Imaging prices at San Juan Hospital
Monticello, UT · every code in this section with a posted price and a Medicare benchmark.
189 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) | $252.60 | $360.86 | 2.9× |
| Abdomen 2 views (74019) | $280.01 | $400.01 | 2.6× |
| Angiography extremity unilateral rs&i (75710) | $1,751.15 | $2,501.64 | 0.5× |
| Ankle 2 views (73600) | $182.22 | $260.32 | 2.1× |
| Bone age studies (77072) | $177.78 | $253.97 | 1.7× |
| Chest 1 view (71045) | $165.93 | $237.04 | 1.9× |
| Chest 2 views (71046) | $225.19 | $321.70 | 2.6× |
| Chest 4 or more views (71048) | $256.31 | $366.15 | 2.4× |
| Clavicle complete (73000) | $165.93 | $237.04 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,629.66 | $2,328.09 | 15.4× |
| Contrast X-Ray Of Knee Joint (73580) | $322.22 | $460.32 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,295.60 | $3,279.43 | 6.5× |
| CT abdomen and pelvis without contrast (74176) | $1,985.97 | $2,837.10 | 8.2× |
| CT abdomen w contrast (74160) | $1,851.89 | $2,645.56 | 10.4× |
| CT abdomen w wo contrast (74170) | $2,052.63 | $2,932.33 | 11.6× |
| CT abdomen w/o contrast (74150) | $1,985.97 | $2,837.10 | 18.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,298.56 | $3,283.66 | 6.5× |
| CT Angio Chest (71275) | $2,249.67 | $3,213.82 | 12.7× |
| CT Angio Head (70496) | $2,052.63 | $2,932.33 | 11.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,751.15 | $2,501.64 | 9.9× |
| CT Angio Neck (70498) | $2,052.63 | $2,932.33 | 11.6× |
| CT cervical spine w/ contrast (72126) | $1,896.34 | $2,709.05 | 5.4× |
| CT cervical spine w/o contrast (72125) | $1,680.04 | $2,400.05 | 15.9× |
| CT cervical spine w/wo cont (72127) | $1,777.81 | $2,539.73 | 10.0× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$2,322.82–$2,392.64 | $3,318.32–$3,418.05 | varies |
| CT chest w/wo contrast (71270) | $2,244.49 | $3,206.41 | 12.6× |
| CT head/brain with contrast (70460) | $1,540.77 | $2,201.10 | 8.7× |
| CT head/brain without and with contrast (70470) | $1,863.74 | $2,662.49 | 10.5× |
| CT iac w contrast (70481) | $1,649.66 | $2,356.66 | 9.3× |
| CT l-spine w&w/o contrast (72133) | $2,300.05 | $3,285.78 | 13.0× |
| CT lower ext w/o (73700) range across 10 matching MRF lines |
$1,274.84–$1,426.69 | $1,821.20–$2,038.13 | varies |
| CT lower extremity w/contrast material (73701) range across 10 matching MRF lines |
$1,426.69–$1,588.92 | $2,038.13–$2,269.89 | varies |
| CT lumbar spine w contrast (72132) | $1,896.34 | $2,709.05 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,660.78 | $2,372.54 | 15.7× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,238.55–$1,595.59 | $1,769.35–$2,279.42 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$866.69–$1,168.17 | $1,238.13–$1,668.82 | varies |
| CT neck tissue combo (70492) | $1,903.75 | $2,719.64 | 10.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,271.90 | $3,245.57 | 12.8× |
| CT orbits w/o contrast (70480) | $1,501.51 | $2,145.01 | 14.2× |
| CT pelvis w&w/o contrast (72194) | $1,866.70 | $2,666.72 | 10.5× |
| CT pelvis w/o contrast (72192) | $1,154.10 | $1,648.71 | 10.9× |
| CT scan of leg combo (73702) range across 10 matching MRF lines |
$1,751.15–$1,819.29 | $2,501.64–$2,598.99 | varies |
| CT scans face/jaw combo (70488) | $2,000.04 | $2,857.20 | 11.3× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,660.78–$1,702.26 | $2,372.54–$2,431.80 | varies |
| CT soft tissue neck w/o contrast (70490) | $835.57 | $1,193.67 | 7.9× |
| CT thoracic spine w contrast (72129) | $1,896.34 | $2,709.05 | 10.7× |
| CT thoracic spine w/o contrast (72128) | $1,414.84 | $2,021.20 | 13.4× |
| CT thoracic spine w/wo cont (72130) | $2,300.05 | $3,285.78 | 13.0× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,629.66–$1,678.39 | $2,328.09–$2,397.70 | varies |
| CT upper ext wo (73200) range across 7 matching MRF lines |
$1,135.46–$1,274.84 | $1,622.09–$1,821.20 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,232.64 | $3,189.48 | 12.6× |
| CT upper extremity with contrast (73201) | $1,834.85 | $2,621.22 | 5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,162.27–$2,419.31 | $3,088.95–$3,456.16 | varies |
| Cta Abdomen (74175) | $2,053.37 | $2,933.39 | 11.6× |
| Dxa Bone Density Axial (77080) | $97.03 | $138.62 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) | $498.53 | $712.19 | 4.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$415.57–$422.23 | $593.67–$603.18 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$282.23–$524.45 | $403.19–$749.22 | varies |
| Foot 2 views (73620) | $165.93 | $237.04 | 1.9× |
| Forearm 2 views (73090) | $189.63 | $270.90 | 2.2× |
| Hand 2 views (73120) | $189.63 | $270.90 | 1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $468.90 | $669.86 | 5.3× |
| Infant hip ultrasound, limited static exam (76886) | $401.49 | $573.55 | 4.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$185.50–$422.23 | $265–$603.18 | varies |
| Magnetic Image Jaw Joint (70336) | $2,323.01 | $3,318.58 | 9.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,198.56 | $3,140.80 | 6.2× |
| MRA head w/o contrast (70544) | $1,728.55 | $2,469.36 | 7.2× |
| MRA head with contrast (70545) | $1,794.85 | $2,564.07 | 5.1× |
| MRA neck w contrast (70548) | $2,190.42 | $3,129.17 | 6.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,805.99 | $4,008.55 | 7.9× |
| MRA neck w/o contrast (70547) | $1,480.03 | $2,114.33 | 6.1× |
| MRI abdomen w contrast (74182) | $2,496.35 | $3,566.21 | 7.1× |
| MRI abdomen w/o contrast (74181) | $2,146.71 | $3,066.73 | 8.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$2,264.49–$2,562.27 | $3,234.99–$3,660.39 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 8 matching MRF lines |
$2,342.27–$3,198.58 | $3,346.10–$4,569.40 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 8 matching MRF lines |
$2,264.49–$2,508.21 | $3,234.99–$3,583.15 | varies |
| MRI cervical spine w contrast (72142) | $2,196.34 | $3,137.63 | 6.2× |
| MRI cervical spine w/o cont (72141) | $1,876.34 | $2,680.48 | 7.8× |
| MRI chest w/o contrast (71550) | $2,146.71 | $3,066.73 | 8.9× |
| MRI chest with contrast (71551) | $2,146.71 | $3,066.73 | 2.7× |
| MRI chest wo w contrast (71552) | $2,551.16 | $3,644.52 | 7.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 9 matching MRF lines |
$2,264.49–$2,562.27 | $3,234.99–$3,660.39 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 8 matching MRF lines |
$2,377.83–$3,198.58 | $3,396.90–$4,569.40 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,264.49 | $3,234.99 | 9.4× |
| MRI lumbar spine w contrast (72149) | $2,236.34 | $3,194.77 | 6.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,761.54 | $3,945.05 | 7.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,323.01 | $3,318.58 | 9.6× |
| MRI orbit face neck w contrast (70542) | $2,632.65 | $3,760.93 | 7.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,872.65 | $4,103.78 | 8.1× |
| MRI pelvis w contrast (72196) | $3,091.91 | $4,417.01 | 8.8× |
| MRI pelvis w/o & w contrast (72197) | $3,091.91 | $4,417.01 | 8.8× |
| MRI pelvis w/o contrast (72195) | $2,043 | $2,918.57 | 8.5× |
| MRI thoracic spine w/o contrast (72146) | $2,222.27 | $3,174.67 | 9.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 8 matching MRF lines |
$2,264.49–$2,508.21 | $3,234.99–$3,583.15 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 8 matching MRF lines |
$2,103–$2,264.49 | $3,004.29–$3,234.99 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 8 matching MRF lines |
$2,508.21–$2,912.65 | $3,583.15–$4,160.93 | varies |
| MRI, abdomen, combo (74183) | $2,900.80 | $4,144 | 8.2× |
| MRI, dorsal spine combo (72157) | $2,761.54 | $3,945.05 | 7.8× |
| MRI, dorsal spine contrast (72147) | $2,470.42 | $3,529.17 | 7.0× |
| MRI, joint upper extrem (73221) range across 8 matching MRF lines |
$2,103–$2,146.71 | $3,004.29–$3,066.73 | varies |
| MRI, joint upper extrem combo (73223) range across 7 matching MRF lines |
$2,264.49–$2,912.65 | $3,234.99–$4,160.93 | varies |
| MRI, lumbar spine combo (72158) | $2,815.62 | $4,022.31 | 8.0× |
| Neck soft tissue (70360) | $189.63 | $270.90 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $712.98 | $1,018.54 | 6.7× |
| Optic foramina (70190) | $250.38 | $357.68 | 2.8× |
| Pelvis 1 or 2 views (72170) | $161.49 | $230.70 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $318.52 | $455.03 | 3.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $247.41 | $353.44 | 2.8× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$182.22–$364.46 | $260.32–$520.65 | varies |
| Radex elbow complete minimum 3 views (73080) | $231.12 | $330.17 | 2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $211.86 | $302.65 | 2.0× |
| Radex fingr minimum 2 views (73140) | $189.63 | $270.90 | 2.2× |
| Radex foot complete minimum 3 views (73630) | $230.37 | $329.10 | 2.6× |
| Radex Hand Minimum 3 Views (73130) | $228.89 | $326.99 | 2.6× |
| Radex lower extremity infant minimum 2 views (73592) | $208.89 | $298.42 | 2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $288.16 | $411.65 | 2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$38.52–$185.19 | $55.03–$264.56 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $202.97 | $289.96 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) | $198.52 | $283.60 | 2.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $185.19 | $264.56 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $250.38 | $357.68 | 2.8× |
| Radex Sternum Minimum 2 Views (71120) | $277.78 | $396.83 | 3.2× |
| Radex Toe Minimum 2 Views (73660) | $225.19 | $321.70 | 2.6× |
| Radex upper extremity infant minimum 2 views (73092) | $185.93 | $265.61 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$34.81–$198.52 | $49.73–$283.60 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $305.94 | $437.05 | 2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $269.63 | $385.18 | 2.5× |
| Radiologic exam knee complete 4/more views (73564) range across 8 matching MRF lines |
$30.37–$422.23 | $43.39–$603.18 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $185.19 | $264.56 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $468.27 | $668.95 | 2.6× |
| Radiologic examination femur 1 view (73551) | $142.97 | $204.24 | 1.6× |
| Radiologic examination femur minimum 2 views (73552) | $203.71 | $291.01 | 2.3× |
| Radiologic examination knee 1/2 views (73560) | $159.26 | $227.52 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $211.86 | $302.65 | 2.4× |
| Ribs bilateral 3 views (71110) | $231.86 | $331.23 | 2.2× |
| Scapula (73010) | $185.93 | $265.61 | 1.8× |
| Shoulder 1 view (73020) | $150.37 | $214.82 | 1.7× |
| Skull less than 4 views (70250) | $256.65 | $366.64 | 2.4× |
| Sternoclavicular joints (71130) | $210.38 | $300.54 | 2.4× |
| Thoracic spine 2 views (72070) | $294.82 | $421.17 | 2.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$82.22–$165.93 | $117.46–$237.04 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$408.16–$442.97 | $583.08–$632.82 | varies |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$294.08–$406.68 | $420.12–$580.97 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$303.72–$411.86 | $433.88–$588.37 | varies |
| Us chest (76604) | $294.08 | $420.12 | 2.8× |
| Us complete joint (76881) | $550.38 | $786.26 | 5.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$336.30–$454.82 | $480.43–$649.74 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $423.71 | $605.30 | 4.0× |
| Us ob detailed single fetus (76811) | $108.14 | $154.49 | 0.4× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$334.82–$415.57 | $478.32–$593.67 | varies |
| Us ob transvaginal (76817) | $454.82 | $649.74 | 4.3× |
| Us pelvic non ob complete (76856) | $503.71 | $719.59 | 4.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $334.82 | $478.32 | 3.2× |
| Us retroperitoneal complete (76770) | $568.90 | $812.71 | 5.4× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$424.45–$556.30 | $606.36–$794.72 | varies |
| Us scrotum and contents (76870) | $550.38 | $786.26 | 5.2× |
| Us spinal canal and contents (76800) | $424.45 | $606.36 | 4.0× |
| Us thyroid (76536) range across 4 matching MRF lines |
$468.90–$550.38 | $669.86–$786.26 | varies |
| Venography extremity bilateral rs&i (75822) | $207.15 | $295.93 | 0.1× |
| Wrist 2 views (73100) | $148.15 | $211.64 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $198.52 | $283.60 | 2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $150.37 | $214.82 | 1.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $98.53 | $140.75 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $157.78 | $225.40 | 1.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $246.67 | $352.39 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $131.86 | $188.37 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $308.15 | $440.22 | 3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $290.37 | $414.82 | 2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $219.26 | $313.23 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $351.12 | $501.60 | 3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $416.31 | $594.73 | 3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $302.23 | $431.75 | 3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $469.64 | $670.91 | 4.4× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$189.63–$193.34 | $270.90–$276.20 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $183.71 | $262.44 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $257.04 | $367.20 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $326.68 | $466.68 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $211.86 | $302.65 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $288.89 | $412.70 | 2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $250.38 | $357.68 | 2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $199.26 | $284.66 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $210.38 | $300.54 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $278.52 | $397.89 | 2.6× |
| X-ray thoracic spine 4 vw (72074) | $375.56 | $536.52 | 3.5× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$136.98–$154.08 | $195.68–$220.11 | varies |
| X-Rays Bone Length Studies (77073) | $105.18 | $150.26 | 1.0× |
| X-Rays Bone Survey Complete (77075) | $322.22 | $460.32 | 3.0× |
| Xr c-spine 4 or 5 views (72050) | $302.23 | $431.75 | 2.9× |
| Xr facial bones less than 3 views (70140) | $211.86 | $302.65 | 2.4× |
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.