Prompt Pay Price (1) Abdomen 1 View $ Abdomen Comp 3 Views w/o Chest $ Abdomen w/ Pa Chest 3 Views $

Transcription

1 (602) Patient Price List Abdomen 1 View $ Abdomen Comp 3 Views w/o Chest $ Abdomen w/ Pa Chest 3 Views $ Ac Jts Bilat w/o & w/ Wt $ Ankle 2 Views $ Ankle Comp $ Arthrogram Injection Shoulder $ Arthrogram Shoulder S & I $ Barium Enema w/air Cont $ Bone Density Axial $ Calcaneus 2+ Views $ Chest 1 View $ Chest Pa & Lat $ Clavicle Comp $ CT Abd & Pelvis w & w/o Cont $ CT Abd w/ Cont $ CT Abd w/o & w/ Cont $ CT Abd w/o Cont $ CT Abdomen & Pelvis w/ Cont $ CT Abdomen & Pelvis w/o Cont $ CT Chest w/ Cont $ CT Chest w/o & w/ Cont $ CT Chest w/o Cont $ CT Colonography $ CT C-Spine w/ Cont $ CT C-Spine w/o & w/ Cont $ CT C-Spine w/o Cont $ CT Ext Lwr w/ Cont $ CT Ext Lwr w/o & w/ Cont $ CT Ext Lwr w/o Cont $ CT Ext Up w/ Cont $ CT Ext Up w/o & w/ Cont $ CT Ext Up w/o Cont $ CT Facl Bones w/ Cont $ CT Facl Bones w/o Cont $ CT Head/Brain w/ Cont $ CT Head/Brain w/o & w/ Cont $ CT Head/Brain w/o Cont $ CT L-Spine w/ Cont $ CT L-Spine w/o & w/ Cont $ CT L-Spine w/o Cont $ CT Neck w/ Cont $ CT Neck w/o & w/ Cont $ CT Neck w/o Cont $ 1 of 5

2 (602) CT Pelvis w/ Cont $ CT Pelvis w/o Cont $ CT Temprl Bone w/ Cont $ CT Temprl Bone w/o Cont $ CT T-Spine w/o Cont $ CTA Abd $ CTA Abd Aorta/Runoff S&I $ CTA Chest $ CTA Ext Lwr $ CTA Head w/o & w/ Cont $ CTA Neck w/o & w/ Cont $ G0288 CTA Reconstruction of Aorta $ Elbow 2 Views $ Elbow Comp $ Esophagus $ Femur 2 Views $ Finger(s) 2+ Views $ Foot 2 Views $ Foot Comp $ Forearm 2 Views $ Hand 2 Views $ Hand 3+ Views $ Hip 1 View $ Hip Bilat Comp w/ap Pelvis $ Hip Comp $ Humerus 2+ Views $ Knee 1-2 Views $ Knee 3 Views $ Knee Comp 4 +Views $ Knees Both Standing $ MRA Abd w/or w/o Cont $ MRA Chest w/o & w/ Cont $ MRA Neck w/ Cont $ MRA Neck w/o & w/ Cont $ MRA Neck w/o Cont $ MRA/MRV Head w/o Cont $ MRI Abd w/ Cont $ MRI Abd w/o & w/ Cont $ MRI Abd w/o Cont $ MRI Brain w/ Cont $ MRI Brain w/o & w/ Cont $ MRI Brain w/o Cont $ MRI Breast Bila w/o & w/ Cont $ 1, MRI Chest w/o & w/ Cont $ MRI Chest w/o Cont $ 2 of 5

3 (602) MRI Ext Jnt Lwr w/ Cont $ MRI Ext Jnt Lwr w/o & w/ Cont $ MRI Ext Jnt Up w/ Cont $ MRI Ext Jnt Up w/o & w/ Cont $ MRI Ext Jnt Up w/o Cont $ MRI Ext Lwr Jnt w/o Cont $ MRI Ext Lwr w/ Cont $ MRI Ext Lwr w/o & w/ Cont $ MRI Ext Lwr w/o Cont $ MRI Ext Up w/o & w/ Cont $ MRI Ext Up w/o Cont $ MRI Lumbar Spine w/ Cont $ 6 72 MRI Lumbar Spine w/o Cont $ MRI Lumbar Spine w/o & w/ Cont $ MRI Orbit/Face/Neck w/o Cont $ MRI Pelvis w/ Cont $ MRI Pelvis w/o & w/ Cont $ MRI Pelvis w/o Cont $ MRI Spine Cervical w/ Cont $ MRI Spine Cervical w/o & w Cont $ MRI Spine Cervical w/o Cont $ MRI Thoracic Spine w/o & w/ Cont $ MRI Thoracic Spine w/o Cont $ MRI Tmj(s) $ Nasal Bones Comp 3 View Min $ Paranasal Sinus 1-2 View $ Paranasal Sinus Comp 3+ Views $ Pelvis 1-2 Views $ Ribs Bila w/pa Chest 4+ Views $ Ribs Bilat 3 Views $ Ribs Uni 2 Views $ Ribs Uni w/pa Chest 3+ Views $ Sacroiliacs 3+ Views $ Sacrum & Coccyx 2+ Views $ Scoliosis Survey Suspin & Erect $ Shoulder 1 View $ Shoulder 2+ Views $ Small Bowel Series $ Soft Tissue Neck $ Spine Cervical 2-3 Views $ Spine Cervical 4+ Views $ Spine Cervical Comp Flex & Ext $ Spine Lumbar 2-3 Views $ Spine Lumbar 4+ Views $ Spine Single View $ Spine Thoracic 3 Views $ 3 of 5

4 (602) Spine Thoracolumbar 2 Views $ Tibia & Fibula 2 Views $ Toe(s) 2+ Views $ Ugi w/air w/sm Bowel $ Ultrasound Abdominal Complete $ Ultrasound Abdominal, Realtime w/image Documentation $ Ultrasound Aorta/Venacava Ltd $ Ultrasound Exam Trans Kidney w/doppler $ Ultrasound Ob < 14WKS $ Ultrasound Ob Comp $ Ultrasound OB Ltd/Fetal Position $ Ultrasound Pelvic $ Ultrasound Pelvis Limited $ Ultrasound Prostate $ Ultrasound Retroperitoneal, Renal, Aorta, Complete $ Ultrasound Soft Tissue Neck/Head $ Ultrasound Testicular $ Ultrasound Transvaginal $ 76 Ultrasound Transvaginal OB $ Ultrasound Xtr Non-Vascular Limited $ Wrist 2 Views $ Wrist Complete, Min 3 Views $ The above prices are for radiological procedures performed at HonorHealth Outpatient Medical Imaging Centers. Prices listed do not include professional fees for services of hospital based Radiologists. Note, not all services provided at all locations. (1) Price is the average price a self-pay patient will pay when paid-in-full at time of service. 4 of 5

5 (602) HonorHealth Outpatient Medical Imaging Centers Glendale Health & Infusion Center X-Ray Ultrasound Infusions 6220 W. Bell Rd Suite 110 Glendale, AZ T: Anthem Outpatient Medical Imaging X-Rays Only 3648 W. Anthem Way Building A-100 Anthem, AZ T: Deer Valley Outpatient Medical Imaging N. 27th Ave. Suite LL1 Phoenix, AZ T: John C. Lincoln Outpatient Medical Imaging 9250 N. Third St. Suite 1002 Phoenix, AZ T: Sonoran Health N. 32nd Ave Phoenix, AZ T: Tatum Outpatient Medical Imaging X-Ray Ultrasound CT MRI N. Tatum Blvd. Suite 103 Phoenix, AZ T: Breast Health & Research Center Mammograms Ultrasound MRI N. 27th Ave., Suite 205, Phoenix, AZ T: HOPE (4673) 5 of 5