Imaging prices at Shriners Hospitals For Children Northern Calif

Sacramento, CA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $329.20 $329.20 2.9×
Abdomen 2 views (74019) $395.10 $395.10 2.9×
Ankle 2 views (73600)
range across 3 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
Arthrogram ankle (73615) $1,945.70 $1,945.70 4.3×
Arthrogram hip (73525) $1,945.70 $1,945.70 4.3×
Arthrogram Wrist (73115) $1,945.70 $1,945.70 4.3×
Bone age studies (77072) $329.20 $329.20 2.4×
Bone Imaging 3 Phase (78315) $2,520.98 $2,520.98 4.9×
Bone Imaging Limited Area (78300) $2,520.98 $2,520.98 4.9×
Bone Imaging Multiple Areas (78305) $2,520.98 $2,520.98 4.9×
Bone Imaging Whole Body (78306) $1,427.43 $1,427.43 2.8×
Bone survey infant (77076) $551.70 $551.70 4.1×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $3,272.19 $3,272.19 4.6×
Cat Scan Follow-Up Study (76380) $549.20 $549.20 4.9×
Chest 1 view (71045) $329.20 $329.20 2.9×
Chest 2 views (71046) $395.10 $395.10 3.5×
Chest 4 or more views (71048) $569 $569 4.2×
Clavicle complete (73000) $329.20 $329.20 2.9×
Contrast X-Ray Bladder (74430) $1,298.90 $1,298.90 2.9×
Contrast X-Ray Of Elbow (73085) $1,945.70 $1,945.70 4.3×
Contrast X-Ray Of Knee Joint (73580) $1,945.70 $1,945.70 4.3×
CT abdomen and pelvis without and with contrast (74178) $4,129.90 $4,129.90 9.1×
CT abdomen and pelvis without contrast (74176) $2,911.10 $2,911.10 9.4×
CT abdomen w contrast (74160) $2,178 $2,178 9.6×
CT abdomen w wo contrast (74170) $2,445.70 $2,445.70 10.7×
CT abdomen w/o contrast (74150) $1,430.40 $1,430.40 10.5×
CT Angio Chest (71275) $2,496.70 $2,496.70 11.0×
CT Angio Head (70496) $2,496.70 $2,496.70 11.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,496.70 $2,496.70 11.0×
CT Angio Neck (70498) $2,496.70 $2,496.70 11.0×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,496.70 $2,496.70 11.0×
CT cervical spine w/ contrast (72126) $6,534.30 $6,534.30 14.4×
CT cervical spine w/o contrast (72125) $4,291.20 $4,291.20 31.6×
CT cervical spine w/wo cont (72127) $7,337 $7,337 32.2×
CT chest w contrast (71260) $2,178 $2,178 9.6×
CT chest w/wo contrast (71270) $2,445.70 $2,445.70 10.7×
CT head/brain with contrast (70460) $2,178 $2,178 9.6×
CT head/brain without and with contrast (70470) $2,445.70 $2,445.70 10.7×
CT iac w contrast (70481) $2,178 $2,178 9.6×
CT l-spine w&w/o contrast (72133) $7,337 $7,337 32.2×
CT lower ext w/o (73700) $1,430.40 $1,430.40 10.5×
CT lower extremity w/contrast material (73701) $2,178 $2,178 9.6×
CT lumbar spine w contrast (72132) $6,534.30 $6,534.30 14.4×
CT lumbar spine w/o contrast (72131) $4,291.20 $4,291.20 31.6×
CT maxillofacial w contrast (70487) $2,178 $2,178 9.6×
CT maxillofacial wo contrast (70486) $1,430.40 $1,430.40 10.5×
CT neck tissue combo (70492) $2,445.70 $2,445.70 10.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,445.70 $2,445.70 10.7×
CT orbits w/o contrast (70480) $1,430.40 $1,430.40 10.5×
CT pelvis w&w/o contrast (72194) $2,445.70 $2,445.70 10.7×
CT pelvis w/o contrast (72192) $1,430.40 $1,430.40 10.5×
CT scan of leg combo (73702) $2,445.70 $2,445.70 10.7×
CT scans face/jaw combo (70488) $2,445.70 $2,445.70 10.7×
CT soft tissue neck w contrast (70491) $2,178 $2,178 9.6×
CT soft tissue neck w/o contrast (70490) $1,430.40 $1,430.40 10.5×
CT thoracic spine w contrast (72129) $6,534.30 $6,534.30 28.7×
CT thoracic spine w/o contrast (72128) $4,291.20 $4,291.20 31.6×
CT thoracic spine w/wo cont (72130) $7,337 $7,337 32.2×
CT thorax w/o contrast (71250) $1,430.40 $1,430.40 10.5×
CT upper ext wo (73200) $1,430.40 $1,430.40 10.5×
CT upper extremity w/o & w/contrast material (73202) $2,445.70 $2,445.70 10.7×
CT upper extremity with contrast (73201) $2,178 $2,178 4.8×
Cta Abdomen (74175) $2,496.70 $2,496.70 11.0×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,311.80 $2,311.80 5.1×
CTA pelvis (72191) $2,496.70 $2,496.70 11.0×
Dxa Bone Density Axial (77080) $531.70 $531.70 3.9×
Dxa bone density study 1/>sites appendiclr skel (77081) $213.50 $213.50 1.9×
Esophagram (74220) $641.90 $641.90 2.8×
Fluoroscopy up to 1 hr (76000) $180.80 $180.80 0.6×
Foot 2 views (73620)
range across 3 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
Forearm 2 views (73090)
range across 3 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
Hand 2 views (73120)
range across 2 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
Infant hip ultrasound with hip movement (dynamic) (76885) $549.70 $549.70 4.9×
Infant hip ultrasound, limited static exam (76886) $458.10 $458.10 4.1×
Knee 3 Views (73562) $411.60 $411.60 3.6×
Magnetic Image Jaw Joint (70336) $2,563 $2,563 8.3×
Mra Head W/O & W/Contrast Material (70546) $3,926.10 $3,926.10 8.7×
MRA head w/o contrast (70544) $2,563 $2,563 8.3×
MRA head with contrast (70545) $3,109 $3,109 6.9×
MRA neck w contrast (70548) $3,109 $3,109 6.9×
Mra Neck W/O &W/Contrast Material (70549) $3,926.10 $3,926.10 8.7×
MRA neck w/o contrast (70547) $2,563 $2,563 8.3×
MRI abdomen w contrast (74182) $3,109 $3,109 6.9×
MRI abdomen w/o contrast (74181) $2,563 $2,563 8.3×
MRI any jt lower extrem w/contrast material (73722) $3,109 $3,109 3.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,926.10 $3,926.10 8.7×
MRI any jt upper extremity w/contrast matrl (73222) $3,109 $3,109 3.1×
MRI cervical spine w contrast (72142) $8,883 $8,883 19.6×
MRI cervical spine w/o cont (72141) $7,323 $7,323 23.6×
MRI chest w/o contrast (71550) $2,563 $2,563 8.3×
MRI chest with contrast (71551) $3,109 $3,109 3.1×
MRI chest wo w contrast (71552) $3,926.10 $3,926.10 8.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,109 $3,109 6.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,926.10 $3,926.10 8.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,563 $2,563 8.3×
MRI lumbar spine w contrast (72149) $8,666.30 $8,666.30 19.1×
Mri Neck Spine W/O & W/Dye (72156) $11,217.50 $11,217.50 24.8×
MRI orbit face &/neck w/o contrast (70540) $2,563 $2,563 8.3×
MRI orbit face neck w contrast (70542) $3,109 $3,109 6.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,926.10 $3,926.10 8.7×
MRI pelvis w contrast (72196) $3,109 $3,109 6.9×
MRI pelvis w/o & w contrast (72197) $3,926.10 $3,926.10 8.7×
MRI pelvis w/o contrast (72195) $2,563 $2,563 8.3×
MRI thoracic spine w/o contrast (72146) $7,144.40 $7,144.40 23.1×
MRI upper extremity oth than jt w/contr matrl (73219) $3,109 $3,109 6.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,563 $2,563 8.3×
Mri Uppr Extremity W/O&W/Dye (73220) $3,926.10 $3,926.10 8.7×
MRI, abdomen, combo (74183) $3,926.10 $3,926.10 8.7×
MRI, dorsal spine combo (72157) $10,943.90 $10,943.90 24.2×
MRI, dorsal spine contrast (72147) $8,666.30 $8,666.30 19.1×
MRI, joint upper extrem (73221) $2,563 $2,563 8.3×
MRI, joint upper extrem combo (73223) $3,926.10 $3,926.10 8.7×
MRI, lumbar spine combo (72158) $10,943.90 $10,943.90 24.2×
Myelograpy 2/more regions rs&i (72270) $4,286 $4,286 4.2×
Neck soft tissue (70360) $329.20 $329.20 2.9×
Nonvascular Shunt X-Ray (75809) $556.30 $556.30 4.1×
Panoramic X-ray of jaws (70355) $329.20 $329.20 2.9×
Pelvis 1 or 2 views (72170) $329.20 $329.20 2.4×
PET whole body (78813) $8,693.30 $8,693.30 4.7×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $551.70 $551.70 4.1×
Radex Ankle Complete Minimum 3 Views (73610) $514.50 $514.50 4.6×
Radex Calcaneus Minimum 2 Views (73650) $411.60 $411.60 3.6×
Radex elbow complete minimum 3 views (73080) $514.50 $514.50 4.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $395.10 $395.10 2.9×
Radex fingr minimum 2 views (73140)
range across 3 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
Radex foot complete minimum 3 views (73630) $514.50 $514.50 4.6×
Radex Hand Minimum 3 Views (73130) $514.50 $514.50 4.6×
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines
$331.30–$662.60 $331.30–$662.60 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $474.20 $474.20 4.2×
Radex Ribs Unilateral 2 Views (71100) $411.60 $411.60 3.6×
Radex shoulder complete minimum 2 views (73030) $411.60 $411.60 3.6×
Radex Sinuses Paransl < 3 Views (70210) $329.20 $329.20 2.9×
Radex Spine 1 View Specify Level (72020) $329.20 $329.20 2.9×
Radex Sternum Minimum 2 Views (71120) $395.10 $395.10 3.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $395.10 $395.10 3.5×
Radex Toe Minimum 2 Views (73660)
range across 3 matching MRF lines
$411.60–$494 $411.60–$494 varies
Radex upper extremity infant minimum 2 views (73092)
range across 2 matching MRF lines
$330.40–$660.80 $330.40–$660.80 varies
Radex Wrist Complete Minimum 3 Views (73110) $514.50 $514.50 4.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $739.20 $739.20 5.4×
Radiolog exam mandible compl minimum 4 views (70110) $395.10 $395.10 2.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $474.20 $474.20 3.5×
Radiologic exam colon single contrast study (74270) $641.90 $641.90 2.8×
Radiologic exam knee complete 4/more views (73564) $514.50 $514.50 3.8×
Radiologic exam pelvis compl minimum 3 views (72190) $395.10 $395.10 2.9×
Radiologic Exam Small Int Single Contrast Study (74250) $641.90 $641.90 2.8×
Radiologic exam swallow function contrast study (74230) $641.90 $641.90 2.8×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $265.10 $265.10 0.9×
Radiologic examination femur 1 view (73551)
range across 3 matching MRF lines
$154.60–$309.20 $154.60–$309.20 varies
Radiologic examination femur minimum 2 views (73552) $182.90 $182.90 1.6×
Radiologic examination knee 1/2 views (73560) $329.20 $329.20 2.9×
Radiologic Examination Osseous Survey Limited (77074) $551.70 $551.70 4.1×
Radiologic examination tibia & fibula 2 views (73590)
range across 2 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
Radiologic examination, teeth; single view Non-Facility (70300) $220.90 $220.90 2.0×
Ribs bilateral 3 views (71110) $617.40 $617.40 4.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,149 $3,149 4.5×
Scapula (73010) $329.20 $329.20 2.4×
Shoulder 1 view (73020) $329.20 $329.20 2.9×
Shoulder Arthrography (73040) $1,945.70 $1,945.70 4.3×
Skull less than 4 views (70250) $329.20 $329.20 2.4×
Speech evaluation, complex (70371) $448.60 $448.60 1.4×
Sternoclavicular joints (71130) $474.20 $474.20 4.2×
Thoracic spine 2 views (72070) $329.20 $329.20 2.4×
Thoracic spine 3 views (72072) $395.10 $395.10 2.9×
Thoracolumbar 2 views (72080) $395.10 $395.10 3.5×
Ultrasound, abdomen limited (76705) $713.60 $713.60 5.3×
Unlisted Dx Radiographic Procedure (76499) $329.20 $329.20 2.9×
Unlisted fluoroscopic procedure (76496) $627.40 $627.40 5.6×
Unlisted us procedure (76999) $458.10 $458.10 4.1×
Upper gi w/o kub (74240) $1,038 $1,038 4.6×
Urethrocystogram voiding (74455) $1,298.90 $1,298.90 4.2×
Us chest (76604) $458.10 $458.10 3.4×
Us complete joint (76881) $713.60 $713.60 5.3×
Us exam, pelvic, limited (76857) $745.10 $745.10 5.5×
Us head (76506) $458.10 $458.10 3.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $713.60 $713.60 5.3×
Us pelvic non ob complete (76856) $745.10 $745.10 5.5×
Us retroperitoneal complete (76770) $856.20 $856.20 6.3×
Us retroperitoneal limited (76775) $713.60 $713.60 5.3×
Us scrotum and contents (76870) $687.80 $687.80 5.1×
Us spinal canal and contents (76800) $713.60 $713.60 5.3×
Us thyroid (76536) $713.60 $713.60 5.3×
Vertebral fracture assessment via dxa (77086) $329.20 $329.20 2.9×
Wrist 2 views (73100) $411.60 $411.60 3.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $329.20 $329.20 2.9×
X-Ray Bend Only L-S Spine (72120) $739.20 $739.20 5.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines
$411.60–$823.20 $411.60–$823.20 varies
X-Ray Exam Entire Spi 1 Vw (72081) $329.20 $329.20 2.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $367.80 $367.80 2.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $399 $399 2.9×
X-Ray Exam Hip Uni 1 View (73501) $163.10 $163.10 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $239.90 $239.90 2.1×
X-Ray Exam Hip Uni 4/> Views (73503) $296.80 $296.80 2.2×
X-Ray Exam Hips Bi 2 Views (73521) $225.70 $225.70 1.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $268.20 $268.20 2.0×
X-Ray Exam Hips Bi 5/> Views (73523) $322.30 $322.30 2.4×
X-Ray Exam L-S Spine Bending (72114) $606.70 $606.70 4.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $329.20 $329.20 2.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $606.70 $606.70 4.5×
X-Ray Exam Unilat Ribs/Chest (71101) $514.50 $514.50 3.8×
X-ray eye for foreign body (70030) $549.20 $549.20 4.9×
X-ray head for orthodontia (70350) $329.20 $329.20 2.9×
X-ray humerus (73060) $411.60 $411.60 3.6×
X-ray IV pyelogram (ivp) (74400) $1,258.40 $1,258.40 5.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $329.20 $329.20 2.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $643.10 $643.10 5.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $329.20 $329.20 2.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $643.10 $643.10 4.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $395.10 $395.10 2.9×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $329.20 $329.20 2.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $395.10 $395.10 3.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $395.10 $395.10 3.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $551.70 $551.70 4.1×
X-Ray Stress View (77071) $329.20 $329.20 2.9×
X-ray thoracic spine 4 vw (72074) $474.20 $474.20 3.5×
X-Ray Tmj Unilat (70328) $329.20 $329.20 2.9×
X-Rays Bone Length Studies (77073) $330.40 $330.40 2.4×
X-Rays Bone Survey Complete (77075) $662.10 $662.10 4.9×
Xr c-spine 4 or 5 views (72050) $551.70 $551.70 4.1×
Xr facial bones less than 3 views (70140) $329.20 $329.20 2.9×
Xr orbits complete 4 views (70200) $739.20 $739.20 5.4×

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.