Imaging prices at White Mountain Regional Medical Center

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

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

Compare against other hospitals interactively →

ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $156.98 $275.41 1.4×
Ankle 2 views (73600) $132.20 $231.94 1.4×
Bone &/Joint Imaging Limited Area (78300) $581.54 $1,020.25 1.4×
Bone &/Joint Imaging Multiple Areas (78305) $627.68 $1,101.20 1.5×
Bone &/joint imaging whole body (78306) $818.20 $1,435.44 1.9×
Bone age studies (77072) $121.37 $212.93 1.1×
Bone Imaging 3 Phase (78315) $901.58 $1,581.72 2.1×
Bone survey complete (77075) $332.96 $584.14 3.0×
Cervical spine 2 or 3 views (72040) $159.15 $279.21 1.7×
Chest 1 view (71045) $162.23 $284.61 1.7×
Clavicle complete (73000) $134.35 $235.70 1.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $148.33 $260.23 1.3×
CT abdomen and pelvis without and with contrast (74178) $1,688.30 $2,961.92 4.5×
CT abdomen and pelvis without contrast (74176) $1,147.75 $2,013.60 4.5×
CT abdomen w contrast (74160) $929.43 $1,630.58 5.0×
CT abdomen w wo contrast (74170) $1,084.76 $1,903.08 5.8×
CT abdomen w/o contrast (74150) $709.38 $1,244.52 6.4×
CT angiography upper extremity lt (73206) $1,020.86 $1,790.98 5.5×
CT c-spine w/o contrast (72125) $759.62 $1,332.66 6.8×
CT cervical spine w&w/o contrast (72127) $1,052.52 $1,846.53 5.6×
CT cervical spine with contrast (72126) $857.12 $1,503.71 2.3×
CT chest w/wo contrast (71270) $1,031.46 $1,809.58 5.5×
CT chest with contrast (71260) $873.92 $1,533.19 4.7×
CT head/brain with contrast (70460) $748.68 $1,313.48 4.0×
CT head/brain without and with contrast (70470) $904.88 $1,587.52 4.8×
CT iac w contrast (70481) $835.96 $1,466.60 4.5×
CT lower ext w/o (73700) $1,122.33 $1,969 10.1×
CT lower extremity w wo contrast (73702) $945.42 $1,658.62 5.1×
CT lower extremity with contrast (73701) $806.10 $1,414.21 4.3×
CT lumbar spine w & w/o contrast (72133) $1,076.74 $1,889.02 5.8×
CT lumbar spine w/o contrast (72131) $753.34 $1,321.66 6.8×
CT lumbar spine with contrast (72132) $891.02 $1,563.19 2.4×
CT maxillofacial w contrast (70487) $834.50 $1,464.03 4.5×
CT maxillofacial w/o contrast (70486) $682.83 $1,197.94 6.1×
CT maxillofacial w/wo contrast (70488) $949.76 $1,666.25 5.1×
CT neck soft tissue w contrast (70491) $852.56 $1,495.72 4.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $912.85 $1,601.50 4.9×
CT orbits w/o contrast (70480) $705.07 $1,236.96 6.3×
CT pelvis w & w/o contrast (72194) $1,027.38 $1,802.42 5.5×
CT pelvis w/o contrast (72192) $700.63 $1,229.18 6.3×
CT scan for measuring calcium and other minerals in bone (77078) $207.69 $364.36 2.2×
CT soft tissue neck w/o & w/contrast material (70492) $961.28 $1,686.46 5.1×
CT soft tissue neck w/o contrast (70490) $5,701.74 $10,003.04 51.1×
CT thoracic spine w/contrast (72129) $851.92 $1,494.58 4.6×
CT thoracic spine w/o contrast (72128) $736.97 $1,292.93 6.6×
CT thoracic spine w/wo contrast (72130) $1,011.50 $1,774.55 5.4×
CT thorax w/o contrast (71250) $1,156.53 $2,029 10.4×
CT upper extremity w/o & w/contrast material (73202) $994.90 $1,745.45 5.3×
CT upper extremity w/o contrast rt (73200) $694.59 $1,218.58 6.2×
CT upper extremity with contrast (73201) $818.78 $1,436.46 2.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,219.66 $2,139.76 6.5×
Cta Abdomen (74175) $1,108.50 $1,944.74 5.9×
CTA abdomen pelvis (74174) $651.92 $1,143.72 1.8×
CTA chest (71275) $1,112.12 $1,951.08 5.9×
Cta Head (70496) $1,077.40 $1,890.18 5.8×
CTA lwr ext w&w/o contrast (73706) $1,121.15 $1,966.93 6.0×
Cta Neck (70498) $1,066.06 $1,870.28 5.7×
Cta Pelvis (72191) $1,063.30 $1,865.45 5.7×
Dx ophthalmic us ant segment immersion uni/bi (76513) $156.08 $273.82 1.4×
Echoencephalography real time imaging (76506) $184.10 $322.98 1.7×
Fetal biophysical profile non-stress testing (76818) $268.58 $471.20 2.4×
Fluoroscopy up to 1 hr (76000) $244.36 $428.70 1.0×
Foot 2 views (73620) $127.55 $223.78 1.4×
Forearm 2 views (73090) $118.66 $208.18 1.3×
Gated Heart Planar Single (78472) $761.20 $1,335.44 1.8×
Hand 2 views (73120) $140.92 $247.22 1.3×
Hand 3 views (73130) $156.92 $275.30 1.7×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $969.42 $1,700.73 1.7×
Hepatobiliary syst imaging including gallbladder (78226) $803.80 $1,410.16 1.9×
Ht muscle image spect sing (78451) $1,294.62 $2,271.25 0.9×
Humerus Min 2 Views Left (73060) $138.62 $243.20 1.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $109.56 $192.21 0.2×
Kidney img morphology vascular flow 1 w/rx (78708) $727.31 $1,275.98 1.3×
Kidney Img Morphology Vascular Flow Multiple (78709) $906.41 $1,590.19 1.6×
Knee 3 views (73562) $166.78 $292.58 1.8×
Liver & spleen imaging static only (78215) $627.88 $1,101.56 1.5×
Lung perf&ventilat diferentl (78598) $849.42 $1,490.20 1.5×
Lung perfusion differential (78597) $597.54 $1,048.32 1.4×
Lung Ventilation Imaging (78579) $287.28 $504 0.7×
Meckels Diverticulum (78290) $644.36 $1,130.44 1.5×
MRA head w/o contrast (70544) $1,017.80 $1,785.60 4.0×
MRA neck w contrast (70548) $852.84 $1,496.21 2.3×
Mra Neck W/O &W/Contrast Material (70549) $1,401.37 $2,458.55 3.8×
MRA neck w/o contrast (70547) $963.40 $1,690.18 3.8×
MRI abdomen w contrast (74182) $1,120.58 $1,965.94 3.0×
MRI abdomen w/o & w/contrast material (74183) $1,539.90 $2,701.58 4.1×
MRI abdomen w/o contrast (74181) $1,058.67 $1,857.32 4.2×
MRI any jnt lwr ext with con lt (73722) $1,856.70 $3,257.36 2.2×
MRI any jt upper extremity w/contrast matrl (73222) $1,899.75 $3,332.90 2.3×
MRI c-spine with contrast (72142) $1,254.62 $2,201.10 3.4×
MRI cervical spine w/o contrast (72141) $1,057.02 $1,854.42 4.2×
MRI chest w/o & w/contrast material (71552) $1,587.28 $2,784.69 4.3×
MRI chest w/o contrast (71550) $1,078.18 $1,891.54 4.2×
MRI chest with contrast (71551) $1,000.75 $1,755.70 1.2×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,199.21 $2,103.88 3.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,212.48 $2,127.16 3.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,016.50 $1,783.32 4.0×
MRI orbit face &/neck w/o contrast (70540) $1,000.04 $1,754.45 3.9×
MRI orbit/face/neck w&w/o cont (70543) $1,473.78 $2,585.57 4.0×
MRI orbit/face/neck w/contrast (70542) $1,248.56 $2,190.46 3.4×
MRI pelvis w contrast (72196) $1,213.55 $2,129.04 3.3×
MRI pelvis w/o & w/contrast material (72197) $1,500.24 $2,632 4.0×
MRI pelvis w/o contrast (72195) $1,084.46 $1,902.57 4.3×
MRI scan of arm joint before and after contrast (73223) $2,345.82 $4,115.46 6.3×
MRI scan of leg joint before and after contrast (73723) $2,382.80 $4,180.35 6.4×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,536.41 $2,695.46 4.1×
MRI spinal canal lumbar w/contrast material (72149) $1,204.80 $2,113.69 3.2×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,541.98 $2,705.24 4.1×
MRI spinal canal thoracic w/contrast matrl (72147) $1,281.46 $2,248.18 3.4×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,515.30 $2,658.42 4.1×
MRI thoracic spine w/o contrast (72146) $1,051.18 $1,844.18 4.1×
MRI tmj (70336) $973.85 $1,708.51 3.8×
MRI upper ext joint w/o contrast (73221) $1,737.99 $3,049.10 6.8×
MRI upper extrem other than jt w/o & w/contras (73220) $1,483.73 $2,603.04 4.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,095.40 $1,921.74 4.3×
Myocardial Spect Multiple Studies (78452) $722.27 $1,267.14 0.5×
Neck soft tissue (70360) $124.64 $218.66 1.3×
Nm gastric emptying study (78264) $817.59 $1,434.37 1.9×
Nuclear medicine of heart muscle at rest with stress (78454) $1,429.05 $2,507.10 1.0×
Nuclear medicine study of heart muscle at rest with stress (78453) $444.31 $779.49 0.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $196.52 $344.77 1.8×
Parathyrd planar w/wo subtrj (78071) $777.01 $1,363.18 1.8×
Parathyroid imaging (78070) $689.30 $1,209.31 1.6×
Pelvis 1 or 2 views (72170) $138.04 $242.18 1.2×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,481.25 $2,598.68 4.0×
Pulmonary Perfusion Imaging Particulate (78580) $765.10 $1,342.28 1.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $873.66 $1,532.74 1.5×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $139.38 $244.52 1.5×
Radex hips bilateral with pelvis 2 views (73521) $116.37 $204.15 1.0×
Radiolog exam mandible compl minimum 4 views (70110) $177.96 $312.20 1.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $121.90 $213.86 1.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $138.42 $242.83 1.5×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $204.63 $359 2.2×
Ribs bilateral 3 views (71110) $189.98 $333.31 1.7×
Scanogram (77073) $146.31 $256.68 1.3×
Scapula complete (73010) $134.17 $235.38 1.2×
Small bowel series (74250) $342.06 $600.12 1.8×
Spine thoracic 3 views (72072) $179.98 $315.74 1.6×
Thyroid carcinoma metastases img whole body (78018) $865.76 $1,518.86 1.5×
Thyroid Imaging With Vascular Flow (78013) $378.34 $663.74 0.9×
Thyroid uptake measurement (78012) $322.10 $565.09 0.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $600.30 $1,053.16 1.4×
Tmj unilateral (70328) $123.52 $216.70 1.3×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $1,562.80 $2,741.76 2.7×
Ultrasound, abdomen limited (76705) $315.26 $553.08 2.8×
Upper Extremity Infant (73092) $76.82 $134.78 0.7×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $225.12 $394.95 1.2×
Us chest (76604) $224.72 $394.24 2.0×
Us compl joint r-t w/image documentation (76881) $152.86 $268.18 1.4×
Us infant hips dynamic (76885) $301.18 $528.40 3.2×
Us kidney transplant (76776) $375.51 $658.79 3.4×
Us ob transvaginal (76817) $213.04 $373.76 1.9×
Us pelvic non ob complete (76856) $275.96 $484.14 2.5×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $159.40 $279.66 1.4×
Us pregnancy ltd (76815) $182.40 $320.01 1.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $316.88 $555.92 2.8×
Us retroperitoneal complete (76770) $353.72 $620.56 3.2×
Us retroperitoneal limited (76775) $257.45 $451.66 2.3×
Us scrotum and contents (76870) $257.13 $451.10 2.3×
Us soft tissue head/neck (76536) $328.64 $576.55 2.9×
Us xtr non-vasc lmtd (76882) $110.92 $194.60 1.0×
Wrist 2 views (73100) $133.76 $234.68 1.4×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $216.18 $379.26 1.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $125.92 $220.90 1.4×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $156.54 $274.63 1.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $96.72 $169.68 1.0×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $151.75 $266.22 1.6×
X-ray exam hip uni 1 view (73501) $155.31 $272.47 1.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $152.31 $267.21 1.6×
X-ray exam of femur 1 (73551) $45.62 $80.04 0.5×
X-ray eye for foreign body (70030) $93.43 $163.92 1.0×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $183.92 $322.66 1.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $154 $270.18 1.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $122.57 $215.04 1.3×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $128.06 $224.66 1.4×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $194.76 $341.68 1.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $155.52 $272.82 1.7×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $73.62 $129.16 0.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $173.32 $304.07 1.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $267.54 $469.38 2.4×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $149.12 $261.61 1.6×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $135.26 $237.30 1.5×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $185.70 $325.78 1.7×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $167.05 $293.07 1.5×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $136.34 $239.19 1.5×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $184.42 $323.56 1.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $232.43 $407.77 2.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $154.04 $270.24 1.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $143.48 $251.72 1.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $155.80 $273.34 1.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $171.94 $301.66 1.9×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $111.28 $195.22 1.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $196.73 $345.14 1.8×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $45.82 $80.38 0.4×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $167.40 $293.68 1.8×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $141.51 $248.26 1.5×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $154.92 $271.80 1.4×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $117.52 $206.18 1.3×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $156.12 $273.88 1.7×
Xr c-spine 6 or more views (72052) $253.36 $444.50 2.3×
Xr finger(s) 2+ views (73140) $125.63 $220.40 1.4×
Xr shoulder 1 view (73020) $111.47 $195.56 1.2×
Xr spine cervical 4 or 5 views (72050) $220.35 $386.58 2.0×
Xr tibia/fibula 2 views (73590) $144.33 $253.21 1.6×
Xr tmj bilateral (70330) $176.14 $309.02 1.9×
Xray knee 1 or 2 views rt (73560) $138.60 $243.16 1.5×