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Methodist Hospitals of Dallas · HC MRI Spinal Canal Lumbar Woc
$1,473.00
Source file dated 2026-03-23 · both
Source note: OPPS APC; APC Pricing (APC Code: 5523 / Adjusted APC Price: 239.69), and; Pricing Extension - MHS HB XR PRC 90 DEGREE - Medicare OPPS Outlier; Note: No outlier payment added to this line. Paid as 165% of $239.69 as defined in the pricing extension.; Estimated Allowed Amount: 395.49
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