Coming Soon

Our patient price estimator tool will be activated by January 1, 2021 or sooner.

Patient Price Information List

Disclaimer: Gonzales Healthcare Systems determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Gonzales Healthcare Systems has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/22. Gonzales Healthcare Systems's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Central Texas Medical Center

San Marcos

TX

Citizens Medical Center

Victoria

TX

Cuero Community Hospital

Cuero

TX

Detar Hospital Navarro

Victoria

TX

El Campo Memorial Hospital

El Campo

TX

Guadalupe Regional Medical Ctr

Seguin

TX

Lavaca Medical Center

Hallettsville

TX

Saint Mark's Medical Center

La Grange

TX

Seton Edgar B. Davis Hospital

Luling

TX

Seton Medical Center Hays

Kyle

TX

Seton Smithville Regional Hospital

Smithville

TX

Yoakum Community Hospital

Yoakum

TX

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$950
$1,616

41% lower than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$1,854
$5,725

68% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$1,140
$1,078

6% higher than market

Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]

$4,767
$7,898

40% lower than market

Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]

$5,191
$6,695

22% lower than market

Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]

$4,990
$9,075

45% lower than market

Gallbladder removal with an endoscope [HCPCS 47562]

$11,473
$31,003

63% lower than market

Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]

$13,060
$19,645

34% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$1,236
$2,653

53% lower than market

Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]

$3,673
$4,820

24% lower than market

Imaging of leg joint by MRI without contrast [HCPCS 73721]

$2,163
$2,883

25% lower than market

Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]

$3,011
$3,249

7% lower than market

Imaging of pelvis by ultrasound through vagina [HCPCS 76830]

$839
$810

4% higher than market

Knee cartilage removal with endoscope (one knee) [HCPCS 29881]

$9,270
$18,345

49% lower than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$47
$178

74% lower than market

Lab analysis of urine specimen by dipstick without microscope (non-automated) [HCPCS 81002]

$38
$66

42% lower than market

Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]

$96
$355

73% lower than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$50
$128

61% lower than market

Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]

$140
$166

16% lower than market

Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]

$74
$151

51% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]

$49
$199

75% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$58
$139

58% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$101
$314

68% lower than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$166
$184

10% lower than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$96
$324

70% lower than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$161
$164

2% lower than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$162
$419

61% lower than market

Mammography of both breasts (screening exam) [HCPCS 77067]

$392
$393

Approximately equal to market

Mammography of both breasts for diagnosis [HCPCS 77066]

$608
$523

16% higher than market

Mammography of one breast for diagnosis [HCPCS 77065]

$531
$404

32% higher than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$31
$107

71% lower than market

Prostate gland biopsy [HCPCS 55700]

$2,884
$15,806

82% lower than market

Sleep pattern monitoring of patient in sleep lab, sleep staging with 4 or more parameters of sleep (6 years of age or older) [HCPCS 95810]

$2,954
$4,752

38% lower than market

Spinal canal injection of substance into lower back or sacrum with imaging guidance [HCPCS 62323]

$2,000
$5,948

66% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$568
$890

36% lower than market

Total Knee or Hip Replacement

$64,612
$90,653

50% lower than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Emergency department visit for minor problem [HCPCS 99281]

$206
$357

42% lower than market

Emergency department visit for problem of high severity [HCPCS 99284]

$721
$1,906

62% lower than market

Emergency department visit for problem of low to moderate severity [HCPCS 99282]

$335
$584

43% lower than market

Emergency department visit for problem of moderate severity [HCPCS 99283]

$438
$947

54% lower than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$1,030
$3,040

66% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Lab analysis by immunoassay (ELISA) to identify cryptosporidium (parasite) [HCPCS 87328]

$52
$105

50% lower than market

Lab analysis by immunoassay (ELISA) to identify giardia (intestinal parasite) [HCPCS 87329]

$52
$195

73% lower than market

Lab analysis by immunoassay to identify influenza virus [HCPCS 87804]

$28
$128

79% lower than market

Lab analysis by immunoassay to identify Strep (streptococcus) [HCPCS 87880]

$58
$77

25% lower than market

Lab analysis of any culture (except blood) to identify anaerobic bacteria [HCPCS 87075]

$149
$267

44% lower than market

Lab analysis of any culture (except urine, blood, or stool) to identify bacteria [HCPCS 87070]

$126
$257

51% lower than market

Lab analysis of blood culture to identify bacteria [HCPCS 87040]

$55
$256

78% lower than market

Lab analysis of special gram or Giemsa stain to idenitfy microorganisms [HCPCS 87205]

$52
$103

49% lower than market

Lab analysis of stool culture to identify bacteria [HCPCS 87045]

$94
$306

69% lower than market

Lab analysis of urine culture to measure the amount of bacteria [HCPCS 87086]

$113
$153

26% lower than market

Lab analysis to identify total thyroxine (thyroid chemical) function in serum specimen for screening [HCPCS 84436]

$53
$159

67% lower than market

Lab analysis to measure blood count (hemoglobin) [HCPCS 85018]

$25
$64

61% lower than market

Lab analysis to measure blood glucose (sugar) level with hand-held instrument [HCPCS 82962]

$11
$53

79% lower than market

Lab analysis to measure red blood cell sedimentation rate to detect inflammation (automated) [HCPCS 85652]

$54
$114

53% lower than market

Lab analysis to measure red blood count (automated test) [HCPCS 85045]

$55
$159

65% lower than market

Lab analysis to measure the ammonia level [HCPCS 82140]

$150
$192

22% lower than market

Lab analysis to measure the amount of blood gases with oxygen saturation [HCPCS 82805]

$93
$398

77% lower than market

Lab analysis to measure the amount of blood in stool specimen by peroxidase activity [HCPCS 82272]

$40
$53

25% lower than market

Lab analysis to measure the amount of blood in stool specimen to screen for colon tumors [HCPCS 82270]

$49
$86

43% lower than market

Lab analysis to measure the amount of immune system protein (complement) antigens (each component) [HCPCS 86160]

$41
$75

46% lower than market

Lab analysis to measure the amount of total digoxin in blood specimen [HCPCS 80162]

$96
$143

33% lower than market

Lab analysis to measure the amount of total phenytoin in blood specimen [HCPCS 80185]

$113
$261

57% lower than market

Lab analysis to measure the amount of total valproic acid in blood specimen [HCPCS 80164]

$143
$129

11% higher than market

Lab analysis to measure the amount of troponin (protein) in serum specimen [HCPCS 84484]

$191
$255

25% lower than market

Lab analysis to measure the amount of vancomycin (antibiotic) in serum specimen [HCPCS 80202]

$141
$188

25% lower than market

Lab analysis to measure the amount of white blood cells in stool specimen [HCPCS 89055]

$52
$135

61% lower than market

Lab analysis to measure the amylase (enzyme) level in serum specimen [HCPCS 82150]

$80
$173

54% lower than market

Lab analysis to measure the chloride level in urine specimen [HCPCS 82436]

$33
$105

69% lower than market

Lab analysis to measure the creatine kinase (cardiac enzyme) level (MB fraction only) [HCPCS 82553]

$163
$217

25% lower than market

Lab analysis to measure the creatinine level in blood specimen to test for kidney function or muscle injury [HCPCS 82565]

$41
$93

56% lower than market

Lab analysis to measure the direct bilirubin level [HCPCS 82248]

$71
$108

34% lower than market

Lab analysis to measure the ferritin (blood protein) level [HCPCS 82728]

$109
$111

1% lower than market

Lab analysis to measure the glucose (sugar) level in blood [HCPCS 82947]

$41
$77

47% lower than market

Lab analysis to measure the glutamyltransferase (liver enzyme) level [HCPCS 82977]

$49
$132

63% lower than market

Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]

$99
$115

14% lower than market

Lab analysis to measure the iron binding capacity [HCPCS 83550]

$62
$83

25% lower than market

Lab analysis to measure the iron level [HCPCS 83540]

$52
$83

37% lower than market

Lab analysis to measure the lactate dehydrogenase (enzyme) level [HCPCS 83615]

$40
$151

74% lower than market

Lab analysis to measure the lactic acid level in blood, plasma, or cerbrospinal fluid specimen [HCPCS 83605]

$77
$171

55% lower than market

Lab analysis to measure the lipase (fat enzyme) level [HCPCS 83690]

$109
$144

24% lower than market

Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]

$65
$143

55% lower than market

Lab analysis to measure the microalbumin (protein) level in urine specimen [HCPCS 82043]

$73
$89

18% lower than market

Lab analysis to measure the natriuretic peptide (heart and blood vessel protein) level in plasma specimen [HCPCS 83880]

$206
$281

27% lower than market

Lab analysis to measure the phosphate level [HCPCS 84100]

$34
$72

53% lower than market

Lab analysis to measure the potassium level in urine specimen [HCPCS 84133]

$33
$67

51% lower than market

Lab analysis to measure the sodium level in urine specimen [HCPCS 84300]

$33
$79

58% lower than market

Lab analysis to measure the total calcium level in blood specimen [HCPCS 82310]

$38
$94

60% lower than market

Lab analysis to measure the total creatine kinase (cardiac enzyme) level in blood specimen [HCPCS 82550]

$99
$159

38% lower than market

Lab analysis to measure the total protein level in urine specimen [HCPCS 84156]

$46
$134

66% lower than market

Lab analysis to measure the uric acid level in blood specimen [HCPCS 84550]

$42
$93

55% lower than market

Lab analysis to measure the vitamin D-3 level in serum or plasma specimen [HCPCS 82306]

$191
$245

22% lower than market

Lab analysis to measure urea nitrogen level in serum or plasma specimen to assess kidney function (quantitative) [HCPCS 84520]

$41
$74

45% lower than market

Lab analysis to measure urine volume [HCPCS 81050]

$17
$23

26% lower than market

Lab analysis to screen for pathogenic organisms [HCPCS 87081]

$68
$237

71% lower than market

Lab blood analysis to confirm blood unit compatibility by antiglobulin technique [HCPCS 86922]

$55
$297

81% lower than market

Lab blood analysis to confirm blood unit compatibility by immediate spin technique [HCPCS 86920]

$38
$134

72% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$47
$165

72% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]

$49
$117

58% lower than market

Lab blood analysis to screen for antibodies to red blood cell antigens (each serum technique) [HCPCS 86850]

$95
$210

55% lower than market

Pathology lab analysis of special stained specimen slides to identify organisms with interpretation and report [HCPCS 88312]

$81
$252

68% lower than market

Psa screening [HCPCS G0103]

$161
$180

11% lower than market

OUTPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Chemotherapy administration into vein by infusion (each additional hour) [HCPCS 96415]

$140
$386

64% lower than market

Drug administration beneath the skin or into muscle by injection for therapy, diagnosis, or prevention [HCPCS 96372]

$155
$273

43% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (each additional hour) [HCPCS 96366]

$129
$208

38% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96365]

$515
$710

27% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of same drug) [HCPCS 96376]

$73
$307

76% lower than market

Hydration administration into vein by infusion (31 minutes to 1 hour) [HCPCS 96360]

$425
$630

33% lower than market

Hydration administration into vein by infusion (each additional hour) [HCPCS 96361]

$119
$187

36% lower than market

Immunization administration of vaccine into, between, or beneath the skin or into muscle (single vaccine) [HCPCS 90471]

$140
$146

4% lower than market

Implanted venous access drug delivery device irrigation [HCPCS 96523]

$175
$231

24% lower than market

Influenza vaccine for injection into muscle (preservation free) [HCPCS 90662]

$50
$441

89% lower than market

Sleep pattern monitoring of patient in sleep lab with continued pressured respiratory assistance by mask or breathing tube (6 years of age or older) [HCPCS 95811]

$3,005
$5,243

43% lower than market

Swallowing function evaluation by fluoroscopy with video recording [HCPCS 92611]

$170
$590

71% lower than market

Therapeutic excercises and water pool therapy to 1 or more areas (each 15 minutes) [HCPCS 97113]

$30
$46

34% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Admin influenza virus vac [HCPCS G0008]

$10
$127

92% lower than market

Chemotherapy administration into vein by infusion (up to 1 hour, single drug) [HCPCS 96413]

$850
$1,082

21% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of new drug) [HCPCS 96375]

$129
$265

51% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (initial drug) [HCPCS 96374]

$425
$414

3% higher than market

Ertapenem injection [HCPCS J1335]

$53
$174

70% lower than market

Inj pantoprazole sodium, via [HCPCS C9113]

$23
$76

70% lower than market

Tetanus, diphtheria toxoids and acellular pertussis (whooping cough) vaccine for injection into muscle (7 years of age or older) [HCPCS 90715]

$129
$419

69% lower than market

OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY

Description

Our Charge
Market Charge

Variance

Function improvement activities with one-on-one contact between patient and provider (each 15 minutes) [HCPCS 97530]

$75
$150

50% lower than market

Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]

$44
$127

65% lower than market

Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]

$268
$321

16% lower than market

Physical therapy evaluation (typically 30 minutes) [HCPCS 97162]

$268
$343

22% lower than market

Physical therapy procedure to re-educate brain-to-nerve-to-muscle function (each 15 minutes) [HCPCS 97112]

$93
$138

33% lower than market

Physical therapy techniques to 1 or more regions (each 15 minutes) [HCPCS 97140]

$139
$152

8% lower than market

Speech, language, voice, communication, and/or hearing processing disorder treatment [HCPCS 92507]

$129
$451

71% lower than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

Aerosol generator, nebulizer, metered dose inhaler, or intermittent positive pressure breathing (IPPB) device demonstration and/or evaluation for patient use [HCPCS 94664]

$425
$354

20% higher than market

Amount and speed of breathed air measurement and graphic recording before and after medication administration [HCPCS 94060]

$587
$873

33% lower than market

Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]

$244
$374

35% lower than market

OUTPATIENT RESPIRATORY THERAPY

Description

Our Charge
Market Charge

Variance

Airway inhalation treatment to relieve airway obstruction or for sputum collection (inhaled pressure or nonpressure treatment) [HCPCS 94640]

$426
$305

40% higher than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Collection of blood specimen from arterial puncture for diagnosis [HCPCS 36600]

$1,063
$5,728

81% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$1,545
$4,648

67% lower than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$2,266
$6,043

62% lower than market

Abdominal blood vessels CTA scan with contrast [HCPCS 74175]

$2,153
$3,929

45% lower than market

Abdominal CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74160]

$1,850
$3,179

42% lower than market

Abdominal CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74150]

$1,421
$2,290

38% lower than market

Abdominal CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74170]

$2,575
$2,844

9% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$693
$779

11% lower than market

Abdominal x-ray (2 views) [HCPCS 74019]

$395
$654

40% lower than market

Abdominal x-ray (minimum of 3 views) [HCPCS 74021]

$483
$375

29% higher than market

Abdominal x-ray (single view) [HCPCS 74018]

$306
$501

39% lower than market

Abdominal, pelvic, and/or scrotal arterial inflow and venous outflow ultrasound (complete study) [HCPCS 93975]

$781
$996

22% lower than market

Ankle x-ray (2 views) [HCPCS 73600]

$210
$412

49% lower than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$288
$547

47% lower than market

Arm CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 73200]

$1,587
$2,978

47% lower than market

Arm or leg ultrasound (complete) [HCPCS 76881]

$610
$1,051

42% lower than market

Arm x-ray of forearm (2 views) [HCPCS 73090]

$306
$435

30% lower than market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$319
$422

24% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (complete, both arms or legs) [HCPCS 93970]

$1,504
$1,616

7% lower than market

Arteries and arterial grafts ultrasound of one leg (limited study) [HCPCS 93926]

$583
$1,003

42% lower than market

Arteries of both arms and legs ultrasound (limited) [HCPCS 93922]

$549
$711

23% lower than market

Blood flow (outside of the brain) ultrasound on both sides of head and neck [HCPCS 93880]

$998
$1,429

30% lower than market

Bone density measurement of the axial skeleton (hips, pelvis, spine) [HCPCS 77080]

$438
$592

26% lower than market

Breast ultrasound (one breast, complete) [HCPCS 76641]

$685
$730

6% lower than market

Breast ultrasound (one breast, limited) [HCPCS 76642]

$706
$634

11% higher than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$1,648
$3,756

56% lower than market

Chest CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 71250]

$1,166
$2,632

56% lower than market

Chest CT scan without contrast, followed by contrast to examine injury, foreign bodies, or tumors [HCPCS 71270]

$2,369
$4,054

42% lower than market

Chest ultrasound [HCPCS 76604]

$277
$692

60% lower than market

Chest x-ray (2 views) [HCPCS 71046]

$339
$505

33% lower than market

Chest x-ray (single view) [HCPCS 71045]

$185
$423

56% lower than market

Collar bone x-ray, complete study [HCPCS 73000]

$183
$435

58% lower than market

CTA scan of chest blood vessels with contrast to examine injury, foreign bodies, or tumors [HCPCS 71275]

$1,536
$3,026

49% lower than market

CTA scan of head blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70496]

$1,536
$3,396

55% lower than market

CTA scan of neck blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70498]

$1,455
$3,023

52% lower than market

Digital tomography of both breasts (screening exam) [HCPCS 77063]

$78
$136

43% lower than market

Elbow x-ray (2 views) [HCPCS 73070]

$315
$379

17% lower than market

Elbow x-ray, complete study (minimum of 3 views) [HCPCS 73080]

$276
$591

53% lower than market

Facial CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70486]

$1,070
$2,807

62% lower than market

Facial CT scan without contrast, followed by contrast to examine injury, foreign bodies, or tumors [HCPCS 70488]

$1,929
$5,701

66% lower than market

Finger(s) x-ray (minimum of 2 views) [HCPCS 73140]

$201
$379

47% lower than market

Foot x-ray (2 views) [HCPCS 73620]

$280
$436

36% lower than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$330
$517

36% lower than market

Hand x-ray (2 views) [HCPCS 73120]

$170
$455

63% lower than market

Hand x-ray (minimum of 2 views) [HCPCS 73130]

$339
$495

32% lower than market

Head and neck ultrasound [HCPCS 76536]

$652
$939

31% lower than market

Head or brain CT scan without contrast, followed by contrast to examine injury, foreign bodies, or tumors [HCPCS 70470]

$2,000
$3,807

47% lower than market

Hip x-ray of hip with pelvis (2 to 3 views) [HCPCS 73502]

$262
$409

36% lower than market

Imaging for swallowing function evaluation with contrast [HCPCS 74230]

$639
$883

28% lower than market

Imaging of abdomen by MRI without contrast [HCPCS 74181]

$1,200
$3,451

65% lower than market

Imaging of abdomen by MRI without contrast, followed by contrast [HCPCS 74183]

$2,000
$4,602

57% lower than market

Imaging of arm joint by MRI without contrast [HCPCS 73221]

$2,163
$2,831

24% lower than market

Imaging of brain by MRI without contrast [HCPCS 70551]

$1,504
$3,050

51% lower than market

Imaging of head blood vessels by MRA without contrast [HCPCS 70544]

$1,353
$2,339

42% lower than market

Imaging of leg by MRI without contrast [HCPCS 73718]

$2,322
$2,703

14% lower than market

Imaging of leg by MRI without contrast, followed by contrast [HCPCS 73720]

$2,700
$4,101

34% lower than market

Imaging of middle spinal canal by MRI without contrast [HCPCS 72146]

$1,917
$3,193

40% lower than market

Imaging of middle spinal canal by MRI without contrast, followed by contrast [HCPCS 72157]

$2,042
$4,601

56% lower than market

Imaging of neck blood vessels by MRA without contrast [HCPCS 70547]

$1,729
$2,423

29% lower than market

Imaging of spinal canal by MRI without contrast, followed by contrast [HCPCS 72156]

$3,653
$4,697

22% lower than market

Imaging of upper spinal canal by MRI without contrast [HCPCS 72141]

$2,575
$3,408

24% lower than market

Knee x-ray (1 or 2 views) [HCPCS 73560]

$114
$481

76% lower than market

Knee x-ray (3 views) [HCPCS 73562]

$324
$594

45% lower than market

Leg CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 73701]

$1,442
$3,569

60% lower than market

Leg CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 73700]

$1,453
$2,729

47% lower than market

Leg ultrasound of arteries and arterial grafts of both legs (complete study) [HCPCS 93925]

$403
$1,545

74% lower than market

Lower leg blood vessels CTA scan with contrast [HCPCS 73706]

$1,975
$3,195

38% lower than market

Lower leg x-ray (2 views) [HCPCS 73590]

$294
$481

39% lower than market

Neck CT scan of the soft tissue of the neck with contrast to examine injury, foreign bodies, or tumors [HCPCS 70491]

$1,171
$3,157

63% lower than market

Paranasal sinuses x-ray usually including 4 to 5 standard views of the skull (complete study, miniumum of 3 views) [HCPCS 70220]

$305
$604

49% lower than market

Pelvis CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 72192]

$1,135
$3,033

63% lower than market

Pelvis ultrasound, not pregnancy related (limited) [HCPCS 76857]

$332
$652

49% lower than market

Pelvis ultrasound, not pregrnancy related (complete) [HCPCS 76856]

$840
$1,154

27% lower than market

Pelvis x-ray (1 or 2 views) [HCPCS 72170]

$559
$498

12% higher than market

Rib cage x-ray of ribs on one side of body (2 views) [HCPCS 71100]

$236
$561

58% lower than market

Shoulder blade x-ray complete study [HCPCS 73010]

$228
$586

61% lower than market

Shoulder x-ray, complete study (minimum of 2 views) [HCPCS 73030]

$412
$522

21% lower than market

Spinal CT scan of lower spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72131]

$1,795
$2,816

36% lower than market

Spinal CT scan of middle spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72128]

$1,917
$2,769

31% lower than market

Spinal CT scan of upper spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72125]

$1,560
$3,321

53% lower than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$269
$671

60% lower than market

Spinal x-ray of middle spine (2 views) [HCPCS 72070]

$338
$420

20% lower than market

Spinal x-ray of upper spine (2 or 3 views) [HCPCS 72040]

$300
$630

52% lower than market

Spinal x-ray of upper spine (4 or 5 views) [HCPCS 72050]

$389
$885

56% lower than market

Spinal x-ray of upper spine including bending views, complete study (6 or more views) [HCPCS 72052]

$445
$978

54% lower than market

Thighbone x-ray (minimum of 2 views) [HCPCS 73552]

$268
$451

41% lower than market

Toe(s) x-ray (minimum of 2 views) [HCPCS 73660]

$205
$385

47% lower than market

Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography

$1,114
$2,791

60% lower than market

Ultrasound of area behind abdominal cavity (complete) [HCPCS 76770]

$755
$981

23% lower than market

Ultrasound of area behind abdominal cavity (limited) [HCPCS 76775]

$286
$972

71% lower than market

Upper digestive tract x-ray with barium swallow (double contrast material [HCPCS 74246]

$776
$1,228

37% lower than market

Wrist x-ray (2 views) [HCPCS 73100]

$251
$393

36% lower than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$302
$511

41% lower than market

X-ray of sacrum and tailbone (minimum of 2 views) [HCPCS 72220]

$297
$433

31% lower than market

INPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Blood infection without major complications

$11,237
$34,078

67% lower than market

Nutritional or Metabolic Disorders without major complications

$9,516
$23,694

60% lower than market

INPATIENT PULMONOLOGY

Description

Our Charge
Market Charge

Variance

Pneumonia with complications

$21,117
$29,696

29% lower than market

INPATIENT UROLOGY

Description

Our Charge
Market Charge

Variance

Kidney & urinary Infection without complications

$7,238
$27,280

73% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Gonzales Healthcare Systems for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Gonzales Healthcare Systems, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Gonzales Healthcare Systems is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Gonzales Healthcare Systems indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Billing Department at 830-672-7581.

If you need more information about the price of a future service, please contact our Customer Service at 830-672-7581. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.