Imaging prices at Mountain View Hospital
Payson, UT · every code in this section with a posted price and a Medicare benchmark.
204 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $453.02 | $453.02 | 5.1× |
| Abdomen 2 views (74019) | $691.66 | $691.66 | 6.5× |
| Angiography extremity bilateral rs&i (75716) | $10,550.11 | $10,550.11 | 3.3× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$412.58–$823.11 | $412.58–$823.11 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $9,814.76 | $9,814.76 | 3.1× |
| Artery X-Rays Abdomen (75726) | $9,814.76 | $9,814.76 | 1.7× |
| Artery X-Rays Pelvis (75736) | $9,814.76 | $9,814.76 | 1.7× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,520.86–$3,041.71 | $1,520.86–$3,041.71 | varies |
| Bone age studies (77072) | $376.15 | $376.15 | 3.6× |
| Bone Imaging 3 Phase (78315) | $3,526.74 | $3,526.74 | 8.7× |
| Bone Imaging Whole Body (78306) | $2,714.26 | $2,714.26 | 6.7× |
| Brain Flow Imaging Only (78610) | $1,729.61 | $1,729.61 | 3.1× |
| Cerebrospinal Fluid Scan (78630) | $3,605.19 | $3,605.19 | 6.6× |
| Chest 1 view (71045) | $390.32 | $390.32 | 4.4× |
| Chest 2 views (71046) | $562.22 | $562.22 | 6.4× |
| Chest 3 views (71047) | $622.91 | $622.91 | 7.1× |
| Chest 4 or more views (71048) | $679.54 | $679.54 | 6.4× |
| Clavicle complete (73000) | $475.27 | $475.27 | 5.4× |
| Contrast X-Ray Bladder (74430) | $986.94 | $986.94 | 2.8× |
| CT abdomen and pelvis without and with contrast (74178) | $9,342.85 | $9,342.85 | 26.4× |
| CT abdomen and pelvis without contrast (74176) | $7,743.42 | $7,743.42 | 32.1× |
| CT abdomen w contrast (74160) | $4,338.83 | $4,338.83 | 24.4× |
| CT abdomen w wo contrast (74170) | $4,651.12 | $4,651.12 | 26.2× |
| CT abdomen w/o contrast (74150) | $3,914.87 | $3,914.87 | 37.0× |
| CT Angio Abdomen and Pelvis (74174) | $9,342.85 | $9,342.85 | 26.4× |
| CT Angio Chest (71275) | $4,915.15 | $4,915.15 | 27.7× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$4,915.15–$6,403.21 | $4,915.15–$6,403.21 | varies |
| CT angio hrt w/3d image (75574) | $3,581.24 | $3,581.24 | 10.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,915.15 | $4,915.15 | 27.7× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$4,915.15–$6,403.21 | $4,915.15–$6,403.21 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,915.15 | $4,915.15 | 27.7× |
| CT cervical spine w/ contrast (72126) | $4,529.25 | $4,529.25 | 12.8× |
| CT cervical spine w/o contrast (72125) | $4,219.49 | $4,219.49 | 39.9× |
| CT chest w contrast (71260) | $4,333.76 | $4,333.76 | 24.4× |
| CT head/brain without and with contrast (70470) | $4,745.03 | $4,745.03 | 26.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,662.93 | $1,662.93 | 18.9× |
| CT iac w contrast (70481) | $4,338.83 | $4,338.83 | 24.4× |
| CT l-spine w&w/o contrast (72133) | $4,970.99 | $4,970.99 | 28.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,528.95–$6,413.98 | $3,528.95–$6,413.98 | varies |
| CT lower extremity w/contrast material (73701) | $3,874.26 | $3,874.26 | 21.8× |
| CT lumbar spine w contrast (72132) | $4,521.63 | $4,521.63 | 12.8× |
| CT lumbar spine w/o contrast (72131) | $4,163.64 | $4,163.64 | 39.3× |
| CT maxillofacial w contrast (70487) | $3,864.10 | $3,864.10 | 21.8× |
| CT maxillofacial wo contrast (70486) | $3,465.48 | $3,465.48 | 32.7× |
| CT neck tissue combo (70492) | $4,745.03 | $4,745.03 | 26.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $4,745.03 | $4,745.03 | 26.7× |
| CT orbits w/o contrast (70480) | $3,864.10 | $3,864.10 | 36.5× |
| CT pelvis w&w/o contrast (72194) | $4,691.70 | $4,691.70 | 26.4× |
| CT pelvis w/o contrast (72192) | $3,828.55 | $3,828.55 | 36.2× |
| CT scan of leg combo (73702) | $4,057 | $4,057 | 22.8× |
| CT scans face/jaw combo (70488) | $4,183.97 | $4,183.97 | 23.6× |
| CT soft tissue neck w contrast (70491) | $4,338.83 | $4,338.83 | 24.4× |
| CT soft tissue neck w/o contrast (70490) | $3,864.10 | $3,864.10 | 36.5× |
| CT thoracic spine w contrast (72129) | $4,521.63 | $4,521.63 | 25.5× |
| CT thoracic spine w/o contrast (72128) | $4,219.49 | $4,219.49 | 39.9× |
| CT thorax w/o contrast (71250) | $3,828.55 | $3,828.55 | 36.2× |
| CT upper ext wo (73200) | $2,828.25 | $2,828.25 | 26.7× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,437.58–$6,367.34 | $3,437.58–$6,367.34 | varies |
| CT upper extremity with contrast (73201) | $3,203.98 | $3,203.98 | 9.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,915.15 | $4,915.15 | 27.7× |
| Cta Abdomen (74175) | $4,915.15 | $4,915.15 | 27.7× |
| CTA pelvis (72191) | $4,915.15 | $4,915.15 | 27.7× |
| Diskography lumbar (72295) | $1,336.81 | $1,336.81 | 0.7× |
| Dxa Bone Density Axial (77080) | $1,023.34 | $1,023.34 | 9.7× |
| Echo exam uterus (76831) | $601.21 | $601.21 | 2.5× |
| Esophagram (74220) | $649.20 | $649.20 | 3.7× |
| Fetal Biophys Profile W/Nst (76818) | $1,019.33 | $1,019.33 | 9.6× |
| Fluoroscopy up to 1 hr (76000) | $817.32 | $817.32 | 3.4× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$412.58–$823.11 | $412.58–$823.11 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$412.58–$823.11 | $412.58–$823.11 | varies |
| Gastric emptying imaging study (78264) | $3,605.19 | $3,605.19 | 8.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$412.58–$823.11 | $412.58–$823.11 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,095.45 | $3,095.45 | 5.6× |
| Hepatobiliary System Imaging (78226) | $3,332.90 | $3,332.90 | 8.2× |
| Ht Muscle Image Spect Sing (78451) | $4,036.51 | $4,036.51 | 3.1× |
| Hysterosalpingogram (74740) | $1,294.32 | $1,294.32 | 5.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $397.85 | $397.85 | 4.5× |
| K Flow/Funct Image W/Drug (78708) | $2,812.28 | $2,812.28 | 5.1× |
| Knee 3 Views (73562) | $873.33 | $873.33 | 9.9× |
| Lung Perf&Ventilat Diferentl (78598) | $2,080.76 | $2,080.76 | 3.8× |
| Lung Ventilat&Perfus Imaging (78582) | $4,287 | $4,287 | 7.8× |
| Lung Ventilation Imaging (78579) | $2,143.50 | $2,143.50 | 5.3× |
| Magnetic Image Jaw Joint (70336) | $9,583.84 | $9,583.84 | 39.7× |
| Mammary ductogram or galactogram multiple (77054) | $956.59 | $956.59 | 4.0× |
| Mammary ductogram or galactogram single (77053) | $695.72 | $695.72 | 2.9× |
| MRA head w/o contrast (70544) | $7,136.84 | $7,136.84 | 29.5× |
| MRA neck w contrast (70548) | $2,440.12 | $2,440.12 | 6.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,440.12 | $2,440.12 | 6.9× |
| MRA neck w/o contrast (70547) | $2,440.12 | $2,440.12 | 10.1× |
| MRI abdomen w contrast (74182) | $5,094.58 | $5,094.58 | 14.4× |
| MRI abdomen w/o contrast (74181) | $4,122.08 | $4,122.08 | 17.1× |
| MRI any jt lower extrem w/contrast material (73722) | $6,199.71 | $6,199.71 | 7.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,199.71 | $6,199.71 | 17.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,199.71 | $6,199.71 | 7.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $5,316.50 | $5,316.50 | 22.0× |
| MRI cervical spine w contrast (72142) | $5,881.43 | $5,881.43 | 16.6× |
| MRI cervical spine w/o cont (72141) | $5,366.45 | $5,366.45 | 22.2× |
| MRI chest w/o contrast (71550) | $5,313.32 | $5,313.32 | 22.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $6,199.71 | $6,199.71 | 17.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $6,199.71 | $6,199.71 | 17.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,802.84 | $4,802.84 | 19.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $6,394.20 | $6,394.20 | 18.1× |
| MRI orbit face &/neck w/o contrast (70540) | $4,122.08 | $4,122.08 | 17.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,304.56 | $5,304.56 | 15.0× |
| MRI pelvis w/o & w contrast (72197) | $5,702.41 | $5,702.41 | 16.1× |
| MRI pelvis w/o contrast (72195) | $3,293.22 | $3,293.22 | 13.6× |
| MRI thoracic spine w/o contrast (72146) | $5,366.45 | $5,366.45 | 22.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,802.84 | $4,802.84 | 19.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,802.84 | $4,802.84 | 13.6× |
| MRI, abdomen, combo (74183) | $7,669.50 | $7,669.50 | 21.7× |
| MRI, dorsal spine combo (72157) | $6,394.20 | $6,394.20 | 18.1× |
| MRI, dorsal spine contrast (72147) | $5,881.43 | $5,881.43 | 16.6× |
| MRI, joint upper extrem (73221) | $4,802.84 | $4,802.84 | 19.9× |
| MRI, joint upper extrem combo (73223) | $4,802.84 | $4,802.84 | 13.6× |
| MRI, lumbar spine combo (72158) | $6,394.20 | $6,394.20 | 18.1× |
| Myelogram Lumbar (72265) | $1,152.78 | $1,152.78 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $6,020.98 | $6,020.98 | 4.6× |
| Neck soft tissue (70360) | $376.15 | $376.15 | 4.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,075.95 | $2,075.95 | 3.8× |
| Pelvis 1 or 2 views (72170) | $412.58 | $412.58 | 3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,143.50 | $2,143.50 | 5.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $819.07 | $819.07 | 7.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$523.82–$1,041.53 | $523.82–$1,041.53 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $386.29 | $386.29 | 4.4× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$523.82–$1,041.53 | $523.82–$1,041.53 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $934.36 | $934.36 | 8.8× |
| Radex fingr minimum 2 views (73140) | $359.99 | $359.99 | 4.1× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$523.82–$1,041.53 | $523.82–$1,041.53 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$523.82–$1,041.53 | $523.82–$1,041.53 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$469.21–$940.45 | $469.21–$940.45 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $390.32 | $390.32 | 4.4× |
| Radex Ribs Unilateral 2 Views (71100) | $562.22 | $562.22 | 6.4× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$562.22–$1,094.15 | $562.22–$1,094.15 | varies |
| Radex Spine 1 View Specify Level (72020) | $463.14 | $463.14 | 5.3× |
| Radex Sternum Minimum 2 Views (71120) | $665.36 | $665.36 | 7.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $624.93 | $624.93 | 7.1× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$386.29–$770.53 | $386.29–$770.53 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$469.21–$940.45 | $469.21–$940.45 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$523.82–$1,041.53 | $523.82–$1,041.53 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $598.62 | $598.62 | 5.7× |
| Radiologic exam colon single contrast study (74270) | $1,092.10 | $1,092.10 | 6.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$616.84–$1,231.66 | $616.84–$1,231.66 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $960.64 | $960.64 | 5.4× |
| Radiologic exam swallow function contrast study (74230) | $1,079.94 | $1,079.94 | 6.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,175.03 | $1,175.03 | 6.6× |
| Radiologic examination femur minimum 2 views (73552) | $289.94 | $289.94 | 3.3× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$469.21–$940.45 | $469.21–$940.45 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$523.82–$1,041.53 | $523.82–$1,041.53 | varies |
| Ribs bilateral 3 views (71110) | $669.41 | $669.41 | 6.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,003.86 | $4,003.86 | 7.3× |
| Scapula (73010) | $505.61 | $505.61 | 4.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $92.35 | $92.35 | 3.9× |
| Shoulder 1 view (73020) | $390.32 | $390.32 | 4.4× |
| Shoulder Arthrography (73040) | $1,520.86 | $1,520.86 | 4.3× |
| Skull less than 4 views (70250) | $598.62 | $598.62 | 5.7× |
| Thoracic spine 2 views (72070) | $515.72 | $515.72 | 4.9× |
| Thoracic spine 3 views (72072) | $570.34 | $570.34 | 5.4× |
| Thoracolumbar 2 views (72080) | $531.89 | $531.89 | 6.0× |
| Thyroid Uptake Measurement (78012) | $3,361.21 | $3,361.21 | 8.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$552.74–$1,026.54 | $552.74–$1,026.54 | varies |
| Ultrasound, abdomen limited (76705) | $1,017.08 | $1,017.08 | 9.6× |
| Unlisted us procedure (76999) | $748.12 | $748.12 | 8.5× |
| Upper gi w/o kub (74240) | $934.36 | $934.36 | 5.3× |
| Urethrocystogram voiding (74455) | $929.61 | $929.61 | 3.8× |
| Urethrocystography retrograde (74450) | $986.94 | $986.94 | 4.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$651.46–$1,184.47 | $651.46–$1,184.47 | varies |
| Us chest (76604) | $1,019.33 | $1,019.33 | 9.6× |
| Us complete joint (76881) | $895.03 | $895.03 | 8.5× |
| Us head (76506) | $788.80 | $788.80 | 7.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $693.86 | $693.86 | 6.6× |
| Us ob limited 1 or more fetuses (76815) | $585.39 | $585.39 | 5.5× |
| Us ob transvaginal (76817) | $619.26 | $619.26 | 5.8× |
| Us pelvic non ob complete (76856) | $1,419.38 | $1,419.38 | 13.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,317.69 | $1,317.69 | 12.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $458.82 | $458.82 | 4.3× |
| Us retroperitoneal complete (76770) | $793.31 | $793.31 | 7.5× |
| Us scrotum and contents (76870) | $1,001.25 | $1,001.25 | 9.5× |
| Us spinal canal and contents (76800) | $884.02 | $884.02 | 8.4× |
| Us thyroid (76536) | $1,084.87 | $1,084.87 | 10.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$412.58–$823.11 | $412.58–$823.11 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$412.58–$823.11 | $412.58–$823.11 | varies |
| X-Ray Exam Breast Specimen (76098) | $262.92 | $262.92 | 0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $480.15 | $480.15 | 4.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $289.94 | $289.94 | 3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $289.94 | $289.94 | 3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $480.15 | $480.15 | 4.5× |
| X-Ray Exam L-S Spine Bending (72114) | $841.31 | $841.31 | 7.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $459.07 | $459.07 | 5.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $879.76 | $879.76 | 8.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $669.41 | $669.41 | 6.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$537.96–$1,079.94 | $537.96–$1,079.94 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $505.61 | $505.61 | 5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $531.89 | $531.89 | 5.0× |
| X-ray nose-rectum child f.b. (76010) | $408.53 | $408.53 | 4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $819.07 | $819.07 | 7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $592.58 | $592.58 | 5.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $572.33 | $572.33 | 6.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $523.82 | $523.82 | 5.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $855.47 | $855.47 | 8.1× |
| X-Rays Bone Length Studies (77073) | $570.34 | $570.34 | 5.4× |
| X-Rays Bone Survey Complete (77075) | $1,510.74 | $1,510.74 | 14.3× |
| Xr c-spine 4 or 5 views (72050) | $622.91 | $622.91 | 5.9× |
| Xr facial bones less than 3 views (70140) | $505.61 | $505.61 | 5.7× |
| Xr orbits complete 4 views (70200) | $608.75 | $608.75 | 5.8× |
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.