• 2635 North 7th Street, Grand Junction, Colorado 81501
  • 970-298-CARE (2273) / 1-800-458-3888

Pricing

Imaging Procedure Pricing

To help you with today's healthcare decisions we have compiled a list of common imaging procedures and their respective pricing. Always double check with your care provider to ensure your expected costs.

If we are paid cash at time of service and insurance is not billed, we can offer the service at a 56% discount which is reflected in the pricing below.

For Financial Counseling, the phone numbers are:
 
970.298.7070 local
855.232.0307 toll free

 
 

Breast Care Center

Pricing of Mammography Procedures: These prices do not include the radiologist’s fee to read the imaging procedure. The radiologist that interprets the images from  your exam will bill you separately. your exam will bill you separately.

Exam CPT/HCPCS Hospital Full Price Hospital Price after Self-Pay Discount Pavilion Full Price Pavilion Price after Self-Pay Discount
Mammogram Diagnostic (bilateral and with CAD)    
G0204 & 77051 $680.08 $315.56 $489.00 $226.90
Mammogram Screening (bilateral and with CAD) G0202 & 77052 $317.90 $147.51 $289.00 $134.10
no pricing difference whether patient has implants or not
         

 

Imaging/ Radiology - CT Procedures

Pricing of Radiology Procedures: These prices do not include the radiologist’s fee to read the imaging procedure. The radiologist that interprets the images from your exam will bill you separately.
Exam CPT/HCPCS Hospital Full Price Hospital Price after Self-Pay Discount Pavilion Full Price Pavilion Price after Self-Pay Discount
CT Abdomen
     CT Abdomen without Contrast 74150 $1,556.50 $722.22 $1,415.00 $656.56
     CT Abdomen with Contrast 74160 $2,260.00 $1,048.64 $1,930.00 $895.52
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Abdomen with/without Contrast 74170 $2,576.20 $1,195.36 $2,342.00 $1,086.69
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
CT Abdomen & Pelvis
     CT Abdomen & Pelvis without Contrast 74176 $3,107.50 $1,441.88 $2,825.00 $1,310.80
     CT Abdomen & Pelvis with Contrast 74177 $4,400.00 $2,041.60 $4,000.00 $1,856.00
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Abdomen & Pelvis with/without Contrast 74178 $5,225.00 $2,424.40 $4,750.00 $2,204.00
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
CT Cervical Spine
     CT Cervical Spine without Contrast 72125 $1,556.00 $721.98 $1,415.00 $656.56
     CT Cervical Spine with Contrast 72126 $2,260.00 $1,048.64 $2,060.00 $955.84
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Cervical Spine with/without Contrast 72127 $2,656.50 $1,232.62 $2,118.88 $983.16
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
Calcium Scoring 75571 $99.00 $45.94 N/A N/A
CT Chest (Thorax)
     CT Chest (Thorax) without Contrast 71250 $1,556.50 $722.22 $1,415.00 $656.56
     CT Chest (Thorax) with Contrast 71260 $2,260.00 $1,048.64 $2,060.00 $955.84
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Chest (Thorax) with/without Contrast 71270 $2,656.50 $1,232.62 $2,418.00 $1,121.95
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
CT Head/Brain
     CT Head/Brain without Contrast 70450 $1,556.50 $722.22 $1,415.00 $656.56
     CT Head/Brain with Contrast 70460 $2,255.00 $1,046.32 $2,060.00 $955.84
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Head/Brain with/without  Contrast 70470 $2,656.50 $1,232.62 $2,415.00 $1,120.56
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
CT Lumbar/Sacral Spine
     CT Lumbar/Sacral Spine without Contrast 72131 $1,556.50 $722.22 $1,415.00 $656.56
     CT Lumbar/Sacral Spine with Contrast 72132 $2,260.00 $1,048.64 $2,060.00 $955.84
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Lumbar/Sacral Spine with/without Contrast 72133 $2,118.88 $983.16 $1,924.45 $892.94
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
CT Pelvis
     CT Pelvis without Contrast 72192 $1,556.50 $722.22 $1,415.00 $656.56
     CT Pelvis with Contrast 72193 $2,260.00 $1,048.64 $2,060.00 $955.84
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Pelvis with/without Contrast 72194 $2,660.00 $1,234.24 $3,393.50 $1,574.58
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
CT Thoracic Spine
     CT Thoracic Spine without Contrast 72128 $1,556.50 $722.22 $1,415.00 $656.56
     CT Thoracic Spine with Contrast 72129 $2,260.00 $1,048.64 $2,060.00 $955.84
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
     CT Thoracic Spine with/without Contrast 72130 $2,693.75 $1,249.90 $2,448.88 $1,136.28
     Contrast (Isovue 300 100ML) * N/A N/A N/A N/A
* There is no additional charge for the contrast used with this procedure.


 

Imaging/ Radiology - MRI Procedures

Pricing of Radiology Procedures: These prices do not include the radiologist’s fee to read the imaging procedure. The radiologist that interprets the images from your exam will bill you separately.

Exam CPT/HCPCS Hospital Full Price Hospital Price after Self-Pay Discount Pavilion Full Price Pavilion Price after Self-Pay Discount
MRI Abdomen
     MRI Abdomen without Contrast 74181 $2,970.00 $1,378.08 $2,700.00 $1,252.80
     MRI Abdomen with Contrast 74182 $4,307.33 $1,998.60 $3,897.30 $1,808.35
     Contrast (Multihance 20ML) * N/A N/A N/A N/A
     MRI Abdomen with/without Contrast 74183 $4,840.00 $2,245.76 $4,400.00 $2,041.60
     Contrast (Multihance 20ML) * N/A N/A N/A N/A
MRI Ankle (unilateral)
     MRI Ankle without Contrast 73721 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Ankle with Contrast 73722 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) * N/A N/A N/A N/A
     MRI Ankle with/without Contrast 73723 $4,455.00 $2,067.12 $4,050.00 $1,879.20
     Contrast (Multihance 20ML) * N/A N/A N/A N/A
MRI Arthrogram (diagnostic-unilateral)
     MRI Knee Arthrogram with Contrast 73722, 73580, & 27370 $6,181.00 $2,867.98 $5,611.00 $2,603.50
     Contrast (Isovue 300 100ML)  N/A N/A N/A N/A
     Gadobenate Multihance 5ML N/A N/A N/A N/A
     MRI Hip Arthrogram with Contrast 73722, 73525, & 27093 $6,311.75 $2,928.65 $5,733.50 $2,660.34
     Contrast (Isovue 300 100ML) N/A N/A N/A N/A
     Gadobenate Multihance 5ML N/A N/A N/A N/A
     MRI Shoulder Arthrogram with Contrast 73222, 73040, & 23350 $6,171.00 $2,863.34 $5,602.25 $2,599.44
     Contrast (Isovue 300 100ML) N/A N/A N/A N/A
     Gadobenate Multihance 5ML N/A N/A N/A N/A
     MRI Wrist Arthrogram with Contrast 73222, 73115, & 25246 $6,248.75 $2,899.42 $5,672.25 $2,631.92
     Contrast (Isovue 300 100ML) N/A N/A N/A N/A
     Gadobenate Multihance 5ML N/A N/A N/A N/A
MRI Breast Bilateral with/without Contrast
     MRI Breast Bilateral with/without Contrast C8908 N/A N/A $3,950.00 $1,832.80
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Foot (unilateral)
     MRI Foot without Contrast 73721 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Foot with Contrast 73722 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Foot with/without Contrast 73723 $4,455.00 $2,067.12 $4,050.00 $1,879.20
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Head (Brain)
     MRI Head (Brain) without Contrast 70551 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Head (Brain) with Contrast 70552 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) N/A N/A N/A N/A
     MRI Head (Brain) with/without Contrast 70553 $3,960.00 $1,837.44 $3,600.00 $1,670.40
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Hip (unilateral)
     MRI Hip without Contrast 73721 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Hip with Contrast 73722 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) N/A N/A N/A N/A
     MRI Hip with/without Contrast 73723 $4,455.00 $2,067.12 $4,050.00 $1,879.20
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Knee (unilateral)
     MRI Knee without Contrast 73721 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Knee with Contrast 73722 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) N/A N/A N/A N/A
     MRI Knee with/without Contrast 73723 $4,455.00 $2,067.12 $4,050.00 $1,879.20
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Pelvis
     MRI Pelvis without Contrast 72195 $2,970.00 $1,378.08 $2,700.00 $1,252.80
     MRI Pelvis with Contrast 72196 $4,173.68 $1,936.59 $3,814.53 $1,769.94
     Contrast (Multihance 20ML) N/A N/A N/A N/A
     MRI Pelvis with/without Contrast 72197 $4,445.00 $2,062.48 $4,050.00 $1,879.20
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Shoulder (unilateral)
     MRI Shoulder without Contrast 73221 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Shoulder with Contrast 73222 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) N/A N/A N/A N/A
     MRI Shoulder with/without Contrast 73223 $4,455.00 $2,067.12 $4,050.00 $1,879.20
     Contrast (Multihance 20ML) N/A N/A N/A N/A
MRI Spine (One Segment - Cervical, Thoracic, or Lumbar)
     MRI Spine (one segment) without Contrast 72141 or 72146 or 72148 $2,860.00 $1,327.04 $2,600.00 $1,206.40
     MRI Spine (one segment) with Contrast 72142 or 72147 or 72149 $3,465.00 $1,607.76 $3,150.00 $1,461.60
     Contrast (Multihance 20ML) N/A N/A N/A N/A
     MRI Spine (one segment) with/without Contrast 72156 or 72157 or 72158 $4,345.00 $2,016.08 $3,950.00 $1,832.80
     Contrast (Multihance 20ML) N/A N/A N/A N/A
* There is no additional charge for the contrast used with this procedure.


 

Imaging/ Radiology - Ultrasound Procedures

Pricing of Radiology Procedures: These prices do not include the radiologist’s fee to read the imaging procedure. The radiologist that interprets the images from your exam will bill you separately.

Exam CPT/HCPCS Hospital Full Price Hospital Price after Self-Pay Discount Pavilion Full Price Pavilion Price after Self-Pay Discount
Ultrasound Abdomen (complete) 76700 $1,206.00 $559.58 $1,096.25 $508.66
Ultrasound OB (complete) 76811 $825.00 $382.80 $723.75 $335.82
Ultrasound Breast Bilateral (limited) 76642 $848.93 $393.90 $550.00 $255.20
Ultrasound Breast Unilateral (limited) 76642 $594.25 $275.73 $500.00 $232.00
Ultrasound Pelvic Transvaginal OB 76801 & 76817 $1,006.00 $466.78 $838.00 $388.83
Ultrasound Pelvic Transvaginal Non-OB 76830 & 76856 $1,320.50 $612.71 $1,200.00 $556.80
Ultrasound Kidneys (complete) 76770 $990.00 $459.36 $900.00 $417.60
Ultrasound Thyroid 76536 $1,012.00 $469.57 $914.50 $424.33


Imaging/ Radiology - Other Procedures

Pricing of Radiology Procedures: These prices do not include the radiologist’s fee to read the imaging procedure. The radiologist that interprets the images from your exam will bill you separately.

Exam CPT/HCPCS Hospital Full Price Hospital Price after Self-Pay Discount
Bone Scan Limited
     Bone Scan Limited 78300 $2,240.11 $1,039.41
     Isotope * A9503 $210.18 $97.52
Bone Scan Limited 3 Phase
     Bone Scan Limited 3 Phase 78315 $2,240.11 $1,039.41
     Isotope * A9503 $210.18 $97.52
Bone Scan Whole Body
     Bone Scan Whole Body 78306 $2,240.11 $1,039.41
     Isotope * A9503 $210.18 $97.52
Liver Biopsy 47000 $6,890-9,473 $3,196-$4,396
* This is the additional expense for the radiopharmaceutical used with this procedure.