Imaging prices at Gulf Breeze Hospital

Gulf Breeze, FL · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $140.40 $936 1.3×
Acute gi blood loss imaging (78278) $497.85 $3,319 1.2×
Angiography extremity unilateral rs&i (75710) $1,864.20 $12,428 0.6×
Ankle 2 views (73600) $155.62 $1,037.50 1.7×
Aortography abdominal serialography rs&i (75625) $1,608.30 $10,722 0.5×
Arthrogram ankle (73615) $196.72 $1,311.50 0.5×
Arthrogram elbow (73085) $169.35 $1,129 0.5×
Arthrogram hip (73525) $404.10 $2,694 1.1×
Arthrogram knee (73580) $334.12 $2,227.50 0.9×
Arthrogram shoulder (73040) $287.48 $1,916.50 0.8×
Arthrogram wrist (73115) $277.72 $1,851.50 0.8×
Basic dosimetry (77300) $208.65 $1,391 1.5×
Bone &/Joint Imaging Limited Area (78300) $713.85 $4,759 1.7×
Bone &/joint imaging whole body (78306) $1,151.25 $7,675 2.8×
Bone age studies (77072) $106.05 $707 1.0×
Bone Imaging 3 Phase (78315) $1,271.55 $8,477 3.0×
Bone survey complete (77075) $94.65 $631 0.9×
Bone survey infant (77076) $81.60 $544 0.7×
Bowel imaging (78290) $378.15 $2,521 0.9×
Brain Imaging < 4 Static Views W Vascular Flow (78601) $378.75 $2,525 0.9×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $620.10 $4,134 1.5×
Cardiac MRI w/w/o contrast & further seq (75561) $817.80 $5,452 2.2×
Cervical spine 2 or 3 views (72040) $159 $1,060 1.7×
Chest 1 view (71045) $109.65 $731 1.2×
Chest xray 3 views (71047) $192 $1,280 2.1×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $243.30 $1,622 1.3×
Clavicle complete (73000) $122.62 $817.50 1.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $188.40 $1,256 1.7×
Continuing medical physics consltj pr wk (77336) $136.50 $910 1.0×
CT abdomen and pelvis without and with contrast (74178) $2,400 $16,000 6.6×
CT abdomen and pelvis without contrast (74176) $1,800 $12,000 7.2×
CT abdomen w contrast (74160) $915 $6,100 5.0×
CT abdomen w wo contrast (74170) $960 $6,400 5.2×
CT abdomen w/o contrast (74150) $870 $5,800 8.0×
CT angio lwr extr w/o&w/dye (73706) $956.25 $6,375 5.2×
CT angiography upper extremity lt (73206) $1,200 $8,000 6.6×
CT c-spine w/contrast (72126) $630 $4,200 1.7×
CT c-spine w/o contrast (72125) $1,200 $8,000 11.0×
CT cervical spine w&w/o contrast (72127) $1,350 $9,000 7.4×
CT chest w contrast (71260) $855 $5,700 4.7×
CT chest w/wo contrast (71270) $960 $6,400 5.2×
CT head/brain with contrast (70460) $915 $6,100 5.0×
CT head/brain without and with contrast (70470) $960 $6,400 5.2×
CT heart w/o contrast quant eval coronary calcium (75571) $38.85 $259 0.4×
CT iac w contrast (70481) $915 $6,100 5.0×
CT limited/localized follow up study (76380) $119.70 $798 1.3×
CT lower ext w/o (73700) $843.75 $5,625 7.7×
CT lower extremity w wo contrast (73702) $956.25 $6,375 5.2×
CT lower extremity w/contrast material (73701) $900 $6,000 4.9×
CT lumbar spine w & w/o contrast (72133) $1,350 $9,000 7.4×
CT lumbar spine w/contrast (72132) $1,275 $8,500 3.5×
CT lumbar spine w/o contrast (72131) $1,200 $8,000 11.0×
CT maxillofacial w contrast (70487) $960 $6,400 5.2×
CT maxillofacial w/wo contrast (70488) $990 $6,600 5.4×
CT maxillofacial wo contrast (70486) $903.75 $6,025 8.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $960 $6,400 5.2×
CT orbits w/o contrast (70480) $870 $5,800 8.0×
CT pelvis w/o contrast (72192) $870 $5,800 8.0×
CT pelvis w/wo contrast (72194) $1,210.05 $8,067 6.6×
CT scan of arm combo (73202) $960 $6,400 5.2×
CT soft tissue neck w contrast (70491) $675 $4,500 3.7×
CT soft tissue neck w/o & w/contrast material (70492) $960 $6,400 5.2×
CT soft tissue neck w/o contrast (70490) $630 $4,200 5.8×
CT thoracic spine w/contrast (72129) $1,275 $8,500 7.0×
CT thoracic spine w/o contrast (72128) $1,200 $8,000 11.0×
CT thoracic spine w/wo contrast (72130) $1,350 $9,000 7.4×
CT thorax w/o contrast (71250) $825 $5,500 7.6×
CT upper ext wo (73200) $1,087.50 $7,250 10.0×
CT upper extremity with contrast (73201) $1,143.75 $7,625 3.1×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,341.60 $8,944 7.3×
Cta Abdomen (74175) $960 $6,400 5.2×
CTA abdomen pelvis (74174) $1,350 $9,000 3.7×
CTA chest (71275) $1,425 $9,500 7.8×
Cta Head (70496) $1,275 $8,500 7.0×
Cta Neck (70498) $1,275 $8,500 7.0×
Cta Pelvis (72191) $577.50 $3,850 3.2×
Cystography minimum 3 views rs&i (74430) $229.95 $1,533 0.6×
Diskography lumbar (72295) $1,021.05 $6,807 0.5×
Dxa bone density study 1/> sites axial skel (77080) $90.45 $603 0.8×
Esophagus (74220) $451.20 $3,008 2.5×
Facial bones min 3 views (70150) $156.15 $1,041 1.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $50.85 $339 0.5×
Fluoroscopy up to 1 hr (76000) $232.20 $1,548 0.9×
Foot 2 views (73620) $162.22 $1,081.50 1.8×
Forearm 2 views (73090) $362.10 $2,414 4.0×
Hand 2 views (73120) $188.10 $1,254 1.7×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,103.40 $7,356 1.9×
Hepatobiliary syst imaging including gallbladder (78226) $780.15 $5,201 1.9×
Hysterosalpingogram (74740) $340.50 $2,270 1.4×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $430.35 $2,869 0.8×
Kidney img morphology vascular flow 1 w/rx (78708) $631.50 $4,210 1.1×
Knee 3 views (73562) $167.85 $1,119 1.8×
Liver & spleen imaging static only (78215) $406.20 $2,708 1.0×
Lung perf&ventilat diferentl (78598) $374.70 $2,498 0.7×
Lymphoscintigraphy (78195) $841.95 $5,613 1.5×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,415.25 $9,435 1.7×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,132.20 $7,548 3.1×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $1,178.10 $7,854 3.2×
Mammary ductogram or galactogram multiple (77054) $458.55 $3,057 1.8×
Mammary ductogram or galactogram single (77053) $316.65 $2,111 1.3×
MRA head w & w/o contrast (70546) $900.90 $6,006 2.5×
MRA head w/o contrast (70544) $657.45 $4,383 2.6×
MRA neck w/o contrast (70547) $673.20 $4,488 2.7×
MRI abdomen w contrast (74182) $765.45 $5,103 2.1×
MRI abdomen w/o & w/contrast material (74183) $780.30 $5,202 2.1×
MRI abdomen w/o contrast (74181) $649.65 $4,331 2.6×
MRI any jt lower extrem w/contrast material (73722) $1,061.48 $7,076.50 1.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,147.50 $7,650 3.1×
MRI breast w/o contrast bilateral (77047) $459 $3,060 1.8×
MRI c-spine with contrast (72142) $1,071 $7,140 2.9×
MRI cervical spine w/o contrast (72141) $918 $6,120 3.7×
MRI chest w/o & w/contrast material (71552) $716.10 $4,774 2.0×
MRI chest w/o contrast (71550) $527.85 $3,519 2.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $849.15 $5,661 2.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,472.62 $9,817.50 4.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,018.50 $6,790 4.1×
MRI orbit face &/neck w/o contrast (70540) $636.45 $4,243 2.6×
MRI orbit/face/neck w&w/o cont (70543) $791.85 $5,279 2.2×
MRI pelvis w/contrast (72196) $994.50 $6,630 2.7×
MRI pelvis w/o & w/contrast material (72197) $1,071 $7,140 2.9×
MRI pelvis w/o contrast (72195) $975.45 $6,503 3.9×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,224 $8,160 3.4×
MRI spinal canal lumbar w/contrast material (72149) $1,224 $8,160 3.4×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,224 $8,160 3.4×
MRI spinal canal thoracic w/contrast matrl (72147) $1,071 $7,140 2.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,224 $8,160 3.4×
MRI thoracic spine w/o contrast (72146) $918 $6,120 3.7×
MRI up ext w/o contrast (73218) $1,357.88 $9,052.50 5.4×
MRI upper ext joint w/o contrast (73221) $1,357.88 $9,052.50 5.4×
MRI, joint upper extrem combo (73223) $1,472.62 $9,817.50 4.0×
Myocardial Spect Multiple Studies (78452) $2,887.50 $19,250 2.1×
Myocardial spect single study at rest or stress (78451) $1,402.50 $9,350 1.0×
Neck soft tissue (70360) $183.60 $1,224 2.0×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $230.25 $1,535 0.6×
Nm gastric emptying study (78264) $921.90 $6,146 2.2×
Nm peritoneal-venous shunt patency (78291) $298.65 $1,991 0.7×
Nonvascular shunt X-ray (75809) $137.10 $914 1.3×
Osseous survey limited (77074) $152.85 $1,019 1.4×
Parathyroid Planar Imaging (78070) $754.65 $5,031 1.8×
Pelvis 1 or 2 views (72170) $114.15 $761 1.0×
PET image w/CT, skull-thigh (78815) $2,520 $16,800 1.7×
Pulmonary Perfusion Imaging Particulate (78580) $441.75 $2,945 1.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $625.05 $4,167 1.1×
Radex abscess/fistula/sinus tract rs&i (76080) $220.50 $1,470 0.4×
Radex Ankle Compl Minimum 3 Views (73610) $161.48 $1,076.50 1.8×
Radex Calcaneus Minimum 2 Views (73650) $164.62 $1,097.50 1.8×
Radex Elbw Compl Minimum 3 Views (73080) $278.62 $1,857.50 3.1×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $84.30 $562 0.9×
Radex fingr minimum 2 views (73140) $149.70 $998 1.6×
Radex Foot Compl Minimum 3 Views (73630) $180.98 $1,206.50 2.0×
Radex Hand Minimum 3 Views (73130) $241.72 $1,611.50 2.7×
Radex Hip Unilateral With Pelvis 1 View (73501) $73.05 $487 0.8×
Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) $175.80 $1,172 1.6×
Radex Hips Bilateral With Pelvis 2 Views (73521) $26.85 $179 0.2×
Radex Humerus Minimum 2 Views (73060) $279.22 $1,861.50 3.1×
Radex Kne 1/2 Views (73560) $149.25 $995 1.6×
Radex Kne Compl 4/More Views (73564) $219.38 $1,462.50 2.0×
Radex Mndbl Compl Minimum 4 Views (70110) $155.85 $1,039 1.4×
Radex Nasal Bones Complete Minimum 3 Views (70160) $129.90 $866 1.4×
Radex Pelvis Compl Minimum 3 Views (72190) $162.90 $1,086 1.5×
Radex Sho Compl Minimum 2 Views (73030) $235.88 $1,572.50 2.6×
Radex Sinuses Paransl < 3 Views (70210) $132.75 $885 1.5×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $139.80 $932 1.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $154.95 $1,033 1.7×
Radex Toe Minimum 2 Views (73660) $181.50 $1,210 2.0×
Radex upper extremity infant minimum 2 views (73092) $41.48 $276.50 0.4×
Radex Wrst Compl Minimum 3 Views (73110) $291.75 $1,945 3.2×
Radiation treatment delivery level 1 (77402) $109.65 $731 1.0×
Radiation treatment delivery level 2 (77407) $199.05 $1,327 0.5×
Radiation treatment delivery level 3 (77412) $561.75 $3,745 1.0×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $122.85 $819 1.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $284.25 $1,895 2.6×
Radiologic exam chest 2 views (71046) $177.75 $1,185 2.0×
Radiologic exam colon single contrast study (74270) $283.95 $1,893 1.6×
Radiologic exam upr gi trc double contrast study (74246) $344.55 $2,297 1.9×
Radiologic exam upr gi trc single contrast study (74240) $230.10 $1,534 1.3×
Radiologic examination femur 1 view (73551) $207.38 $1,382.50 2.3×
Radiologic examination tibia & fibula 2 views (73590) $284.25 $1,895 3.1×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $138.30 $922 1.3×
Radiological examination surgical specimen (76098) $123.15 $821 0.2×
Ribs bilateral 3 views (71110) $213.45 $1,423 2.0×
Rp loclzj tum plnr whole body single day imaging (78802) $630.15 $4,201 1.1×
Rp loclzj tum spect 1 area single day imaging (78803) $776.40 $5,176 1.4×
Salivary gland function study (78232) $341.40 $2,276 0.8×
Scapula (73010) $111.38 $742.50 1.0×
Screening Digital Breast Tomosynthesis Bi (77063) $86.25 $575 3.7×
Shoulder 1 view (73020) $154.35 $1,029 1.7×
Small bowel series (74250) $250.50 $1,670 1.4×
Special dosimetry (77331) $227.55 $1,517 1.6×
Special Physics Consult (77370) $216.75 $1,445 1.5×
Spine thoracic 3 views (72072) $284.25 $1,895 2.6×
Ther rad simulaj-aided field setting complex (77290) $513.60 $3,424 1.3×
Ther rad simulaj-aided field setting simple (77280) $229.05 $1,527 1.6×
Thoracolumbar 2 views (72080) $150 $1,000 1.7×
Thyroid carcinoma metastases img whole body (78018) $702.60 $4,684 1.2×
Thyroid imaging w/blood flow (78013) $349.65 $2,331 0.8×
Thyroid uptake measurement (78012) $273.75 $1,825 0.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $493.05 $3,287 1.2×
Treatment device complex (77334) $401.25 $2,675 1.0×
Treatment device intermediate (77333) $288.90 $1,926 2.1×
Treatment devices simple (77332) $240.75 $1,605 1.7×
Ultrasound breast complete (76641) $331.12 $2,207.50 3.0×
Ultrasound Exam Aaa Screen (76706) $112.95 $753 1.0×
Ultrasound, abdomen limited (76705) $470.40 $3,136 4.3×
Unlisted ultrasound procedure (76999) $200.10 $1,334 2.2×
Urethrocystogram voiding (74455) $277.80 $1,852 1.1×
Urethrocystography retrograde rs&i (74450) $485.10 $3,234 1.9×
Us breast unilateral limited (76642) $311.85 $2,079 3.4×
Us chest (76604) $137.40 $916 1.3×
Us compl joint r-t w/image documentation (76881) $246.45 $1,643 2.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $234.30 $1,562 2.1×
Us ob limited (76815) $217.80 $1,452 2.0×
Us ob transvaginal (76817) $64.20 $428 0.6×
Us pelvic non ob complete (76856) $332.40 $2,216 3.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $171.30 $1,142 1.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $151.20 $1,008 1.4×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $48.15 $321 0.4×
Us retroperitoneal complete (76770) $335.55 $2,237 3.1×
Us retroperitoneal limited (76775) $453.60 $3,024 4.2×
Us scrotum and contents (76870) $410.55 $2,737 3.8×
Us soft tissue head/neck (76536) $200.40 $1,336 1.8×
Us,transplanted kidney, real time/ doppler (76776) $426 $2,840 3.9×
Venogram extremity bilateral (75822) $670.20 $4,468 0.4×
Venogram Extremity Unilateral (75820) $605.85 $4,039 0.4×
Venography caval inferior serialography rs&i (75825) $1,224.60 $8,164 0.4×
Wrist 2 views (73100) $264.98 $1,766.50 2.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $237.45 $1,583 2.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $156.75 $1,045 1.7×
X-ray b.e. reductn intuss (74283) $291.15 $1,941 1.6×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $520.50 $3,470 2.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $212.48 $1,416.50 2.3×
X-Ray Exam Hip Uni 2-3 Views (73502) $125.25 $835 1.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $168.60 $1,124 1.5×
X-ray exam of femur 2/> (73552) $228.22 $1,521.50 2.5×
X-ray eye for foreign body (70030) $107.70 $718 1.2×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $69.45 $463 0.8×
X-ray leg, infant (73592) $38.85 $259 0.4×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $225.15 $1,501 2.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $387 $2,580 3.5×
X-ray nose-rectum child f.b. (76010) $58.95 $393 0.6×
X-ray optic foramen (70190) $58.95 $393 0.6×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $194.40 $1,296 1.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $331.65 $2,211 3.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $334.35 $2,229 3.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $237 $1,580 2.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $132.90 $886 1.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $282.60 $1,884 3.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $156.75 $1,045 1.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $256.20 $1,708 2.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $145.50 $970 1.3×
X-Ray Spine One View - Xr Spine (72020) $219.45 $1,463 2.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $137.25 $915 1.5×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $179.40 $1,196 2.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $159.90 $1,066 1.5×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $298.35 $1,989 2.7×
Xr bone length studies (77073) $125.85 $839 1.2×
Xr c-spine 4 or 5 views (72050) $329.10 $2,194 3.0×
Xr c-spine 6 or more views (72052) $387.90 $2,586 3.6×
Xr chest 4+ views (71048) $207.45 $1,383 1.9×
Xr urogram antegrade (74425) $239.55 $1,597 0.7×