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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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018)
range across 2 matching MRF lines
$69.13–$172.70 $281–$702 varies
Abdomen 2 views (74019)
range across 2 matching MRF lines
$101.85–$257.32 $414–$1,046 varies
Acute Gastrointestinal Blood Loss Imaging (78278) $647.72 $2,633 1.5×
Angio internal mammary (75756) $2,252.63 $9,157 0.7×
Angio pulmonary bilat (75743) $3,232.44 $13,140 1.0×
Angiography extremity bilateral rs&i (75716) $2,713.88 $11,032 0.8×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $2,585.96 $10,512 0.8×
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure
$1,963.08 $7,980 0.3×
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure
$2,278.95 $9,264 0.4×
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure
$2,176.12 $8,846 0.4×
Artery X-Rays Spine (75705) $4,792.33 $19,481 0.8×
Basic radiation dosimetry calculation (77300) $147.11 $598 1.0×
Bone age studies (77072) $140.22 $570 1.3×
Bone Imaging 3 Phase (78315) $993.84 $4,040 2.3×
Bone Imaging Whole Body (78306) $725.46 $2,949 1.7×
Bone marrow imaging; whole body (78104) $724.72 $2,946 1.7×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $670.60 $2,726 1.2×
Cardiac MRI w/w/o contrast & further seq (75561) $832.96 $3,386 2.2×
Cardiac MRI w/w/o contrast w/stress (75563) $832.96 $3,386 1.0×
Cat Scan Follow-Up Study (76380)
range across 2 matching MRF lines
$124.73–$149.57 $507–$608 varies
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $383.03 $1,557 0.7×
Chest 1 view (71045)
range across 2 matching MRF lines
$53.39–$133.58 $217–$543 varies
Chest 2 views (71046)
range across 2 matching MRF lines
$56.09–$138.99 $228–$565 varies
Chest 3 views (71047)
range across 2 matching MRF lines
$57.32–$144.16 $233–$586 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $136.29 $554 1.2×
Contrast Exam Abdominl Aorta (75625) $2,342.91 $9,524 0.7×
Contrast X-Ray Bladder (74430) $299.14 $1,216 0.8×
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 Abdomen and Pelvis (74174) $1,346.12 $5,472 3.6×
CT Angio Chest (71275) $924.23 $3,757 4.9×
CT Angio Head (70496) $990.40 $4,026 5.3×
CT angio hrt w/3d image (75574) $842.06 $3,423 2.3×
CT Angio Neck (70498) $1,048.95 $4,264 5.6×
CT cervical spine w/ contrast (72126) $1,352.51 $5,498 3.6×
CT cervical spine w/o contrast (72125) $1,108.48 $4,506 9.9×
CT cervical spine w/wo cont (72127) $1,718.31 $6,985 9.2×
CT chest w contrast (71260) $1,047.96 $4,260 5.6×
CT chest w/wo contrast (71270) $1,257.56 $5,112 6.7×
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 l-spine w&w/o contrast (72133) $1,778.83 $7,231 9.5×
CT lumbar spine w contrast (72132) $1,400.24 $5,692 3.8×
CT lumbar spine w/o contrast (72131) $1,147.59 $4,665 10.3×
CT maxillofacial w contrast (70487) $886.10 $3,602 4.7×
CT maxillofacial wo contrast (70486) $732.10 $2,976 6.6×
CT neck tissue combo (70492) $1,033.20 $4,200 5.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (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 scans face/jaw combo (70488) $1,039.85 $4,227 5.6×
CT soft tissue neck w contrast (70491) $914.39 $3,717 4.9×
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 cont (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 pelvis (72191) $329.89 $1,341 1.8×
Dilation ureters/urethra rs&i (74485) $481.43 $1,957 0.2×
Diskography lumbar (72295) $669.12 $2,720 0.3×
Doppler Fetal Mid Cerebral Artery (76821) $124.48 $506 1.1×
Dxa Bone Density Axial (77080) $191.88 $780 1.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $97.91 $398 1.1×
Echo exam uterus (76831) $84.63 $344 0.3×
Echo Guide For Artery Repair (76936) $222.39 $904 1.0×
Echograp Trans R Pros Study (76873) $524.97 $2,134 4.7×
Esophagram (74220) $410.82 $1,670 2.2×
Fetal Biophys Profile W/Nst (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×
Follow-Up Angiography (75898) $2,331.10 $9,476 0.7×
Gastric emptying imaging study (78264) $909.22 $3,696 2.1×
Gated Heart Planar Single (78472) $800.24 $3,253 1.9×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $2,331.10 $9,476 0.7×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $2,331.10 $9,476 0.7×
Hepatobil Syst Image W/Drug (78227) $1,023.86 $4,162 1.8×
Hepatobiliary System Imaging (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×
Infant hip ultrasound, limited static exam (76886) $130.63 $531 1.4×
K Flow/Funct Image Multiple (78709) $1,463.70 $5,950 2.5×
K Flow/Funct Image W/Drug (78708) $786.96 $3,199 1.4×
K Flow/Funct Image W/O Drug (78707) $621.65 $2,527 1.1×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $779.09 $3,167 1.8×
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 Ventilat&Perfus Imaging (78582) $625.83 $2,544 1.1×
Lung Ventilation Imaging (78579) $433.95 $1,764 1.0×
Lymph System Imaging (78195) $1,141.20 $4,639 2.0×
Magnetic Image Jaw Joint (70336) $415.99 $1,691 1.6×
Meckels Divert Exam (78290) $465.19 $1,891 1.1×
Mr safety determination physician/other qhp (76016) $57.81 $235 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 implt pos&/immoblj (76019) $38.87 $158 0.6×
Mr safety med physics xm customization plng&mntr (76017) $158.43 $644 0.6×
Mra Head W/O & W/Contrast Material (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 contrast (74181) $1,023.61 $4,161 4.0×
MRI Breast W/O Contrast Bilateral (77047) $1,255.34 $5,103 4.9×
MRI cardiac w/o contrast (75557) $724.72 $2,946 2.8×
MRI cervical spine w contrast (72142) $1,162.35 $4,725 3.1×
MRI cervical spine w/o cont (72141) $833.45 $3,388 3.3×
MRI chest w/o contrast (71550) $600.98 $2,443 2.4×
MRI chest with contrast (71551) $901.59 $3,665 1.1×
MRI chest wo w contrast (71552) $1,001.47 $4,071 2.7×
MRI lumbar spine w contrast (72149) $1,162.35 $4,725 3.1×
Mri Neck Spine W/O & W/Dye (72156) $2,193.34 $8,916 5.9×
MRI orbit face &/neck w/o contrast (70540) $760.39 $3,091 3.0×
MRI orbit face neck w contrast (70542) $1,132.10 $4,602 3.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,689.53 $6,868 4.5×
MRI pelvis w contrast (72196) $1,479.20 $6,013 4.0×
MRI pelvis w/o & w contrast (72197) $1,740.21 $7,074 4.7×
MRI pelvis w/o contrast (72195) $1,026.81 $4,174 4.0×
MRI thoracic spine w/o contrast (72146) $833.45 $3,388 3.3×
MRI, abdomen, combo (74183) $1,740.21 $7,074 4.7×
MRI, dorsal spine combo (72157) $2,193.34 $8,916 5.9×
MRI, dorsal spine contrast (72147) $1,162.35 $4,725 3.1×
MRI, lumbar spine combo (72158) $2,193.34 $8,916 5.9×
Myelogram Lumbar (72265) $828.53 $3,368 1.0×
Myelograpy 2/more regions rs&i (72270) $469.37 $1,908 0.6×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $1,499.37 $6,095 1.1×
Myocardial Spect Multiple Studies (78452) $1,999 $8,126 1.4×
N-invas est c ffr sw aly CTA (75580) $1,836.39 $7,465 2.0×
Neck soft tissue (70360)
range across 2 matching MRF lines
$70.11–$174.91 $285–$711 varies
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $521.52 $2,120 1.2×
Nonvascular Shunt X-Ray (75809)
range across 2 matching MRF lines
$101.85–$107.01 $414–$435 varies
Nuclear Rx Intra-Arterial (79445)
range across 2 matching MRF lines
$344.16–$819.68 $1,399–$3,332 varies
Parathyroid Planar Imaging (78070) $577.12 $2,346 1.4×
Pelvis 1 or 2 views (72170)
range across 2 matching MRF lines
$76.76–$192.13 $312–$781 varies
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $2,331.10 $9,476 0.7×
Pulmonary Perfusion Imaging Particulate (78580) $456.83 $1,857 1.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022)
range across 2 matching MRF lines
$155.48–$390.41 $632–$1,587 varies
Radex abscess/fistula/sinus tract rs&i (76080) $403.44 $1,640 0.7×
Radex Facial Bones Complete Minimum 3 Views (70150)
range across 2 matching MRF lines
$111.93–$279.71 $455–$1,137 varies
Radex Nasal Bones Complete Minimum 3 Views (70160)
range across 2 matching MRF lines
$116.36–$290.78 $473–$1,182 varies
Radex Sinuses Paransl < 3 Views (70210) $215.75 $877 2.3×
Radex Spine 1 View Specify Level (72020)
range across 2 matching MRF lines
$51.91–$129.65 $211–$527 varies
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines
$84.63–$211.56 $344–$860 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $149.82 $609 1.6×
Radiolog exam mandible compl minimum 4 views (70110)
range across 2 matching MRF lines
$99.63–$249.20 $405–$1,013 varies
Radiologic exam colon double contrast study (74280) $778.59 $3,165 4.2×
Radiologic exam colon single contrast study (74270) $350.80 $1,426 1.9×
Radiologic exam pelvis compl minimum 3 views (72190)
range across 2 matching MRF lines
$101.85–$255.60 $414–$1,039 varies
Radiologic Exam Small Int Single Contrast Study (74250) $429.77 $1,747 2.3×
Radiologic exam swallow function contrast study (74230) $372.69 $1,515 2.0×
Radiologic exam upr gi trc double contrast study (74246) $352.28 $1,432 1.9×
Radiologic Examination Osseous Survey Limited (77074) $123.50 $502 1.1×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,767.76 $7,186 3.1×
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×
Screening Digital Breast Tomosynthesis Bi (77063) $36.90 $150 1.6×
Skull less than 4 views (70250)
range across 2 matching MRF lines
$53.63–$134.07 $218–$545 varies
Sternoclavicular joints (71130)
range across 2 matching MRF lines
$104.06–$260.03 $423–$1,057 varies
Superior sagittal sinus venogram (75870) $840.09 $3,415 0.2×
Thoracic spine 2 views (72070) $212.30 $863 1.9×
Thoracic spine 3 views (72072)
range across 2 matching MRF lines
$95.45–$238.38 $388–$969 varies
Thoracolumbar 2 views (72080)
range across 2 matching MRF lines
$77.74–$194.10 $316–$789 varies
Thyroid Met Imaging Body (78018) $560.64 $2,279 1.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $347.85 $1,414 0.8×
Ultrasound, abdomen limited (76705) $471.83 $1,918 4.2×
Umbilical-artery Doppler (OB) (76820) $124.48 $506 1.1×
Unlisted Dx Radiographic Procedure (76499) $1,374.90 $5,589 14.8×
Upper gi w/o kub (74240) $261.50 $1,063 1.4×
Urethrocystogram voiding (74455) $231.49 $941 0.9×
Urethrocystography retrograde (74450) $241.08 $980 0.9×
Us chest (76604) $283.89 $1,154 2.5×
Us exam, pelvic, limited (76857) $248.22 $1,009 2.2×
Us head (76506) $147.85 $601 1.3×
Us kidney transplant (76776) $218.45 $888 2.0×
Us ob detailed single fetus (76811) $258.55 $1,051 1.0×
Us ob limited 1 or more fetuses (76815) $282.41 $1,148 2.5×
Us ob transvaginal (76817) $328.17 $1,334 2.9×
Us pelvic non ob complete (76856) $349.57 $1,421 3.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $246.99 $1,004 2.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $380.81 $1,548 3.4×
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 spinal canal and contents (76800) $136.53 $555 1.2×
Us thyroid (76536) $264.21 $1,074 2.4×
Vein X-Ray Chest (75827) $1,165.55 $4,738 0.7×
Vein X-Ray Liver W/O Hemodyn (75887) $669.12 $2,720 0.2×
Vein X-Ray Skull Epidural (75872) $734.56 $2,986 1.1×
Vein X-Ray Spleen/Liver (75810) $2,764.55 $11,238 0.8×
Venogram Sinus/Jugular (75860) $2,270.34 $9,229 0.7×
Venography caval inferior serialography rs&i (75825) $2,331.10 $9,476 0.7×
Venography extremity bilateral rs&i (75822) $2,050.41 $8,335 1.2×
Venous sampling by catheter (75893) $3,277.71 $13,324 0.6×
Vertebral fracture assessment via dxa (77086) $87.09 $354 0.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 2 matching MRF lines
$63.96–$159.90 $260–$650 varies
X-Ray Aorta Leg Arteries (75630) $2,319.54 $9,429 0.7×
X-Ray Bend Only L-S Spine (72120) $177.12 $720 1.6×
X-Ray Exam Breast Specimen (76098) $403.44 $1,640 0.7×
X-Ray Exam Entire Spi 1 Vw (72081) $198.28 $806 2.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $272.08 $1,106 2.4×
X-Ray Exam Hips Bi 2 Views (73521)
range across 2 matching MRF lines
$88.56–$221.40 $360–$900 varies
X-Ray Exam Hips Bi 3-4 Views (73522)
range across 2 matching MRF lines
$105.54–$265.68 $429–$1,080 varies
X-Ray Exam Hips Bi 5/> Views (73523) $299.39 $1,217 2.7×
X-Ray Exam L-S Spine Bending (72114) $409.35 $1,664 3.7×
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 2 matching MRF lines
$83.15–$208.12 $338–$846 varies
X-Ray Exam Neck Spine 6/>Vws (72052) $351.54 $1,429 3.2×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565)
range across 2 matching MRF lines
$113.90–$312.42 $463–$1,270 varies
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100)
range across 2 matching MRF lines
$92.01–$230.01 $374–$935 varies
X-ray nose-rectum child f.b. (76010)
range across 2 matching MRF lines
$42.81–$107.26 $174–$436 varies
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111)
range across 2 matching MRF lines
$216.73–$542.19 $881–$2,204 varies
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202)
range across 2 matching MRF lines
$120.54–$303.81 $490–$1,235 varies
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220)
range across 2 matching MRF lines
$100.37–$251.17 $408–$1,021 varies
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220)
range across 2 matching MRF lines
$86.35–$215.75 $351–$877 varies
X-ray thoracic spine 4 vw (72074) $302.83 $1,231 2.7×
X-Ray Urinary Tract Exam With Contrast Material (74420) $386.96 $1,573 1.0×
X-Rays Bone Length Studies (77073) $84.38 $343 0.8×
X-Rays Bone Survey Complete (77075) $169.25 $688 1.5×
Xr c-spine 4 or 5 views (72050) $114.39 $465 1.0×
Xr facial bones less than 3 views (70140)
range across 2 matching MRF lines
$88.32–$220.42 $359–$896 varies
Xr orbits complete 4 views (70200)
range across 2 matching MRF lines
$93.24–$233.21 $379–$948 varies

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.