6×
X-ray eye for foreign body (70030) $244 $244 3.1×
X-ray humerus (73060) $458 $458 5.8×
X-ray IV pyelogram (ivp) (74400) $1,020 $1,020 6.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $249 $249 3.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $442 $442 4.7×
X-ray nose-rectum child f.b. (76010) $182 $182 2.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $619 $619 6.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $394 $394 4.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $363 $363 4.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $339 $339 4.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $591 $591 6.2×
X-Ray Urinary Tract Exam With Contrast Material (74420) $968 $968 3.1×
X-Rays Bone Length Studies (77073) $334 $334 3.5×
Xr c-spine 4 or 5 views (72050) $574 $574 6.1×
Xr orbits complete 4 views (70200) $405 $405 4.3×

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.