Imaging prices at Dignity Health Mercy Gilbert Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $179.58 $730 1.6×
Acute gastrointestinal blood loss imaging (78278) $647.72 $2,633 1.5×
Angiography extremity bilateral rs&i (75716) $2,713.88 $11,032 0.8×
Angiography internal mammary rs&i (75756) $2,252.63 $9,157 0.7×
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure
$2,176.12 $8,846 0.4×
Angiography pulmonary bilateral slctv rs&i (75743) $3,232.44 $13,140 1.0×
Angiography Spinal Selective Rs&I (75705) $4,792.33 $19,481 0.8×
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure
$2,278.95 $9,264 0.4×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $2,331.10 $9,476 0.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $2,585.96 $10,512 0.8×
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure
$1,963.08 $7,980 0.3×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $2,319.54 $9,429 0.7×
Aortography abdominal serialography rs&i (75625) $2,342.91 $9,524 0.7×
Basic radiation dosimetry calculation (77300) $147.11 $598 1.0×
Bone &/joint imaging whole body (78306) $725.46 $2,949 1.7×
Bone age studies (77072) $140.22 $570 1.3×
Bone Imaging 3 Phase (78315) $993.84 $4,040 2.3×
Bone survey complete (77075) $169.25 $688 1.5×
Brain image w/flow 4 + views (78606) $670.60 $2,726 1.2×
Cardiac MRI w/w/o contrast & further seq (75561) $832.96 $3,386 2.2×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $383.03 $1,557 0.7×
Cervical spine 2 or 3 views (72040) $145.64 $592 1.6×
Chest 1 view (71045) $93.48 $380 1.0×
Chest 3 views (71047) $100.74 $409.50 1.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $372.69 $1,515 2.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $136.29 $554 1.2×
CT abdomen and pelvis without and with contrast (74178) $1,917.57 $7,795 5.2×
CT abdomen and pelvis without contrast (74176) $992.37 $4,034 3.9×
CT abdomen w contrast (74160) $966.05 $3,927 5.2×
CT abdomen w wo contrast (74170) $1,081.91 $4,398 5.8×
CT abdomen w/o contrast (74150) $878.96 $3,573 7.9×
CT angio hrt w/3d image (75574) $842.06 $3,423 2.3×
CT c-spine w/o contrast (72125) $1,108.48 $4,506 9.9×
CT cervical spine w&w/o contrast (72127) $1,718.31 $6,985 9.2×
CT cervical spine with contrast (72126) $1,352.51 $5,498 3.6×
CT chest w/wo contrast (71270) $1,257.56 $5,112 6.7×
CT chest with contrast (71260) $1,047.96 $4,260 5.6×
CT head/brain with contrast (70460) $1,109.71 $4,511 5.9×
CT head/brain without and with contrast (70470) $1,308.48 $5,319 7.0×
CT heart contrast eval cardiac structure&morph (75572) $842.06 $3,423 2.3×
CT heart no contrast quant eval coronry calcium (75571) $614.76 $2,499 6.6×
CT hrt w/3d image congen (75573) $842.06 $3,423 2.3×
CT iac w contrast (70481) $1,187.20 $4,826 6.3×
CT limited/localized follow up study (76380) $137.15 $557.50 1.5×
CT lumbar spine w & w/o contrast (72133) $1,778.83 $7,231 9.5×
CT lumbar spine w/o contrast (72131) $1,147.59 $4,665 10.3×
CT lumbar spine with contrast (72132) $1,400.24 $5,692 3.8×
CT maxillofacial w contrast (70487) $886.10 $3,602 4.7×
CT maxillofacial w/o contrast (70486) $732.10 $2,976 6.6×
CT maxillofacial w/wo contrast (70488) $1,039.85 $4,227 5.6×
CT neck soft tissue w contrast (70491) $914.39 $3,717 4.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,282.16 $5,212 6.9×
CT orbits w/o contrast (70480) $1,009.10 $4,102 9.0×
CT pelvis w & w/o contrast (72194) $1,121.52 $4,559 6.0×
CT pelvis w/o contrast (72192) $919.31 $3,737 8.2×
CT soft tissue neck w/o & w/contrast material (70492) $1,033.20 $4,200 5.5×
CT soft tissue neck w/o contrast (70490) $667.40 $2,713 6.0×
CT thoracic spine w/contrast (72129) $1,339.47 $5,445 7.2×
CT thoracic spine w/o contrast (72128) $1,097.90 $4,463 9.8×
CT thoracic spine w/wo contrast (72130) $1,701.83 $6,918 9.1×
CT thorax w/o contrast (71250) $534.56 $2,173 4.8×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $738 $3,000 3.9×
Cta Abdomen (74175) $1,063.46 $4,323 5.7×
CTA abdomen pelvis (74174) $1,346.12 $5,472 3.6×
CTA chest (71275) $924.23 $3,757 4.9×
Cta Head (70496) $990.40 $4,026 5.3×
Cta Neck (70498) $1,048.95 $4,264 5.6×
Cta Pelvis (72191) $329.89 $1,341 1.8×
Cystography minimum 3 views rs&i (74430) $299.14 $1,216 0.8×
Diskography lumbar (72295) $669.12 $2,720 0.3×
Doppler Fetal Mid Cerebral Artery (76821) $124.48 $506 1.1×
Dxa bone density study 1/> sites axial skel (77080) $191.88 $780 1.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $97.91 $398 1.1×
Echoencephalography real time imaging (76506) $147.85 $601 1.3×
Esophagus (74220) $410.82 $1,670 2.2×
Fetal biophysical profile non-stress testing (76818) $572.69 $2,328 5.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $417.96 $1,699 3.7×
Fluoroscopy up to 1 hr (76000) $316.11 $1,285 1.2×
Gated Heart Planar Single (78472) $800.24 $3,253 1.9×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $2,331.10 $9,476 0.7×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,023.86 $4,162 1.8×
Hepatobiliary syst imaging including gallbladder (78226) $747.35 $3,038 1.8×
Ht muscle image spect sing (78451) $1,659.03 $6,744 1.2×
Hysterosalpingogram (74740) $302.09 $1,228 1.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $621.65 $2,527 1.1×
Kidney img morphology vascular flow 1 w/rx (78708) $786.96 $3,199 1.4×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,463.70 $5,950 2.5×
Liver & spleen imaging static only (78215) $448.95 $1,825 1.1×
Liver imaging static only (78201) $1,282.89 $5,215 2.2×
Liver imaging w/vascular flow (78202) $692.74 $2,816 1.2×
Lung perf&ventilat diferentl (78598) $498.15 $2,025 0.9×
Lung perfusion differential (78597) $498.15 $2,025 1.2×
Lung Ventilation Imaging (78579) $433.95 $1,764 1.0×
Lymphoscintigraphy (78195) $1,141.20 $4,639 2.0×
Meckels Diverticulum (78290) $465.19 $1,891 1.1×
Mr safety determination physician/other qhp (76016) $57.81 $235 0.6×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $38.87 $158 0.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $15.99 $65 0.5×
Mr safety implt electronics prepj supvj phys/qhp (76018) $60.27 $245 0.6×
Mr safety med physics xm customization plng&mntr (76017) $158.43 $644 0.6×
MRA head w & w/o contrast (70546) $1,641.07 $6,671 4.4×
MRA head w/o contrast (70544) $970.97 $3,947 3.8×
Mra Neck W/O &W/Contrast Material (70549) $1,354.73 $5,507 3.6×
MRA neck w/o contrast (70547) $801.72 $3,259 3.1×
MRI abdomen w/o & w/contrast material (74183) $1,740.21 $7,074 4.7×
MRI abdomen w/o contrast (74181) $1,023.61 $4,161 4.0×
MRI breast w/o contrast bilateral (77047) $1,255.34 $5,103 4.9×
MRI c-spine with contrast (72142) $1,162.35 $4,725 3.1×
MRI cardiac w/o contrast (75557) $724.72 $2,946 2.8×
MRI cervical spine w/o contrast (72141) $833.45 $3,388 3.3×
MRI chest w/o & w/contrast material (71552) $1,001.47 $4,071 2.7×
MRI chest w/o contrast (71550) $600.98 $2,443 2.4×
MRI chest with contrast (71551) $901.59 $3,665 1.1×
MRI orbit face &/neck w/o contrast (70540) $760.39 $3,091 3.0×
MRI orbit/face/neck w&w/o cont (70543) $1,689.53 $6,868 4.5×
MRI orbit/face/neck w/contrast (70542) $1,132.10 $4,602 3.0×
MRI pelvis w contrast (72196) $1,479.20 $6,013 4.0×
MRI pelvis w/o & w/contrast material (72197) $1,740.21 $7,074 4.7×
MRI pelvis w/o contrast (72195) $1,026.81 $4,174 4.0×
MRI scan of heart before and after contrast with stress imaging (75563) $832.96 $3,386 1.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,193.34 $8,916 5.9×
MRI spinal canal lumbar w/contrast material (72149) $1,162.35 $4,725 3.1×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,193.34 $8,916 5.9×
MRI spinal canal thoracic w/contrast matrl (72147) $1,162.35 $4,725 3.1×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,193.34 $8,916 5.9×
MRI thoracic spine w/o contrast (72146) $833.45 $3,388 3.3×
MRI tmj (70336) $415.99 $1,691 1.6×
Myelogram Lumbar (72265) $828.53 $3,368 1.0×
Myelography 2 or more regions (72270) $469.37 $1,908 0.6×
Myocardial Spect Multiple Studies (78452) $1,999 $8,126 1.4×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $1,836.39 $7,465 2.0×
Neck soft tissue (70360) $122.51 $498 1.3×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $521.52 $2,120 1.2×
Nm bone marrow wb (78104) $724.72 $2,946 1.7×
Nm gastric emptying study (78264) $909.22 $3,696 2.1×
Nuclear medicine study of heart muscle at rest with stress (78453) $1,499.37 $6,095 1.1×
Nuclear medicine study of kidney and blood flow (78701) $779.09 $3,167 1.8×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $380.81 $1,548 3.4×
Osseous survey limited (77074) $123.50 $502 1.1×
Parathyroid imaging (78070) $577.12 $2,346 1.4×
Pelvis 1 or 2 views (72170) $134.44 $546.50 1.2×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $2,331.10 $9,476 0.7×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $669.12 $2,720 0.2×
Pulmonary Perfusion Imaging Particulate (78580) $456.83 $1,857 1.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $625.83 $2,544 1.1×
Radex abscess/fistula/sinus tract rs&i (76080) $403.44 $1,640 0.7×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $198.28 $806 2.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $272.08 $1,106 2.4×
Radex hips bilateral with pelvis 2 views (73521) $154.98 $630 1.4×
Radiolog exam mandible compl minimum 4 views (70110) $174.42 $709 1.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $120.92 $491.50 1.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $97.54 $396.50 1.1×
Radiologic exam colon single contrast study (74270) $350.80 $1,426 1.9×
Radiologic exam upr gi trc double contrast study (74246) $352.28 $1,432 1.9×
Radiologic exam upr gi trc single contrast study (74240) $261.50 $1,063 1.4×
Radiological examination surgical specimen (76098) $403.44 $1,640 0.7×
Review by radiologist of liver vein image with assessment of blood flow (75889) $2,331.10 $9,476 0.7×
Rp loclzj tum plnr whole body single day imaging (78802) $1,007.62 $4,096 1.7×
Rp loclzj tum spect 1 area single day imaging (78803) $1,060.76 $4,312 1.8×
Rp therapy intra-arterial particulate admn (79445) $581.92 $2,365.50 2.3×
Saline Infus Sonohysterography W/Color Doppler (76831) $84.63 $344 0.3×
Scanogram (77073) $84.38 $343 0.8×
Screening digital breast tomosynthesis (77063) $36.90 $150 1.6×
Shuntogram indwelling nonvascular shunt rs&i (75809) $104.43 $424.50 0.9×
Small bowel series (74250) $429.77 $1,747 2.3×
Spine thoracic 3 views (72072) $166.92 $678.50 1.5×
Splenoportograpy rs&i (75810) $2,764.55 $11,238 0.8×
Superior sagittal sinus venogram (75870) $840.09 $3,415 0.2×
Thoracolumbar 2 views (72080) $135.92 $552.50 1.5×
Thyroid carcinoma metastases img whole body (78018) $560.64 $2,279 1.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $347.85 $1,414 0.8×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $1,767.76 $7,186 3.1×
Ultrasound, abdomen limited (76705) $471.83 $1,918 4.2×
Umbilical-artery Doppler (OB) (76820) $124.48 $506 1.1×
Unlisted Diagnostic Radiographic Procedure (76499) $1,374.90 $5,589 14.8×
Urethrocystography retrograde rs&i (74450) $241.08 $980 0.9×
Urethrocystography voiding (74455) $231.49 $941 0.9×
Us chest (76604) $283.89 $1,154 2.5×
Us guided compression repair (76936) $222.39 $904 1.0×
Us infant hips limited static (76886) $130.63 $531 1.4×
Us kidney transplant (76776) $218.45 $888 2.0×
Us ob detailed single fetus (76811) $258.55 $1,051 1.0×
Us ob transvaginal (76817) $328.17 $1,334 2.9×
Us pelvic non ob complete (76856) $349.57 $1,421 3.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $248.22 $1,009 2.2×
Us pregnancy ltd (76815) $282.41 $1,148 2.5×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $246.99 $1,004 2.2×
Us retroperitoneal complete (76770) $340.71 $1,385 3.1×
Us retroperitoneal limited (76775) $224.85 $914 2.0×
Us scrotum and contents (76870) $348.34 $1,416 3.1×
Us soft tissue head/neck (76536) $264.21 $1,074 2.4×
Us spinal canal and contents (76800) $136.53 $555 1.2×
Us transrectal prostate volume (76873) $524.97 $2,134 4.7×
Venogram extremity bilateral (75822) $2,050.41 $8,335 1.2×
Venography caval inferior serialography rs&i (75825) $2,331.10 $9,476 0.7×
Venography caval superior serialography rs&i (75827) $1,165.55 $4,738 0.7×
Venography epidural rs&i (75872) $734.56 $2,986 1.1×
Venography venous sinus/jugular cath rs&i (75860) $2,270.34 $9,229 0.7×
Venous sampling thru cath w/wo angiography rs& (75893) $3,277.71 $13,324 0.6×
Vertebral fracture assessment via dxa (77086) $87.09 $354 0.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $272.94 $1,109.50 2.4×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $111.93 $455 1.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $778.59 $3,165 4.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $185.61 $754.50 1.7×
X-Ray Exam Hips Bi 5/> Views (73523) $299.39 $1,217 2.7×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $195.82 $796 1.8×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $154.37 $627.50 1.7×
X-ray guide gu dilation - ir nephrostomy dilation (74485) $481.43 $1,957 0.2×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $213.16 $866.50 2.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $161.01 $654.50 1.4×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $409.35 $1,664 3.7×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $177.12 $720 1.6×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $203.57 $827.50 2.2×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $75.04 $305 0.8×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $163.22 $663.50 1.5×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $178.72 $726.50 1.6×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $386.96 $1,573 1.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $379.46 $1,542.50 3.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $212.18 $862.50 1.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $175.77 $714.50 1.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $151.05 $614 1.6×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $215.75 $877 2.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $93.85 $381.50 0.8×
X-Ray Spine One View - Xr Spine (72020) $90.78 $369 1.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $182.04 $740 2.0×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $148.10 $602 1.6×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $212.30 $863 1.9×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $302.83 $1,231 2.7×
Xr c-spine 6 or more views (72052) $351.54 $1,429 3.2×
Xr spine cervical 4 or 5 views (72050) $114.39 $465 1.0×
Xr tmj bilateral (70330) $149.82 $609 1.6×