Imaging prices at Santa Rosa Medical Center
Milton, FL · every code in this section with a posted price and a Medicare benchmark.
222 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $448.25 | $2,988.36 | 4.1× |
| Acute gi blood loss imaging (78278) | $356.89 | $2,379.24 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $1,340.39 | $8,935.92 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,340.39 | $8,935.92 | 0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) likely a partial charge, not the full procedure |
$1,340.39 | $8,935.92 | 0.2× |
| Ankle 2 views (73600) | $326.27 | $2,175.12 | 3.6× |
| Aortogram thoracic (75605) likely a partial charge, not the full procedure |
$1,333.75 | $8,891.64 | 0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $1,078.27 | $7,188.48 | 0.3× |
| Aortography abdominal serialography rs&i (75625) | $1,801.60 | $12,010.68 | 0.5× |
| Arthrogram hip (73525) | $415.37 | $2,769.12 | 1.1× |
| Arthrogram shoulder (73040) | $754.92 | $5,032.80 | 2.1× |
| Arthrogram wrist (73115) | $520.18 | $3,467.88 | 1.4× |
| Bone &/Joint Imaging Limited Area (78300) | $579.64 | $3,864.24 | 1.4× |
| Bone &/joint imaging whole body (78306) | $1,102.09 | $7,347.24 | 2.6× |
| Bone age studies (77072) | $528.28 | $3,521.88 | 4.8× |
| Bone Imaging 3 Phase (78315) | $732.08 | $4,880.52 | 1.8× |
| Bone survey infant (77076) | $234.90 | $1,566 | 2.2× |
| Brain Imaging Vascular Flow Only (78610) | $208.33 | $1,388.88 | 0.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) | $937.98 | $6,253.20 | 2.2× |
| Cervical spine 2 or 3 views (72040) | $464.45 | $3,096.36 | 5.1× |
| Chest 1 view (71045) | $183.87 | $1,225.80 | 2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $452.30 | $3,015.36 | 2.5× |
| Clavicle complete (73000) | $361.42 | $2,409.48 | 4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $23 | $153.36 | 0.2× |
| CT abdomen and pelvis without and with contrast (74178) | $2,133.86 | $14,225.76 | 5.9× |
| CT abdomen and pelvis without contrast (74176) | $1,248.37 | $8,322.48 | 5.0× |
| CT abdomen w contrast (74160) | $1,858.14 | $12,387.60 | 10.1× |
| CT abdomen w wo contrast (74170) | $1,942.38 | $12,949.20 | 10.6× |
| CT abdomen w/o contrast (74150) | $1,368.09 | $9,120.60 | 12.5× |
| CT angio hrt w/3d image (75574) | $1,837.40 | $12,249.36 | 5.0× |
| CT angio lwr extr w/o&w/dye (73706) | $1,031.29 | $6,875.28 | 5.6× |
| CT angiography upper extremity lt (73206) | $1,107.27 | $7,381.80 | 6.0× |
| CT c-spine w/contrast (72126) | $790.07 | $5,267.16 | 2.2× |
| CT c-spine w/o contrast (72125) | $1,141.78 | $7,611.84 | 10.5× |
| CT cervical spine w&w/o contrast (72127) | $758.65 | $5,057.64 | 4.1× |
| CT chest w contrast (71260) | $2,087.69 | $13,917.96 | 11.4× |
| CT chest w/wo contrast (71270) | $1,611.09 | $10,740.60 | 8.8× |
| CT head/brain with contrast (70460) | $1,424.30 | $9,495.36 | 7.8× |
| CT head/brain without and with contrast (70470) | $1,907.23 | $12,714.84 | 10.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $1,304.26 | $8,695.08 | 14.4× |
| CT iac w contrast (70481) | $1,023.68 | $6,824.52 | 5.6× |
| CT lower ext w/o (73700) | $1,044.41 | $6,962.76 | 9.6× |
| CT lower extremity w wo contrast (73702) | $1,257.12 | $8,380.80 | 6.9× |
| CT lower extremity w/contrast material (73701) | $1,111 | $7,406.64 | 6.1× |
| CT lumbar spine w & w/o contrast (72133) | $1,687.39 | $11,249.28 | 9.2× |
| CT lumbar spine w/contrast (72132) | $1,419.61 | $9,464.04 | 3.9× |
| CT lumbar spine w/o contrast (72131) | $1,377 | $9,180 | 12.6× |
| CT maxillofacial w contrast (70487) | $1,006.02 | $6,706.80 | 5.5× |
| CT maxillofacial w/wo contrast (70488) | $1,083.29 | $7,221.96 | 5.9× |
| CT maxillofacial wo contrast (70486) | $1,378.13 | $9,187.56 | 12.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $1,442.45 | $9,616.32 | 7.9× |
| CT orbits w/o contrast (70480) | $690.61 | $4,604.04 | 6.3× |
| CT pelvis w/o contrast (72192) | $933.93 | $6,226.20 | 8.6× |
| CT pelvis w/wo contrast (72194) | $1,410.70 | $9,404.64 | 7.7× |
| CT scan of arm combo (73202) | $1,178.55 | $7,857 | 6.4× |
| CT soft tissue neck w contrast (70491) | $1,503.68 | $10,024.56 | 8.2× |
| CT soft tissue neck w/o & w/contrast material (70492) | $1,329.21 | $8,861.40 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $919.03 | $6,126.84 | 8.4× |
| CT thoracic spine w/contrast (72129) | $1,522.15 | $10,147.68 | 8.3× |
| CT thoracic spine w/o contrast (72128) | $1,494.13 | $9,960.84 | 13.7× |
| CT thoracic spine w/wo contrast (72130) | $1,348.65 | $8,991 | 7.4× |
| CT thorax w/o contrast (71250) | $1,271.05 | $8,473.68 | 11.6× |
| CT upper ext wo (73200) | $1,248.05 | $8,320.32 | 11.4× |
| CT upper extremity with contrast (73201) | $1,226.34 | $8,175.60 | 3.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $2,014.63 | $13,430.88 | 11.0× |
| Cta Abdomen (74175) | $1,077.95 | $7,186.32 | 5.9× |
| CTA abdomen pelvis (74174) | $1,552.77 | $10,351.80 | 4.3× |
| CTA chest (71275) | $1,101.44 | $7,342.92 | 6.0× |
| Cta Head (70496) | $1,324.03 | $8,826.84 | 7.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,955.20 | $19,701.36 | 8.1× |
| Cta Neck (70498) | $1,631.18 | $10,874.52 | 8.9× |
| Cta Pelvis (72191) | $1,186.16 | $7,907.76 | 6.5× |
| Cystography minimum 3 views rs&i (74430) | $399.82 | $2,665.44 | 1.1× |
| Dxa bone density study 1/> sites axial skel (77080) | $147.91 | $986.04 | 1.4× |
| Esophagus (74220) | $536.06 | $3,573.72 | 2.9× |
| Facial bones min 3 views (70150) | $473.69 | $3,157.92 | 4.3× |
| Fetal biophysical profile non-stress testing (76818) | $568.31 | $3,788.70 | 5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $167.83 | $1,118.88 | 1.5× |
| Fluoroscopy up to 1 hr (76000) | $444.53 | $2,963.52 | 1.8× |
| Foot 2 views (73620) | $295.16 | $1,967.76 | 3.2× |
| Forearm 2 views (73090) | $320.27 | $2,135.16 | 3.5× |
| Hand 2 views (73120) | $232.47 | $1,549.80 | 2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $337.61 | $2,250.72 | 0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) | $212.38 | $1,415.88 | 0.5× |
| Hysterosalpingogram (74740) | $693.20 | $4,621.32 | 2.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) | $611.55 | $4,077 | 1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $540.92 | $3,606.12 | 1.0× |
| Knee 3 views (73562) | $233.93 | $1,559.52 | 2.6× |
| Lymphoscintigraphy (78195) | $306.18 | $2,041.20 | 0.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $1,380.40 | $9,202.68 | 3.8× |
| MRA head w & w/o contrast (70546) | $1,584.20 | $10,561.32 | 4.3× |
| MRA head w/o contrast (70544) | $899.26 | $5,995.08 | 3.6× |
| MRA neck w contrast (70548) | $1,665.85 | $11,105.64 | 4.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,705.05 | $11,367 | 4.7× |
| MRA neck w/o contrast (70547) | $844.51 | $5,630.04 | 3.4× |
| MRI abdomen w/o & w/contrast material (74183) | $2,200.61 | $14,670.72 | 6.0× |
| MRI abdomen w/o contrast (74181) | $1,597.97 | $10,653.12 | 6.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,903.34 | $12,688.92 | 2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,749.76 | $11,665.08 | 4.8× |
| MRI c-spine with contrast (72142) | $1,187.95 | $7,919.64 | 3.3× |
| MRI cervical spine w/o contrast (72141) | $2,091.10 | $13,940.64 | 8.4× |
| MRI chest w/o contrast (71550) | $1,319.98 | $8,799.84 | 5.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,912.73 | $12,751.56 | 5.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,369.06 | $9,127.08 | 5.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,491.86 | $9,945.72 | 6.0× |
| MRI orbit/face/neck w&w/o cont (70543) | $1,957.45 | $13,049.64 | 5.4× |
| MRI pelvis w/contrast (72196) | $1,143.88 | $7,625.88 | 3.1× |
| MRI pelvis w/o & w/contrast material (72197) | $1,605.26 | $10,701.72 | 4.4× |
| MRI pelvis w/o contrast (72195) | $1,041.34 | $6,942.24 | 4.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $2,381.40 | $15,876 | 6.5× |
| MRI spinal canal lumbar w/contrast material (72149) | $1,383.16 | $9,221.04 | 3.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $2,467.58 | $16,450.56 | 6.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $1,073.09 | $7,153.92 | 2.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $2,292.30 | $15,282 | 6.3× |
| MRI thoracic spine w/o contrast (72146) | $1,803.71 | $12,024.72 | 7.2× |
| MRI up ext w/o contrast (73218) | $644.76 | $4,298.40 | 2.6× |
| MRI upper ext joint w/o contrast (73221) | $1,859.27 | $12,395.16 | 7.5× |
| MRI, joint upper extrem combo (73223) | $2,125.12 | $14,167.44 | 5.8× |
| Myocardial Spect Multiple Studies (78452) | $1,587.28 | $10,581.84 | 1.2× |
| Neck soft tissue (70360) | $342.14 | $2,280.96 | 3.8× |
| Nm cardiac blood pool multiple (78473) | $998.73 | $6,658.20 | 2.4× |
| Nm gastric emptying study (78264) | $643.46 | $4,289.76 | 1.5× |
| Parathyroid Planar Imaging (78070) | $373.25 | $2,488.32 | 0.9× |
| Pelvis 1 or 2 views (72170) | $315.09 | $2,100.60 | 2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $225.83 | $1,505.52 | 0.4× |
| Radex Ankle Compl Minimum 3 Views (73610) | $465.91 | $3,106.08 | 5.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $221.78 | $1,478.52 | 2.4× |
| Radex Elbw Compl Minimum 3 Views (73080) | $433.35 | $2,889 | 4.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $347.81 | $2,318.76 | 3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $727.38 | $4,849.20 | 6.7× |
| Radex fingr minimum 2 views (73140) | $188.57 | $1,257.12 | 2.1× |
| Radex Foot Compl Minimum 3 Views (73630) | $340.85 | $2,272.32 | 3.8× |
| Radex Hand Minimum 3 Views (73130) | $356.24 | $2,374.92 | 3.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $269.41 | $1,796.04 | 2.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) | $374.54 | $2,496.96 | 3.4× |
| Radex Humerus Minimum 2 Views (73060) | $424.60 | $2,830.68 | 4.7× |
| Radex Kne 1/2 Views (73560) | $282.37 | $1,882.44 | 3.1× |
| Radex Kne Compl 4/More Views (73564) | $283.01 | $1,886.76 | 2.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $272 | $1,813.32 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $309.58 | $2,063.88 | 3.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) | $419.58 | $2,797.20 | 3.8× |
| Radex Sho Compl Minimum 2 Views (73030) | $374.06 | $2,493.72 | 4.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $452.79 | $3,018.60 | 5.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) | $476.12 | $3,174.12 | 4.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $511.92 | $3,412.80 | 5.6× |
| Radex Toe Minimum 2 Views (73660) | $312.50 | $2,083.32 | 3.4× |
| Radex upper extremity infant minimum 2 views (73092) | $194.24 | $1,294.92 | 1.8× |
| Radex Wrst Compl Minimum 3 Views (73110) | $444.20 | $2,961.36 | 4.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $315.25 | $2,101.68 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $409.05 | $2,727 | 3.7× |
| Radiologic exam chest 2 views (71046) | $208.49 | $1,389.96 | 2.3× |
| Radiologic exam colon single contrast study (74270) | $620.14 | $4,134.24 | 3.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $481.14 | $3,207.60 | 2.6× |
| Radiologic exam upr gi trc single contrast study (74240) | $427.03 | $2,846.88 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $295.49 | $1,969.92 | 3.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) | $279.77 | $1,865.16 | 2.6× |
| Radiological examination surgical specimen (76098) | $57.90 | $386 | 0.1× |
| Ribs bilateral 3 views (71110) | $749.25 | $4,995 | 6.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $667.60 | $4,450.68 | 1.2× |
| Scapula (73010) | $334.53 | $2,230.20 | 3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $50.71 | $338.04 | 2.2× |
| Shoulder 1 view (73020) | $248.83 | $1,658.88 | 2.7× |
| Small bowel series (74250) | $514.19 | $3,427.92 | 2.8× |
| Spine thoracic 3 views (72072) | $427.36 | $2,849.04 | 3.9× |
| Thoracolumbar 2 views (72080) | $724.30 | $4,828.68 | 8.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $457.81 | $3,052.08 | 1.1× |
| Ultrasound breast complete (76641) | $241.22 | $1,608.12 | 2.2× |
| Ultrasound Exam Aaa Screen (76706) | $512.79 | $3,418.58 | 4.7× |
| Ultrasound, abdomen limited (76705) | $588.87 | $3,925.80 | 5.4× |
| Umbilical-artery Doppler (OB) (76820) | $474.82 | $3,165.48 | 4.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) | $27.86 | $185.76 | 0.3× |
| Unlisted ultrasound procedure (76999) | $88.29 | $588.60 | 1.0× |
| Us breast unilateral limited (76642) | $231.34 | $1,542.24 | 2.5× |
| Us chest (76604) | $647.84 | $4,318.92 | 5.9× |
| Us compl joint r-t w/image documentation (76881) | $197.88 | $1,319.22 | 1.8× |
| Us hips infant static (76886) | $127.95 | $853 | 1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $147.42 | $982.80 | 1.4× |
| Us ob limited (76815) | $289.17 | $1,927.80 | 2.6× |
| Us ob transvaginal (76817) | $98.50 | $656.64 | 0.9× |
| Us pelvic non ob complete (76856) | $705.67 | $4,704.48 | 6.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $210.44 | $1,402.92 | 1.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $397.87 | $2,652.48 | 3.6× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $206.87 | $1,379.16 | 1.9× |
| Us retroperitoneal complete (76770) | $395.77 | $2,638.44 | 3.6× |
| Us retroperitoneal limited (76775) | $535.90 | $3,572.64 | 4.9× |
| Us scrotum and contents (76870) | $640.55 | $4,270.32 | 5.9× |
| Us soft tissue head/neck (76536) | $304.88 | $2,032.56 | 2.8× |
| Venogram extremity bilateral (75822) | $372.44 | $2,482.92 | 0.2× |
| Venogram Extremity Unilateral (75820) | $432.38 | $2,882.52 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,110.35 | $7,402.32 | 0.3× |
| Venography caval superior serialography rs&i (75827) | $785.86 | $5,239.08 | 0.5× |
| Wrist 2 views (73100) | $307.48 | $2,049.84 | 3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $475.15 | $3,167.64 | 4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $316.39 | $2,109.24 | 3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $896.51 | $5,976.72 | 4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $228.10 | $1,520.64 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $283.99 | $1,893.24 | 3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $338.58 | $2,257.20 | 3.1× |
| X-ray exam of femur 2/> (73552) | $286.90 | $1,912.68 | 3.2× |
| X-ray eye for foreign body (70030) | $353.48 | $2,356.56 | 3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $235.87 | $1,572.48 | 2.6× |
| X-ray leg, infant (73592) | $196.34 | $1,308.96 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $369.04 | $2,460.24 | 3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $545.78 | $3,638.52 | 5.0× |
| X-ray nose-rectum child f.b. (76010) | $475.15 | $3,167.64 | 5.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $547.07 | $3,647.16 | 5.0× |
| X-ray retrograde pyelogram (74420) | $666.14 | $4,440.96 | 1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $342.14 | $2,280.96 | 3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $342.14 | $2,280.96 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $731.92 | $4,879.44 | 6.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $384.75 | $2,565 | 3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $336.64 | $2,244.24 | 3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $476.60 | $3,177.36 | 5.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $477.58 | $3,183.84 | 4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $349.27 | $2,328.48 | 3.2× |
| X-Ray Spine One View - Xr Spine (72020) | $260.50 | $1,736.64 | 2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $396.25 | $2,641.68 | 4.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $469.31 | $3,128.76 | 4.3× |
| Xr bone length studies (77073) | $298.16 | $1,987.74 | 2.7× |
| Xr c-spine 4 or 5 views (72050) | $637.96 | $4,253.04 | 5.8× |
| Xr c-spine 6 or more views (72052) | $679.43 | $4,529.52 | 6.2× |
| Xr chest 4+ views (71048) | $175.61 | $1,170.72 | 1.6× |