Imaging prices at Cobre Valley Regional Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $4,919
Abdomen 2 views (74019) $210
Acute gastrointestinal blood loss imaging (78278) $2,206
Angiography extremity bilateral rs&i (75716) $6,831
Angiography extremity unilateral rs&i (75710) $9,426
Angiography pelvic slctv/supraslctv rs&i (75736) $10,089
Angiography pulmonary bilateral slctv rs&i (75743) $10,444
Angiography pulmonary unilateral slctv rs&i (75741) $10,763
Ankle 2 views (73600) $208
Aortogram thoracic (75605) $9,426
Aortography abdl bi iliofem low extrem cath rs&i (75630) $9,426
Aortography abdominal serialography rs&i (75625) $9,426
Aortography thoracic w/o serialography rs&i (75600) $7,570
Arthrogram elbow (73085) $906
Arthrogram hip (73525) $1,187
Arthrogram shoulder (73040) $1,187
Arthrogram wrist (73115) $906
Arthrography knee lt (73580) $906
Basic radiation dosimetry calculation (77300) $501
Bone &/Joint Imaging Limited Area (78300) $1,632
Bone &/Joint Imaging Multiple Areas (78305) $1,632
Bone &/joint imaging whole body (78306) $1,910
Bone age studies (77072) $335.50
Bone Imaging 3 Phase (78315) $2,177
Bone survey complete (77075) $492
Cardiac shunt detection (78428) $1,795
Cervical spine 2 or 3 views (72040) $339
Chest 1 view (71045) $143
Chest 3 views (71047) $258
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $566
Clavicle complete (73000) $208
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $536
Continuing medical physics consltj pr wk (77336) $692
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $403
CT abdomen and pelvis without and with contrast (74178) $1,949
CT abdomen and pelvis without contrast (74176) $1,193
CT abdomen w contrast (74160) $2,057
CT abdomen w wo contrast (74170) $2,437
CT abdomen w/o contrast (74150) $1,574
CT angio hrt w/3d image (75574) $3,012
CT angiography upper extremity lt (73206) $2,322
CT c-spine w/o contrast (72125) $1,193
CT cervical spine w&w/o contrast (72127) $2,385
CT cervical spine with contrast (72126) $2,057
CT chest w/wo contrast (71270) $2,489
CT chest with contrast (71260) $1,441
CT head/brain with contrast (70460) $2,057
CT head/brain without and with contrast (70470) $2,437
CT heart contrast eval cardiac structure&morph (75572) $1,314
CT heart no contrast quant eval coronry calcium (75571) $467
CT hrt w/3d image congen (75573) $1,868
CT iac w contrast (70481) $1,971
CT limited/localized follow up study (76380) $1,934
CT lower ext w/o (73700) $1,104
CT lower extremity w wo contrast (73702) $2,437
CT lower extremity with contrast (73701) $1,971
CT lumbar spine w & w/o contrast (72133) $2,489
CT lumbar spine w/o contrast (72131) $1,193
CT lumbar spine with contrast (72132) $1,971
CT maxillofacial w contrast (70487) $2,057
CT maxillofacial w/o contrast (70486) $1,028
CT maxillofacial w/wo contrast (70488) $2,437
CT neck soft tissue w contrast (70491) $2,057
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $2,437
CT orbits w/o contrast (70480) $1,574
CT pelvis w & w/o contrast (72194) $2,437
CT pelvis w/o contrast (72192) $1,703
CT soft tissue neck w/o & w/contrast material (70492) $2,437
CT soft tissue neck w/o contrast (70490) $1,574
CT thoracic spine w/contrast (72129) $2,057
CT thoracic spine w/o contrast (72128) $1,703
CT thoracic spine w/wo contrast (72130) $2,489
CT thorax w/o contrast (71250) $1,193
CT upper extremity w/o & w/contrast material (73202) $2,437
CT upper extremity w/o contrast rt (73200) $1,574
CT upper extremity with contrast (73201) $2,057
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,425
Cta Abdomen (74175) $2,425
CTA abdomen pelvis (74174) $2,052
CTA chest (71275) $1,697
Cta Head (70496) $2,425
Cta Neck (70498) $2,425
Cta Pelvis (72191) $2,425
Cystography minimum 3 views rs&i (74430) $761
Diskography lumbar (72295) $3,024
Doppler Echo Fetal Spectral Display Complete (76827) $375
Dxa bone density study 1/> sites axial skel (77080) $341
Dxa bone density study 1/>sites appendiclr skel (77081) $210
Esophageal motility (78258) $1,544
Esophagus (74220) $513
Fetal biophysical profile non-stress testing (76818) $379
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $567
Fluoroscopy up to 1 hr (76000) $621
Foot 2 views (73620) $208
Forearm 2 views (73090) $208
Gated Heart Planar Single (78472) $1,876
Hand 2 views (73120) $339
Hand 3 views (73130) $208
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,860
Ht muscle image spect sing (78451) $1,834
Humerus Min 2 Views Left (73060) $208
Hysterosalpingogram (74740) $877
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,532
Kidney img morphology vascular flow 1 w/rx (78708) $1,808
Knee 3 views (73562) $167
Liver & Spleen Imaging W/Vascular Flow (78216) $1,783
Lung perf&ventilat diferentl (78598) $2,171
Lymphoscintigraphy (78195) $2,250
Mammary ductogram or galactogram single (77053) $753
Meckels Diverticulum (78290) $2,184
Mlc imrt design & construction per imrt plan (77338) $2,257
MRA head w & w/o contrast (70546) $2,392
MRA head w/o contrast (70544) $1,797
MRA neck w contrast (70548) $2,752
MRA neck w/o contrast (70547) $1,797
MRI abdomen w/o & w/contrast material (74183) $3,720
MRI abdomen w/o contrast (74181) $2,568
MRI any jnt lwr ext with con lt (73722) $2,636
MRI any jt upper extremity w/contrast matrl (73222) $2,579
MRI bone marrow blood supply (77084) $2,341
MRI c-spine with contrast (72142) $2,752
MRI cervical spine w/o contrast (72141) $1,797
MRI chest w/o & w/contrast material (71552) $4,266
MRI chest w/o contrast (71550) $2,460
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,392
MRI orbit face &/neck w/o contrast (70540) $2,568
MRI orbit/face/neck w&w/o cont (70543) $3,720
MRI orbit/face/neck w/contrast (70542) $2,636
MRI pelvis w contrast (72196) $2,636
MRI pelvis w/o & w/contrast material (72197) $4,453
MRI pelvis w/o contrast (72195) $2,568
MRI scan of arm joint before and after contrast (73223) $4,266
MRI scan of leg joint before and after contrast (73723) $3,564
MRI spinal canal cervical w/o & w/contr matrl (72156) $4,453
MRI spinal canal lumbar w/contrast material (72149) $2,636
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,453
MRI spinal canal thoracic w/contrast matrl (72147) $2,636
MRI spinal canal thoracic w/o & w/contr matrl (72157) $4,453
MRI thoracic spine w/o contrast (72146) $2,568
MRI tmj (70336) $2,347
MRI upper ext joint w/o contrast (73221) $1,797
MRI upper extrem other than jt w/o & w/contras (73220) $1,856
MRI upper extremity oth than jt w/o contr matrl (73218) $1,856
Myelogram Cervical (72240) $2,389
Myelogram Lumbar (72265) $2,321
Myelogram thoracic (72255) $2,389
Myocardial Imaging Pet Metabolic Evaluation (78459) $2,842
Myocardial Spect Multiple Studies (78452) $2,654
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $4,429
Neck soft tissue (70360) $208
Nm adrenal scan (78075) $1,281
Nm gastric emptying study (78264) $2,175
Nm gastroesophageal reflux study (78262) $1,544
Nm peritoneal-venous shunt patency (78291) $1,544
Ntsty modul radthx pln dose-vol histos (77301) $12,925
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $2,842
Nuclear medicine of heart muscle at rest with stress (78454) $2,042
Nuclear medicine study from skull base to mid-thigh (78812) $9,519
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $2,842
Nuclear Rx Oral Admin (79005) $275
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $303.50
Osseous survey infant (77076) $332
Osseous survey limited (77074) $335.50
Parathyrd planar w/spect&CT (78072) $2,893
Parathyroid imaging (78070) $1,908
Pelvis 1 or 2 views (72170) $339
Peritoneogram rs&i (74190) $880
PET image w/CT, skull-thigh (78815) $10,813
PET imaging CT for attenuation limited area (78814) $3,567
PET imaging for CT attenuation whole body (78816) $10,645
PET imaging limited area chest head/neck (78811) $3,260
PET whole body (78813) $9,519
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,392
Pr non-imaging heart function (78414) $1,795
Pulmonary Perfusion Imaging Particulate (78580) $1,484
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $1,410
Radex abscess/fistula/sinus tract rs&i (76080) $383
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $342.50
Radex mastoids compl minimum 3 views pr side (70130) $253
Radiation treatment delivery 1 mev >= complex (77412) $2,187
Radiation treatment delivery 1 mev >= simple (77402) $1,270
Radiation tx delivery 1 mev >= intermediate (77407) $2,303
Radiolog exam mandible compl minimum 4 views (70110) $339
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $210
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $210
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $147
Radiologic exam colon single contrast study (74270) $712
Radiologic exam upr gi trc double contrast study (74246) $570
Radiologic exam upr gi trc single contrast study (74240) $513
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $210
Radiologic Examination Salivary Gland Calculus (70380) $227
Radiological examination surgical specimen (76098) $196
Salivary gland imaging (78230) $1,544
Scanogram (77073) $265
Scapula complete (73010) $208
Screening digital breast tomosynthesis (77063) $33.60
Sella turcica (70240) $203
Sialogram (70390) $503
Small bowel series (74250) $513
Spec medical radj physics consltj (77370) $1,077
Spec telethx port pln parts hemibdy tot bdy (77321) $1,323
Special dosimetry (77331) $501
Special treatment procedure (77470) $2,129
Spine thoracic 3 views (72072) $339
Spleen imaging only (78185) $1,632
Stereotactic body radiation delivery (77373) $10,490
Telethx isodose pln cplx w/basic dosimetry (77307) $1,323
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,323
Testicular Imaging With Vascular Flow (78761) $1,532
Ther rad simulaj-aided field setting complex (77290) $3,607
Ther rad simulaj-aided field setting simple (77280) $2,814.50
Thoracolumbar 2 views (72080) $227
Thyroid carcinoma metastases img whole body (78018) $1,758
Thyroid uptake measurement (78012) $907
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,122
Tomogram (76100) $379
Treatment device intermediate (77333) $610.50
Treatment devices simple (77332) $407
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $4,790
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $1,633
Tx devices design & construction complex (77334) $1,323
Ultrasound, abdomen limited (76705) $400
Umbilical-artery Doppler (OB) (76820) $325
Unlisted magnetic resonance procedure (76498) $2,347
Upper Extremity Infant (73092) $339
Ureteral Reflux Study Rp Voiding Cystogram (78740) $1,531
Urethrocystography retrograde rs&i (74450) $730
Urethrocystography voiding (74455) $730
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $730
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $761
Us breast unilateral complete (76641) $396
Us breast unilateral limited (76642) $300
Us chest (76604) $366
Us compl joint r-t w/image documentation (76881) $343.50
Us elastography parenchyma (76981) $486
Us fetal nuchal translucency 1st gestation (76813) $167
Us infant hips dynamic (76885) $531.50
Us ob detailed single fetus (76811) $850.50
Us ob transvaginal (76817) $572.50
Us pelvic non ob complete (76856) $513
Us pregnancy ltd (76815) $361
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $572.50
Us retroperitoneal complete (76770) $400
Us retroperitoneal limited (76775) $554
Us scrotum and contents (76870) $567
Us soft tissue head/neck (76536) $578
Us spinal canal and contents (76800) $572.50
Us transrectal (76872) $554
Us xtr non-vasc lmtd (76882) $572.50
Venogram extremity bilateral (75822) $1,909.50
Venography caval inferior serialography rs&i (75825) $7,326
Venography caval superior serialography rs&i (75827) $5,047
Venography extremity unilateral rs&i (75820) $2,519
Wrist 2 views (73100) $208
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $339
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $208
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $208
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $998
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $208
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $208
X-ray exam entire spi 4/5 vw (72083) $357
X-ray exam hip uni 1 view (73501) $208
X-Ray Exam Hip Uni 2-3 Views (73502) $210
X-Ray Exam Hips Bi 3-4 Views (73522) $234
X-Ray Exam Hips Bi 5/> Views (73523) $228.50
X-ray exam of femur 1 (73551) $210
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $754
X-ray eye for foreign body (70030) $203
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $339
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $210
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $146
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $208
X-ray IV pyelogram+drip infusn (74410) $730
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $339
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $208
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $208
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $339
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $339
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $208
X-Ray Nasal Bones - Xr Nasal Bones (70160) $339
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $282
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $265
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $339
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $1,292
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $208
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $339
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $339
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $339
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $208
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $208
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $208
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $210
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $339
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $339
X-Ray Spine One View - Xr Spine (72020) $208
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $208
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $208
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $227
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $208
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $208
Xr arthrogram ankle (73615) $906
Xr c-spine 6 or more views (72052) $339
Xr chest 4+ views (71048) $258
Xr finger(s) 2+ views (73140) $208
Xr internal auditory meati complete (70134) $341
Xr optic foramina (70190) $203
Xr shoulder 1 view (73020) $208
Xr spine cervical 4 or 5 views (72050) $339
Xr tibia/fibula 2 views (73590) $208
Xr tmj bilateral (70330) $208
Xray knee 1 or 2 views rt (73560) $208