Diagnostic radiology · Texas

Diagnostic radiology commercial reimbursement in Texas

How Texas diagnostic radiology rates compare with the national market.

Diagnostic radiology in Texas

49 codes · 133 sampled providers
Index vs national
75
25% below
Rank among states
50 of 51
1 = highest
Codes above national
0 of 49
median code at 75%
Providers
133
sampled

What the data shows

1

Diagnostic radiology ranks 50th of 51 states in Texas with an index of 75 (100 = the specialty's national median), across 49 codes and 133 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Texas, 0 pay above the national median and 49 below; the typical code sits at 75% of the national median.

3

Largest premium over the national median: CPT 37243 (Vasc embolize/occlude organ) at 95%; largest discount: CPT 77080 (Dxa bone density axial) at 65%.

4

Measured against Medicare, Texas diagnostic radiology rates have a median of 115% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeTexasNationalGapProv.
37243
Vasc embolize/occlude organ
$813$858-5%132
93000
Electrocardiogram complete
$23$25-6%133
99214
Office o/p est mod 30 min
$118$128-8%133
99212
Office o/p est sf 10 min
$46$50-8%133
99213
Office o/p est low 20 min
$80$88-9%133

Lowest vs national

CodeTexasNationalGapProv.
77080
Dxa bone density axial
$43$66-35%133
70450
Ct head/brain w/o dye
$131$194-33%133
72148
Mri lumbar spine w/o dye
$265$392-32%133
70551
Mri brain stem w/o dye
$272$402-32%133
72141
Mri neck spine w/o dye
$265$390-32%133

All diagnostic radiology codes in Texas

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeTexasNationalGap% of MedicareProvidersTINsLevel
CPT 37243
Vasc embolize/occlude organ
$813$858-5%168%132374
CPT 93000
Electrocardiogram complete
$23$25-6%152%133380
CPT 99214
Office o/p est mod 30 min
$118$128-8%87%133385
CPT 99212
Office o/p est sf 10 min
$46$50-8%78%133384
CPT 99213
Office o/p est low 20 min
$80$88-9%84%133383
CPT 99203
Office o/p new low 30 min
$109$121-9%93%133383
CPT 20610
Drain/inj joint/bursa w/o us
$75$83-10%109%133387
CPT 99204
Office o/p new mod 45 min
$167$187-11%94%133385
CPT 99215
Office o/p est hi 40 min
$158$182-13%82%133382
CPT 99205
Office o/p new hi 60 min
$213$244-13%90%133383
CPT 93880
Extracranial bilat study
$233$277-16%123%133382
CPT 74178
Ct abd&plv wo cntr flwd cntr
$408$520-22%121%133378
CPT 71045
X-ray exam chest 1 view
$26$33-22%101%133378
CPT 77066
Dx mammo incl cad bi
$176$225-22%112%133380
CPT 93970
Extremity study
$211$270-22%115%133382
CPT 77065
Dx mammo incl cad uni
$139$179-22%112%133379
CPT 93971
Extremity study
$134$172-22%115%133382
CPT 71271
Ct thorax lung cancer scr c-
$162$208-22%119%133377
CPT 76536
Us exam of head and neck
$118$154-24%109%133384
CPT 76770
Us exam abdo back wall comp
$121$158-24%114%133379
CPT 76642
Ultrasound breast limited
$92$120-24%110%133379
CPT 76705
Echo exam of abdomen
$96$126-24%111%133379
CPT 76700
Us exam abdom complete
$127$168-24%111%133380
CPT 77067
Scr mammo bi incl cad
$138$182-24%109%133378
CPT 74183
Mri abd w/o cntr flwd cntr
$477$634-25%142%133379
CPT 76641
Ultrasound breast complete
$109$145-25%109%133374
CPT 72197
Mri pelvis w/o & w/dye
$475$634-25%142%133383
CPT 74177
Ct abd & pelvis w/contrast
$336$448-25%112%133381
CPT 73502
X-ray exam hip uni 2-3 views
$46$61-25%94%133381
CPT 72158
Mri lumbar spine w/o & w/dye
$439$593-26%138%133383
CPT 74176
Ct abd & pelvis w/o contrast
$212$287-26%116%133381
CPT 77049
Mri breast c-+ w/cad bi
$410$558-26%121%133377
CPT 71275
Ct angiography chest
$339$462-27%121%133380
CPT 70496
Ct angiography head
$334$457-27%122%133378
CPT 70498
Ct angiography neck
$334$459-27%122%133383
CPT 71046
X-ray exam chest 2 views
$33$45-28%99%133377
CPT 71260
Ct thorax dx c+
$225$312-28%135%133378
CPT 72125
Ct neck spine w/o dye
$179$249-28%137%133377
CPT 71250
Ct thorax dx c-
$179$250-28%135%133382
CPT 72131
Ct lumbar spine w/o dye
$177$248-28%137%133382
CPT 74174
Cta abd&plvs w/contrast
$430$601-28%114%133378
CPT 73221
Mri joint upr extrem w/o dye
$288$407-29%140%133386
CPT 73721
Mri jnt of lwr extre w/o dye
$287$407-29%141%133382
CPT 70553
Mri brain stem w/o & w/dye
$414$600-31%131%133382
CPT 72141
Mri neck spine w/o dye
$265$390-32%139%133385
CPT 70551
Mri brain stem w/o dye
$272$402-32%139%133384
CPT 72148
Mri lumbar spine w/o dye
$265$392-32%138%133385
CPT 70450
Ct head/brain w/o dye
$131$194-33%123%133379
CPT 77080
Dxa bone density axial
$43$66-35%109%133379

Frequently asked questions

How do Texas diagnostic radiology rates compare with the rest of the country?

Texas ranks 50th of 51 states with an index of 75; 0 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Texas?

CPT 37243 (Vasc embolize/occlude organ), at 95% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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