Imaging prices at Mayo Clinic Hospital — Phoenix

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

263 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) $4,326.75 $5,769 2.9×
Abdomen 2 views (74019) $260.25 $347 2.3×
Acute gastrointestinal blood loss imaging (78278) $1,115.25 $1,487 2.6×
Angiography extremity bilateral rs&i (75716) $8,395.50 $11,194 2.5×
Angiography extremity unilateral rs&i (75710) $6,633.75 $8,845 2.0×
Angiography pelvic slctv/supraslctv rs&i (75736) $11,356.50 $15,142 1.9×
Angiography pulmonary bilateral slctv rs&i (75743) $6,908.25 $9,211 2.1×
Angiography pulmonary unilateral slctv rs&i (75741) $7,145.25 $9,527 2.1×
Angiography Spinal Selective Rs&I (75705) $12,346.50 $16,462 2.1×
Angiography visceral slctv/supraslctv rs&i (75726) $10,189.50 $13,586 1.7×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $5,349 $7,132 1.6×
Ankle 2 views (73600) $210.38 $280.50 2.3×
Antegrade urography radiological supvj & interpj (74425) $859.50 $1,146 2.3×
Aortogram thoracic (75605) $7,752.75 $10,337 1.3×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $10,056.75 $13,409 3.0×
Aortography abdominal serialography rs&i (75625) $7,045.50 $9,394 2.1×
Basic radiation dosimetry calculation (77300) $530.25 $707 3.7×
Bone &/joint imaging whole body (78306) $987 $1,316 2.3×
Bone Imaging 3 Phase (78315) $993.75 $1,325 2.3×
Bone survey complete (77075) $278.25 $371 2.5×
Brachytx isodose complex (77318) $493.50 $658 1.2×
Brachytx isodose pln smpl w/dosimetry cal (77316) $982.50 $1,310 2.5×
Brain Imaging Pet Metabolic Evaluation (78608) $4,027.50 $5,370 2.6×
Cardiac MRI w/w/o contrast & further seq (75561) $2,127 $2,836 5.7×
Cardiac shunt detection (78428) $993.75 $1,325 2.3×
Cervical spine 2 or 3 views (72040) $213.75 $285 2.3×
Chest 1 view (71045) $120 $160 1.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $491.25 $655 2.6×
Clavicle complete (73000) $219.75 $293 2.4×
Continuing medical physics consltj pr wk (77336) $512.25 $683 3.6×
CT abdomen and pelvis without and with contrast (74178) $1,731.75 $2,309 4.7×
CT abdomen and pelvis without contrast (74176) $1,266 $1,688 5.0×
CT abdomen w contrast (74160) $1,105.50 $1,474 5.9×
CT abdomen w wo contrast (74170) $1,366.50 $1,822 7.3×
CT abdomen w/o contrast (74150) $639.75 $853 5.7×
CT angiography upper extremity lt (73206) $959.25 $1,279 5.1×
CT c-spine w/o contrast (72125) $766.50 $1,022 6.9×
CT cervical spine w&w/o contrast (72127) $1,312.50 $1,750 7.0×
CT cervical spine with contrast (72126) $1,251.75 $1,669 3.4×
CT chest w/wo contrast (71270) $1,352.25 $1,803 7.2×
CT chest with contrast (71260) $1,013.25 $1,351 5.4×
CT colonography w/dye (74262) $1,038.75 $1,385 5.5×
CT colonography w/o cntrst (74261) $631.50 $842 5.7×
CT head/brain with contrast (70460) $704.25 $939 3.8×
CT head/brain without and with contrast (70470) $822 $1,096 4.4×
CT heart no contrast quant eval coronry calcium (75571) $381.75 $509 4.1×
CT iac w contrast (70481) $831 $1,108 4.4×
CT lower ext w/o (73700) $666 $888 6.0×
CT lower extremity w wo contrast (73702) $831 $1,108 4.4×
CT lower extremity with contrast (73701) $831 $1,108 4.4×
CT lumbar spine w/o contrast (72131) $787.50 $1,050 7.1×
CT lumbar spine with contrast (72132) $1,251.75 $1,669 3.4×
CT maxillofacial w contrast (70487) $825.75 $1,101 4.4×
CT maxillofacial w/o contrast (70486) $815.25 $1,087 7.3×
CT neck soft tissue w contrast (70491) $1,539 $2,052 8.2×
CT orbits w/o contrast (70480) $612.75 $817 5.5×
CT pelvis w & w/o contrast (72194) $1,074 $1,432 5.7×
CT pelvis w/o contrast (72192) $693.75 $925 6.2×
CT soft tissue neck w/o contrast (70490) $668.25 $891 6.0×
CT thoracic spine w/contrast (72129) $1,002 $1,336 5.4×
CT thoracic spine w/o contrast (72128) $871.50 $1,162 7.8×
CT thoracic spine w/wo contrast (72130) $1,188 $1,584 6.3×
CT thorax w/o contrast (71250) $690 $920 6.2×
CT unlisted procedure (76497) $652.50 $870 7.0×
CT upper extremity w/o contrast rt (73200) $689.25 $919 6.2×
CT upper extremity with contrast (73201) $947.25 $1,263 2.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,832.25 $2,443 9.8×
Cta Abdomen (74175) $1,683.75 $2,245 9.0×
CTA abdomen pelvis (74174) $2,534.25 $3,379 6.8×
CTA chest (71275) $1,506 $2,008 8.0×
Cta Head (70496) $1,377.75 $1,837 7.4×
CTA lwr ext w&w/o contrast (73706) $1,008.75 $1,345 5.4×
Cta Neck (70498) $1,377.75 $1,837 7.4×
Cta Pelvis (72191) $1,077.75 $1,437 5.8×
Cystography minimum 3 views rs&i (74430) $922.50 $1,230 2.5×
Dxa bone density study 1/> sites axial skel (77080) $402.75 $537 3.6×
Esophagus (74220) $430.50 $574 2.3×
Fluoroscopy up to 1 hr (76000) $555.75 $741 2.2×
Foot 2 views (73620) $207.75 $277 2.2×
Forearm 2 views (73090) $231.75 $309 2.5×
Functional MRI brain by phys/psych (70555) $2,189.25 $2,919 8.6×
Functional MRI brain by tech (70554) $1,836.75 $2,449 7.2×
Hand 2 views (73120) $268.12 $357.50 2.4×
Hand 3 views (73130) $219.75 $293 2.4×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $2,117.25 $2,823 2.8×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $2,328 $3,104 3.1×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $864 $1,152 1.2×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $6,839.25 $9,119 2.0×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,566 $2,088 2.7×
Hepatobiliary syst imaging including gallbladder (78226) $1,173.75 $1,565 2.8×
Ht muscle image spect sing (78451) $2,976 $3,968 2.2×
Humerus Min 2 Views Left (73060) $240 $320 2.6×
Hysterosalpingogram (74740) $594 $792 2.3×
Io rad tx deliver by elctrns (77425) $14,234.25 $18,979 1.8×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,171.50 $1,562 2.0×
Kidney img morphology vascular flow 1 w/rx (78708) $1,197 $1,596 2.1×
Knee 3 views (73562) $188.25 $251 2.0×
Lung perf&ventilat diferentl (78598) $1,249.50 $1,666 2.2×
Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) $7,053.75 $9,405 2.1×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $6,444 $8,592 1.9×
Lymphoscintigraphy (78195) $1,234.50 $1,646 2.1×
Meckels Diverticulum (78290) $987 $1,316 2.3×
Mlc imrt design & construction per imrt plan (77338) $1,276.50 $1,702 3.2×
MRA head w & w/o contrast (70546) $2,672.25 $3,563 7.2×
MRA head w/o contrast (70544) $1,793.25 $2,391 7.0×
MRA head with contrast (70545) $1,928.25 $2,571 5.2×
Mra Neck W/O &W/Contrast Material (70549) $2,555.25 $3,407 6.9×
MRA neck w/o contrast (70547) $1,416 $1,888 5.6×
MRI abdomen w contrast (74182) $1,947 $2,596 5.2×
MRI abdomen w/o & w/contrast material (74183) $2,633.25 $3,511 7.1×
MRI abdomen w/o contrast (74181) $1,767 $2,356 6.9×
MRI any jnt lwr ext with con lt (73722) $2,011.50 $2,682 2.4×
MRI any jt upper extremity w/contrast matrl (73222) $2,070 $2,760 2.5×
MRI breast w/o contrast bilateral (77047) $2,067.75 $2,757 8.1×
MRI breast w/o contrast unilat (77046) $1,950 $2,600 7.7×
MRI c-spine with contrast (72142) $1,827 $2,436 4.9×
MRI cardiac w/o contrast (75557) $1,484.25 $1,979 5.8×
MRI cervical spine w/o contrast (72141) $1,517.25 $2,023 6.0×
MRI chest w/o & w/contrast material (71552) $2,386.50 $3,182 6.4×
MRI chest w/o contrast (71550) $1,637.25 $2,183 6.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,318.50 $1,758 5.2×
MRI orbit face &/neck w/o contrast (70540) $1,795.50 $2,394 7.1×
MRI orbit/face/neck w&w/o cont (70543) $2,704.50 $3,606 7.3×
MRI orbit/face/neck w/contrast (70542) $2,466 $3,288 6.6×
MRI pelvis w contrast (72196) $2,145 $2,860 5.8×
MRI pelvis w/o & w/contrast material (72197) $2,621.25 $3,495 7.0×
MRI pelvis w/o contrast (72195) $1,500 $2,000 5.9×
MRI scan of arm joint before and after contrast (73223) $2,211 $2,948 5.9×
MRI scan of heart before and after contrast with stress imaging (75563) $2,729.25 $3,639 3.3×
MRI scan of leg joint before and after contrast (73723) $2,226.75 $2,969 6.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,163.75 $2,885 5.8×
MRI spinal canal lumbar w/contrast material (72149) $1,773 $2,364 4.8×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,188.50 $2,918 5.9×
MRI spinal canal thoracic w/contrast matrl (72147) $1,829.25 $2,439 4.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $2,322 $3,096 6.2×
MRI thoracic spine w/o contrast (72146) $1,265.25 $1,687 5.0×
MRI tmj (70336) $1,459.50 $1,946 5.7×
MRI upper ext joint w/o contrast (73221) $1,401 $1,868 5.5×
MRI upper extrem other than jt w/o & w/contras (73220) $2,088.75 $2,785 5.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,269 $1,692 5.0×
Myocardial Spect Multiple Studies (78452) $3,615 $4,820 2.6×
Neck soft tissue (70360) $242.25 $323 2.6×
Nm bone marrow wb (78104) $999.75 $1,333 2.3×
Nm cisternogram (78630) $1,249.50 $1,666 2.2×
Nm csf leak detection (78650) $2,466 $3,288 1.8×
Nm gastric emptying study (78264) $918 $1,224 2.2×
Nm whole blood volume (78122) $3,562.50 $4,750 6.1×
Ntsty modul radthx pln dose-vol histos (77301) $6,300 $8,400 4.3×
Nuclear medicine study from skull base to mid-thigh (78812) $4,463.25 $5,951 2.9×
Nuclear medicine study of stomach to assess emptying small bowel movement (78265) $993 $1,324 2.3×
Orthopantogram (70355) $215.25 $287 2.3×
Pelvis 1 or 2 views (72170) $267.75 $357 2.4×
PET image w/CT, skull-thigh (78815) $4,887 $6,516 3.2×
PET imaging for CT attenuation whole body (78816) $5,102.25 $6,803 3.3×
PET imaging limited area chest head/neck (78811) $3,447 $4,596 2.5×
PET whole body (78813) $4,719 $6,292 3.1×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $7,752 $10,336 5.6×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,839 $2,452 4.9×
Proton trmt simple w/comp (77522) $3,538.50 $4,718 2.7×
Proton tx delivery complex (77525) $3,981 $5,308 3.0×
Proton tx delivery intermediate (77523) $3,981 $5,308 3.0×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $7,069.50 $9,426 2.1×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $6,249 $8,332 1.9×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,219.50 $1,626 2.1×
Radex abscess/fistula/sinus tract rs&i (76080) $1,168.50 $1,558 2.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $264 $352 2.4×
Radiation Delivery Stereotactic Cranial Linear (77372) $14,234.25 $18,979 1.8×
Radiation treatment delivery 1 mev >= complex (77412) $1,234.50 $1,646 2.1×
Radiation treatment delivery 1 mev >= simple (77402) $510 $680 4.7×
Radiation tx delivery 1 mev >= intermediate (77407) $2,346 $3,128 5.7×
Radiolog exam mandible compl minimum 4 views (70110) $263.25 $351 2.4×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $237.75 $317 2.6×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $177.75 $237 1.9×
Radiologic exam colon single contrast study (74270) $435.75 $581 2.3×
Radiologic exam upr gi trc single contrast study (74240) $493.50 $658 2.6×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $233.25 $311 2.5×
Radiological examination surgical specimen (76098) $1,029 $1,372 1.8×
Red Cell Volume Determination Spx Mult Samplings (78121) $3,404.25 $4,539 5.9×
Review by radiologist of liver vein image with assessment of blood flow (75889) $7,299.75 $9,733 2.2×
Ribs bilateral 3 views (71110) $253.50 $338 2.3×
Rp loclzj tum spect 1 area single day imaging (78803) $3,016.50 $4,022 5.2×
Rp therapy intra-arterial particulate admn (79445) $1,225.50 $1,634 4.9×
Rp Therapy Intravenous Administration (79101) $641.25 $855 2.6×
Sacroiliac Joints < 3 Views (72200) $249 $332 2.2×
Scanogram (77073) $255.75 $341 2.3×
Scapula complete (73010) $258.75 $345 2.3×
Small bowel series (74250) $434.25 $579 2.3×
Spec medical radj physics consltj (77370) $738 $984 5.1×
Spec telethx port pln parts hemibdy tot bdy (77321) $607.50 $810 1.5×
Special dosimetry (77331) $492.75 $657 3.4×
Special treatment procedure (77470) $1,350.75 $1,801 2.3×
Spine thoracic 3 views (72072) $346.50 $462 3.1×
Stereotactic body radiation delivery (77373) $10,111.50 $13,482 5.3×
Superior sagittal sinus venogram (75870) $2,774.25 $3,699 0.8×
Telethx isodose pln cplx w/basic dosimetry (77307) $936 $1,248 2.3×
Telethx isodose pln smpl w/dosimetry calculation (77306) $909.75 $1,213 2.3×
Ther rad simulaj-aided field setting complex (77290) $2,398.50 $3,198 6.0×
Ther rad simulaj-aided field setting simple (77280) $790.50 $1,054 5.5×
Treatment device intermediate (77333) $536.25 $715 3.7×
Treatment devices simple (77332) $433.50 $578 3.0×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $600.75 $801 1.4×
Tx devices design & construction complex (77334) $1,240.50 $1,654 3.1×
Ultrasound scan of cornea to determine thickness (76514) $238.50 $318 7.7×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $797.25 $1,063 2.1×
Ultrasound, abdomen limited (76705) $408 $544 3.7×
Unlisted fluoroscopic procedure (76496) $428.25 $571 4.6×
Unlisted magnetic resonance procedure (76498) $4,352.25 $5,803 46.9×
Us abdl aorta screen aaa (76706) $399.75 $533 3.6×
Us breast unilateral limited (76642) $313.50 $418 3.4×
Us chest (76604) $318 $424 2.9×
Us compl joint r-t w/image documentation (76881) $354.75 $473 3.2×
Us kidney transplant (76776) $494.25 $659 4.4×
Us ob transvaginal (76817) $307.50 $410 2.8×
Us pelvic non ob complete (76856) $358.50 $478 3.2×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $294 $392 2.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $416.25 $555 3.7×
Us retroperitoneal complete (76770) $448.50 $598 4.0×
Us retroperitoneal limited (76775) $326.25 $435 2.9×
Us scrotum and contents (76870) $369 $492 3.3×
Us soft tissue head/neck (76536) $382.50 $510 3.4×
Us xtr non-vasc lmtd (76882) $285.75 $381 2.6×
Us, eye b-scan (76512) $781.50 $1,042 7.0×
Venogram extremity bilateral (75822) $3,654.75 $4,873 2.2×
Venography caval inferior serialography rs&i (75825) $7,032.75 $9,377 2.1×
Venography caval superior serialography rs&i (75827) $3,588.75 $4,785 2.1×
Venography extremity unilateral rs&i (75820) $3,306.75 $4,409 2.0×
Venography renal unilateral selective rs&i (75831) $6,863.25 $9,151 2.0×
Venography venous sinus/jugular cath rs&i (75860) $6,630.75 $8,841 2.0×
Venous sampling thru cath w/wo angiography rs& (75893) $12,521.25 $16,695 2.1×
Wrist 2 views (73100) $192 $256 2.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $237.75 $317 2.6×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $238.50 $318 2.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $226.50 $302 2.4×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $224.25 $299 2.4×
X-ray exam hip uni 1 view (73501) $189.75 $253 2.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $213.75 $285 2.3×
X-ray exam hip uni 4/> views (73503) $255.75 $341 2.3×
X-ray exam of femur 1 (73551) $181.50 $242 2.0×
X-ray eye for foreign body (70030) $219.75 $293 2.4×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $261.75 $349 2.3×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $225 $300 2.4×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $226.12 $301.50 2.4×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $250.50 $334 2.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $267.75 $357 2.4×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $306 $408 2.7×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $205.50 $274 2.2×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $259.50 $346 2.3×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $560.25 $747 1.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $210.75 $281 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $229.50 $306 2.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $192.75 $257 2.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $247.50 $330 2.2×
X-Ray Spine One View - Xr Spine (72020) $177.75 $237 1.9×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $188.25 $251 2.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $304.50 $406 2.7×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $210.75 $281 2.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $189 $252 2.0×
Xr c-spine 6 or more views (72052) $327.75 $437 2.9×
Xr finger(s) 2+ views (73140) $210.75 $281 2.3×
Xr shoulder 1 view (73020) $211.50 $282 2.3×
Xr spine cervical 4 or 5 views (72050) $288 $384 2.6×
Xr tibia/fibula 2 views (73590) $207 $276 2.2×
Xray knee 1 or 2 views rt (73560) $182.25 $243 2.0×