Imaging prices at Banner Ironwood Medical Center

Queen Creek, AZ · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $126.66 $539 1.1×
Ankle 2 views (73600) $79.66 $339 0.9×
Antegrade urography radiological supvj & interpj (74425) $317.96 $1,353 0.9×
Arthrogram elbow (73085) $405.17 $1,101 1.1×
Arthrogram hip (73525) $456.32 $1,240 1.2×
Arthrogram shoulder (73040) $405.17 $1,101 1.1×
Arthrogram wrist (73115) $401.12 $1,090 1.1×
Arthrography knee lt (73580) $405.17 $1,101 1.1×
Bone age studies (77072) $78.25 $333 0.7×
Bone survey complete (77075) $129.01 $549 1.2×
Cervical spine 2 or 3 views (72040) $86.95 $370 0.9×
Chest 1 view (71045) $66.64 $272 0.7×
Chest 3 views (71047) $89.67 $366 1.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $145.46 $619 0.8×
Cineradiography/videoradiography (76120) $532.04 $2,264 4.8×
Clavicle complete (73000) $75.20 $320 0.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $84.53 $467 0.8×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $120.55 $513 0.6×
CT abdomen and pelvis without and with contrast (74178) $687.80 $3,800 1.8×
CT abdomen and pelvis without contrast (74176) $458.47 $2,533 1.8×
CT abdomen w contrast (74160) $402.72 $2,225 2.2×
CT abdomen w wo contrast (74170) $483.27 $2,670 2.6×
CT abdomen w/o contrast (74150) $322.18 $1,780 2.9×
CT angio hrt w/3d image (75574) $388.90 $2,509 1.0×
CT angiography upper extremity lt (73206) $491.05 $2,713 2.6×
CT c-spine w/o contrast (72125) $478.20 $2,642 4.3×
CT cervical spine w&w/o contrast (72127) $717.30 $3,963 3.8×
CT cervical spine with contrast (72126) $597.84 $3,303 1.6×
CT chest w/wo contrast (71270) $637.30 $3,521 3.4×
CT chest with contrast (71260) $531.05 $2,934 2.8×
CT head/brain with contrast (70460) $357.81 $2,033 1.9×
CT head/brain without and with contrast (70470) $429.26 $2,439 2.3×
CT heart contrast eval cardiac structure&morph (75572) $353.86 $2,283 1.0×
CT heart no contrast quant eval coronry calcium (75571) $401.14 $2,588 4.3×
CT iac w contrast (70481) $419.23 $2,382 2.2×
CT limited/localized follow up study (76380) $90.83 $586 1.0×
CT lower ext w/o (73700) $295.39 $1,632 2.6×
CT lower extremity w wo contrast (73702) $443.09 $2,448 2.4×
CT lower extremity with contrast (73701) $369.24 $2,040 2.0×
CT lumbar spine w & w/o contrast (72133) $704.09 $3,890 3.8×
CT lumbar spine w/o contrast (72131) $469.33 $2,593 4.2×
CT lumbar spine with contrast (72132) $586.80 $3,242 1.6×
CT maxillofacial w contrast (70487) $335.10 $1,904 1.8×
CT maxillofacial w/o contrast (70486) $268.05 $1,523 2.4×
CT maxillofacial w/wo contrast (70488) $402.16 $2,285 2.1×
CT neck soft tissue w contrast (70491) $326.83 $1,857 1.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $503.01 $2,858 2.7×
CT orbits w/o contrast (70480) $335.28 $1,905 3.0×
CT pelvis w & w/o contrast (72194) $531.42 $2,936 2.8×
CT pelvis w/o contrast (72192) $354.22 $1,957 3.2×
CT scan for measuring calcium and other minerals in bone (77078) $64.98 $359 0.7×
CT soft tissue neck w/o & w/contrast material (70492) $392.13 $2,228 2.1×
CT soft tissue neck w/o contrast (70490) $261.36 $1,485 2.3×
CT thoracic spine w/contrast (72129) $595.31 $3,289 3.2×
CT thoracic spine w/o contrast (72128) $476.21 $2,631 4.3×
CT thoracic spine w/wo contrast (72130) $714.41 $3,947 3.8×
CT thorax w/o contrast (71250) $424.81 $2,347 3.8×
CT upper extremity w/o & w/contrast material (73202) $467.52 $2,583 2.5×
CT upper extremity w/o contrast rt (73200) $311.68 $1,722 2.8×
CT upper extremity with contrast (73201) $389.69 $2,153 1.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $379.13 $2,446 2.0×
Cta Abdomen (74175) $507.52 $2,804 2.7×
CTA abdomen pelvis (74174) $722.19 $3,990 1.9×
CTA chest (71275) $669.34 $3,698 3.6×
Cta Head (70496) $450.74 $2,561 2.4×
CTA lwr ext w&w/o contrast (73706) $465.35 $2,571 2.5×
Cta Neck (70498) $411.84 $2,340 2.2×
Cta Pelvis (72191) $558.02 $3,083 3.0×
Cystography minimum 3 views rs&i (74430) $239.23 $1,018 0.6×
Dacryocystography (70170) $152.51 $649 0.6×
Diskogram cervical (72285) $835.19 $3,554 0.4×
Diskography lumbar (72295) $844.12 $3,592 0.4×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $253.26 $603 2.3×
Doppler Echo Fetal Spectral Display Complete (76827) $322.56 $768 2.9×
Doppler Fetal Mid Cerebral Artery (76821) $167.58 $399 1.5×
Echo exam of fetal heart (76825) $606.90 $1,445 1.0×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $288.96 $688 1.1×
Echoencephalography real time imaging (76506) $311.64 $742 2.8×
Esophagus (74220) $125.49 $534 0.7×
Fetal biophysical profile non-stress testing (76818) $408.66 $973 3.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $267.12 $636 2.4×
Fluoroscopy up to 1 hr (76000) $161.68 $688 0.6×
Foot 2 views (73620) $73.32 $312 0.8×
Forearm 2 views (73090) $76.38 $325 0.8×
Hand 2 views (73120) $76.61 $326 0.7×
Hand 3 views (73130) $84.60 $360 0.9×
Humerus Min 2 Views Left (73060) $82.72 $352 0.9×
Hysterosalpingogram (74740) $161.68 $688 0.6×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $83.89 $357 0.8×
Knee 3 views (73562) $94 $400 1.0×
Mammary ductogram or galactogram single (77053) $187.76 $799 0.7×
Manual appl stress pfrmd phys/qhp joint films (77071) $74.02 $315 0.8×
Mr safety determination physician/other qhp (76016) $31.72 $135 0.3×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $68.15 $290 1.1×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $9.40 $40 0.3×
Mr safety implt electronics prepj supvj phys/qhp (76018) $48.64 $207 0.5×
Mr safety med physics xm customization plng&mntr (76017) $127.84 $544 0.5×
MRA head w & w/o contrast (70546) $410.51 $3,258 1.1×
MRA head w/o contrast (70544) $273.67 $2,172 1.1×
MRA head with contrast (70545) $342.09 $2,715 0.9×
MRA neck w contrast (70548) $282.11 $2,239 0.8×
Mra Neck W/O &W/Contrast Material (70549) $338.56 $2,687 0.9×
MRA neck w/o contrast (70547) $225.67 $1,791 0.9×
MRI abdomen w contrast (74182) $488.03 $2,638 1.3×
MRI abdomen w/o & w/contrast material (74183) $585.52 $3,165 1.6×
MRI abdomen w/o contrast (74181) $390.35 $2,110 1.5×
MRI any jnt lwr ext with con lt (73722) $550.19 $2,974 0.7×
MRI any jt upper extremity w/contrast matrl (73222) $563.32 $3,045 0.7×
MRI bone marrow blood supply (77084) $336.33 $1,818 1.3×
MRI breast w/o contrast bilateral (77047) $539.46 $2,916 2.1×
MRI breast w/o contrast unilat (77046) $359.64 $1,944 1.4×
MRI c-spine with contrast (72142) $352.52 $3,013 0.9×
MRI cervical spine w/o contrast (72141) $281.97 $2,410 1.1×
MRI chest w/o & w/contrast material (71552) $473.97 $2,562 1.3×
MRI chest w/o contrast (71550) $315.98 $1,708 1.2×
MRI chest with contrast (71551) $394.98 $2,135 0.5×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $382.58 $2,068 1.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $482.66 $2,609 1.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $386.09 $2,087 1.5×
MRI orbit face &/neck w/o contrast (70540) $335.61 $2,034 1.3×
MRI orbit/face/neck w&w/o cont (70543) $503.42 $3,051 1.4×
MRI orbit/face/neck w/contrast (70542) $419.60 $2,543 1.1×
MRI pelvis w contrast (72196) $459.36 $2,483 1.2×
MRI pelvis w/o & w/contrast material (72197) $551.12 $2,979 1.5×
MRI pelvis w/o contrast (72195) $367.41 $1,986 1.4×
MRI scan of arm joint before and after contrast (73223) $675.99 $3,654 1.8×
MRI scan of leg joint before and after contrast (73723) $660.26 $3,569 1.8×
MRI spinal canal cervical w/o & w/contr matrl (72156) $422.96 $3,615 1.1×
MRI spinal canal lumbar w/contrast material (72149) $353.57 $3,022 0.9×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $424.24 $3,626 1.1×
MRI spinal canal thoracic w/contrast matrl (72147) $351.59 $3,005 0.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $421.90 $3,606 1.1×
MRI thoracic spine w/o contrast (72146) $281.27 $2,404 1.1×
MRI tmj (70336) $306.18 $1,655 1.2×
MRI upper ext joint w/o contrast (73221) $450.66 $2,436 1.8×
MRI upper extrem other than jt w/o & w/contras (73220) $458.98 $2,481 1.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $305.99 $1,654 1.2×
Myelogram Cervical (72240) $502.66 $2,139 0.6×
Myelogram Lumbar (72265) $502.66 $2,139 0.6×
Myelogram thoracic (72255) $503.14 $2,141 0.6×
Myelography 2 or more regions (72270) $635.20 $2,703 0.8×
Neck soft tissue (70360) $72.61 $309 0.8×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $213.36 $508 1.9×
Orthopantogram (70355) $68.62 $292 0.7×
Osseous survey infant (77076) $247.45 $1,053 2.2×
Osseous survey limited (77074) $97.05 $413 0.9×
Pelvis 1 or 2 views (72170) $83.66 $356 0.7×
Perineogram (74775) $277.77 $1,182 1.1×
Peritoneogram rs&i (74190) $194.34 $827 0.3×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $579.24 $3,131 1.6×
Radex abscess/fistula/sinus tract rs&i (76080) $249.57 $1,062 0.4×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $84.60 $360 0.9×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $138.65 $590 1.2×
Radex hips bilateral with pelvis 2 views (73521) $76.61 $326 0.7×
Radex mastoids compl minimum 3 views pr side (70130) $196.46 $836 1.8×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $191.29 $814 1.7×
Radiolog exam mandible compl minimum 4 views (70110) $91.41 $389 0.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $103.87 $442 1.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $146.17 $622 1.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $80.36 $328 0.9×
Radiologic exam colon single contrast study (74270) $220.43 $938 1.2×
Radiologic exam upr gi trc double contrast study (74246) $144.52 $615 0.8×
Radiologic exam upr gi trc single contrast study (74240) $142.41 $606 0.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $86.95 $370 0.9×
Radiologic Examination Salivary Gland Calculus (70380) $55.22 $235 0.6×
Radiological examination surgical specimen (76098) $120.79 $514 0.2×
Review by radiologist of liver vein image with assessment of blood flow (75889) $1,156.90 $4,923 0.3×
Ribs bilateral 3 views (71110) $79.66 $339 0.7×
Sacroiliac Joints < 3 Views (72200) $76.61 $326 0.7×
Saline Infus Sonohysterography W/Color Doppler (76831) $288.96 $688 1.1×
Scanogram (77073) $90 $383 0.8×
Scapula complete (73010) $85.30 $363 0.8×
Sella turcica (70240) $80.37 $342 0.9×
Shuntogram indwelling nonvascular shunt rs&i (75809) $76.61 $326 0.7×
Sialogram (70390) $161.68 $688 0.6×
Small bowel series (74250) $129.01 $549 0.7×
Speech evaluation complex (70371) $175.54 $747 0.7×
Spine thoracic 3 views (72072) $88.36 $376 0.8×
Temporomandble Jt Arthrography Rs&I (70332) $405.90 $1,103 1.6×
Therapeutic Enema (74283) $315.37 $1,342 1.7×
Thoracolumbar 2 views (72080) $80.37 $342 0.9×
Tmj unilateral (70328) $75.20 $320 0.8×
Tomogram (76100) $188.70 $803 1.7×
Ultrasound, abdomen limited (76705) $276.36 $658 2.5×
Umbilical-artery Doppler (OB) (76820) $163.80 $390 1.5×
Upper Extremity Infant (73092) $122.90 $523 1.1×
Urethrocystography retrograde rs&i (74450) $249.57 $1,062 1.0×
Urethrocystography voiding (74455) $161.68 $688 0.6×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $356.02 $1,515 1.9×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $641.55 $2,730 3.4×
Us abdl aorta screen aaa (76706) $167.16 $398 1.5×
Us breast unilateral complete (76641) $176.40 $420 1.6×
Us breast unilateral limited (76642) $135.66 $323 1.5×
Us chest (76604) $185.22 $441 1.7×
Us compl joint r-t w/image documentation (76881) $196.56 $468 1.8×
Us fetal nuchal translucency 1st gestation (76813) $186.90 $445 1.7×
Us guided compression repair (76936) $262.92 $626 1.1×
Us infant hips dynamic (76885) $236.04 $562 2.5×
Us infant hips limited static (76886) $172.62 $411 1.9×
Us kidney transplant (76776) $234.36 $558 2.1×
Us ob detailed single fetus (76811) $366.66 $873 1.4×
Us ob transvaginal (76817) $241.08 $574 2.2×
Us pelvic non ob complete (76856) $325.08 $774 2.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $274.68 $654 2.5×
Us pregnancy ltd (76815) $212.10 $505 1.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $224.70 $535 2.0×
Us retroperitoneal complete (76770) $285.18 $679 2.6×
Us retroperitoneal limited (76775) $183.96 $438 1.6×
Us scrotum and contents (76870) $299.88 $714 2.7×
Us soft tissue head/neck (76536) $248.22 $591 2.2×
Us spinal canal and contents (76800) $329.28 $784 3.0×
Us transrectal (76872) $227.64 $542 2.0×
Us transrectal prostate volume (76873) $221.76 $528 2.0×
Us xtr non-vasc lmtd (76882) $141.54 $337 1.3×
Us, eye b-scan (76512) $155.40 $370 1.4×
Venogram extremity bilateral (75822) $536.27 $2,282 0.3×
Venography caval inferior serialography rs&i (75825) $1,156.90 $4,923 0.3×
Venography caval superior serialography rs&i (75827) $301.27 $1,282 0.2×
Venography extremity unilateral rs&i (75820) $458.25 $1,950 0.3×
Venography Renal Bilateral (75833) $1,032.36 $4,393 0.3×
Venography renal unilateral selective rs&i (75831) $860.10 $3,660 0.3×
Venography venous sinus/jugular cath rs&i (75860) $963.26 $4,099 0.3×
Vertebral fracture assessment via dxa (77086) $63.45 $270 0.7×
Wrist 2 views (73100) $69.80 $297 0.8×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $168.96 $719 1.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $70.74 $301 0.8×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $87.66 $373 0.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $245.34 $1,044 1.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $79.66 $339 0.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $86.48 $368 0.9×
X-ray exam entire spi 4/5 vw (72083) $160.74 $684 1.4×
X-ray exam hip uni 1 view (73501) $61.33 $261 0.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $74.49 $317 0.8×
X-ray exam hip uni 4/> views (73503) $92.35 $393 0.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $88.60 $377 0.8×
X-Ray Exam Hips Bi 5/> Views (73523) $104.34 $444 0.9×
X-ray exam of femur 1 (73551) $56.87 $242 0.6×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $464.36 $1,976 2.5×
X-ray eye for foreign body (70030) $56.87 $242 0.6×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $82.48 $351 0.7×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $74.73 $318 0.8×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $86.48 $368 0.9×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $67.44 $287 0.7×
X-ray IV pyelogram+drip infusn (74410) $549.66 $2,339 2.9×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $80.37 $342 0.9×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $105.28 $448 0.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $93.06 $396 1.0×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $110.68 $471 1.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $103.63 $441 0.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $140.06 $596 1.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $86.71 $369 0.8×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $70.74 $301 0.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $79.43 $338 0.9×
X-ray of voice box or throat (70370) $124.08 $528 1.3×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $101.75 $433 0.9×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $103.63 $441 0.9×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $258.74 $1,101 0.7×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $67.91 $289 0.7×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $77.78 $331 0.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $108.57 $462 1.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $85.07 $362 0.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $85.30 $363 0.9×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $91.18 $388 1.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $79.66 $339 0.9×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $66.97 $285 0.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $101.05 $430 0.9×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $79.43 $338 0.7×
X-Ray Spine One View - Xr Spine (72020) $57.10 $243 0.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $99.40 $423 1.1×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $78.02 $332 0.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $76.61 $326 0.7×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $94.70 $403 0.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $58.98 $251 0.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $83.19 $354 0.9×
Xr arthrogram ankle (73615) $405.17 $1,101 1.1×
Xr c-spine 6 or more views (72052) $125.96 $536 1.1×
Xr chest 4+ views (71048) $108.53 $443 1.0×
Xr Cholecystography Oral Contrast (74290) $173.20 $737 0.9×
Xr finger(s) 2+ views (73140) $61.10 $260 0.7×
Xr internal auditory meati complete (70134) $133.24 $567 0.2×
XR Mastoids < 3 Views Bilateral (70120) $120.55 $513 1.1×
Xr optic foramina (70190) $98.23 $418 1.1×
Xr shoulder 1 view (73020) $65.56 $279 0.7×
Xr spine cervical 4 or 5 views (72050) $94.47 $402 0.8×
Xr tibia/fibula 2 views (73590) $74.26 $316 0.8×
Xr tmj bilateral (70330) $92.35 $393 1.0×
Xray knee 1 or 2 views rt (73560) $79.90 $340 0.9×