| Abdomen 2 views (74019) |
$235.69 |
$314.25 |
2.5× |
| Ankle 2 views (73600) |
$194.81 |
$259.74 |
2.5× |
| Arthrography knee lt (73580) |
$65.36 |
$87.15 |
0.2× |
| Bone age studies (77072) |
$128.56 |
$171.42 |
1.4× |
| Bone survey complete (77075) |
$149.20 |
$198.93 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$110.06 |
$146.74 |
1.4× |
| Chest 1 view (71045) |
$194.81 |
$259.74 |
2.5× |
| Chest 3 views (71047) |
$30.80 |
$41.07 |
0.4× |
| Clavicle complete (73000) |
$194.81 |
$259.74 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$251.60 |
$335.46 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$825.46 |
$1,100.62 |
2.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,275 |
$1,700 |
5.9× |
| CT abdomen w contrast (74160) |
$742.50 |
$990 |
4.7× |
| CT abdomen w wo contrast (74170) |
$450.36 |
$600.48 |
2.8× |
| CT abdomen w/o contrast (74150) |
$742.50 |
$990 |
7.8× |
| CT angiography upper extremity lt (73206) |
$201.80 |
$269.07 |
1.3× |
| CT c-spine w/o contrast (72125) |
$393.85 |
$525.14 |
4.2× |
| CT cervical spine w&w/o contrast (72127) |
$938.25 |
$1,251 |
5.9× |
| CT cervical spine with contrast (72126) |
$755.69 |
$1,007.58 |
2.4× |
| CT chest w/wo contrast (71270) |
$452.66 |
$603.55 |
2.9× |
| CT chest with contrast (71260) |
$742.50 |
$990 |
4.7× |
| CT colonography w/dye (74262) |
$360.74 |
$480.99 |
2.3× |
| CT colonography w/o cntrst (74261) |
$269.60 |
$359.46 |
2.8× |
| CT head/brain with contrast (70460) |
$551.29 |
$735.06 |
3.5× |
| CT head/brain without and with contrast (70470) |
$615.52 |
$820.69 |
3.9× |
| CT iac w contrast (70481) |
$749.25 |
$999 |
4.7× |
| CT lower ext w/o (73700) |
$742.50 |
$990 |
7.8× |
| CT lower extremity w wo contrast (73702) |
$975 |
$1,300 |
6.1× |
| CT lower extremity with contrast (73701) |
$825 |
$1,100 |
5.2× |
| CT lumbar spine w & w/o contrast (72133) |
$577.66 |
$770.21 |
3.6× |
| CT lumbar spine w/o contrast (72131) |
$431.35 |
$575.14 |
4.6× |
| CT lumbar spine with contrast (72132) |
$755.69 |
$1,007.58 |
2.4× |
| CT maxillofacial w contrast (70487) |
$749.25 |
$999 |
4.7× |
| CT maxillofacial w/o contrast (70486) |
$675 |
$900 |
7.1× |
| CT maxillofacial w/wo contrast (70488) |
$788.25 |
$1,051 |
5.0× |
| CT neck soft tissue w contrast (70491) |
$415.14 |
$553.52 |
2.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$502.28 |
$669.71 |
3.2× |
| CT orbits w/o contrast (70480) |
$416.05 |
$554.73 |
4.4× |
| CT pelvis w & w/o contrast (72194) |
$466.15 |
$621.53 |
2.9× |
| CT pelvis w/o contrast (72192) |
$361.08 |
$481.44 |
3.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$140.70 |
$187.60 |
1.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$466.76 |
$622.36 |
2.9× |
| CT soft tissue neck w/o contrast (70490) |
$409.64 |
$546.20 |
4.3× |
| CT thoracic spine w/contrast (72129) |
$612.78 |
$817.03 |
3.9× |
| CT thoracic spine w/o contrast (72128) |
$112.70 |
$150.27 |
1.2× |
| CT thoracic spine w/wo contrast (72130) |
$615.52 |
$820.69 |
3.9× |
| CT thorax w/o contrast (71250) |
$402.49 |
$536.66 |
4.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$518.65 |
$691.53 |
3.3× |
| CT upper extremity w/o contrast rt (73200) |
$742.50 |
$990 |
7.8× |
| CT upper extremity with contrast (73201) |
$1,374.08 |
$1,832.10 |
4.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$842.14 |
$1,122.86 |
5.3× |
| Cta Abdomen (74175) |
$204.05 |
$272.07 |
1.3× |
| CTA abdomen pelvis (74174) |
$246.22 |
$328.29 |
0.8× |
| CTA chest (71275) |
$204.77 |
$273.03 |
1.3× |
| Cta Head (70496) |
$196.94 |
$262.59 |
1.2× |
| CTA lwr ext w&w/o contrast (73706) |
$211.25 |
$281.67 |
1.3× |
| Cta Neck (70498) |
$196.94 |
$262.59 |
1.2× |
| Cta Pelvis (72191) |
$201.80 |
$269.07 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$235.69 |
$314.25 |
2.5× |
| Esophagus (74220) |
$229 |
$305.32 |
1.4× |
| Foot 2 views (73620) |
$194.81 |
$259.74 |
2.5× |
| Forearm 2 views (73090) |
$194.81 |
$259.74 |
2.5× |
| Hand 2 views (73120) |
$235.69 |
$314.25 |
2.5× |
| Hand 3 views (73130) |
$194.81 |
$259.74 |
2.5× |
| Humerus Min 2 Views Left (73060) |
$194.81 |
$259.74 |
2.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,931.21 |
$2,574.95 |
3.9× |
| Knee 3 views (73562) |
$194.81 |
$259.74 |
2.5× |
| MRA head w & w/o contrast (70546) |
$167.58 |
$223.44 |
0.5× |
| MRA head w/o contrast (70544) |
$554.98 |
$739.97 |
2.6× |
| MRA head with contrast (70545) |
$134.96 |
$179.94 |
0.4× |
| MRA neck w contrast (70548) |
$169.20 |
$225.60 |
0.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$203.15 |
$270.87 |
0.6× |
| MRA neck w/o contrast (70547) |
$135.68 |
$180.90 |
0.6× |
| MRI abdomen w contrast (74182) |
$623.04 |
$830.72 |
2.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$723.18 |
$964.24 |
2.3× |
| MRI abdomen w/o contrast (74181) |
$607.62 |
$810.16 |
2.8× |
| MRI any jnt lwr ext with con lt (73722) |
$692.12 |
$922.84 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$688.38 |
$917.84 |
1.0× |
| MRI bone marrow blood supply (77084) |
$180.88 |
$241.17 |
0.8× |
| MRI c-spine with contrast (72142) |
$757.38 |
$1,009.84 |
2.4× |
| MRI cervical spine w/o contrast (72141) |
$608.79 |
$811.72 |
2.8× |
| MRI chest w/o & w/contrast material (71552) |
$688.83 |
$918.44 |
2.2× |
| MRI chest w/o contrast (71550) |
$607.62 |
$810.16 |
2.8× |
| MRI chest with contrast (71551) |
$656.05 |
$874.74 |
0.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$688.38 |
$917.84 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$691.76 |
$922.36 |
2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,117.50 |
$1,490 |
5.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,050 |
$1,400 |
4.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,144.12 |
$1,525.50 |
3.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,050 |
$1,400 |
3.3× |
| MRI pelvis w contrast (72196) |
$656.41 |
$875.22 |
2.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$779.43 |
$1,039.24 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$570.12 |
$760.16 |
2.6× |
| MRI scan of arm joint before and after contrast (73223) |
$757.92 |
$1,010.56 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$795.42 |
$1,060.56 |
2.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$785.53 |
$1,047.37 |
2.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$738.28 |
$984.38 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$804.28 |
$1,072.37 |
2.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$832.03 |
$1,109.38 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,066.40 |
$1,421.87 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$702.92 |
$937.22 |
3.3× |
| MRI tmj (70336) |
$166.86 |
$222.48 |
0.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,233.75 |
$1,645 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$757.92 |
$1,010.56 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$634.81 |
$846.42 |
2.9× |
| Neck soft tissue (70360) |
$107.72 |
$143.62 |
1.4× |
| Osseous survey infant (77076) |
$78.46 |
$104.61 |
0.8× |
| Osseous survey limited (77074) |
$49.91 |
$66.54 |
0.5× |
| Pelvis 1 or 2 views (72170) |
$127.76 |
$170.34 |
1.3× |
| Peritoneogram rs&i (74190) |
$52.74 |
$70.32 |
0.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,251 |
$1,668 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$29.99 |
$39.99 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$36.50 |
$48.66 |
0.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$130.50 |
$174 |
1.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$137.31 |
$183.08 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$46.76 |
$62.34 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$132.08 |
$176.10 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$194.81 |
$259.74 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$30.08 |
$40.11 |
0.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$194.81 |
$259.74 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$194.81 |
$259.74 |
2.5× |
| Ribs bilateral 3 views (71110) |
$134.40 |
$179.20 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$127.76 |
$170.34 |
1.3× |
| Scanogram (77073) |
$133.35 |
$177.80 |
1.4× |
| Scapula complete (73010) |
$235.69 |
$314.25 |
2.5× |
| Sella turcica (70240) |
$108.48 |
$144.64 |
1.4× |
| Small bowel series (74250) |
$393.89 |
$525.18 |
2.5× |
| Spine thoracic 3 views (72072) |
$130.90 |
$174.54 |
1.4× |
| Thoracolumbar 2 views (72080) |
$109.66 |
$146.20 |
1.4× |
| Tmj unilateral (70328) |
$194.81 |
$259.74 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$392.81 |
$523.75 |
4.1× |
| Upper Extremity Infant (73092) |
$235.69 |
$314.25 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$224.28 |
$299.04 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$227.40 |
$303.20 |
2.4× |
| Us breast unilateral complete (76641) |
$392.81 |
$523.75 |
4.1× |
| Us breast unilateral limited (76642) |
$324.68 |
$432.90 |
4.1× |
| Us chest (76604) |
$392.81 |
$523.75 |
4.1× |
| Us compl joint r-t w/image documentation (76881) |
$286.16 |
$381.55 |
3.0× |
| Us infant hips dynamic (76885) |
$83.14 |
$110.85 |
1.1× |
| Us infant hips limited static (76886) |
$69.82 |
$93.09 |
0.9× |
| Us kidney transplant (76776) |
$86.78 |
$115.71 |
0.9× |
| Us ob transvaginal (76817) |
$238.38 |
$317.84 |
2.5× |
| Us pelvic non ob complete (76856) |
$234.87 |
$313.16 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$224.15 |
$298.86 |
2.4× |
| Us retroperitoneal complete (76770) |
$237.62 |
$316.82 |
2.5× |
| Us retroperitoneal limited (76775) |
$228.98 |
$305.30 |
2.4× |
| Us scrotum and contents (76870) |
$232.12 |
$309.50 |
2.5× |
| Us soft tissue head/neck (76536) |
$228.16 |
$304.22 |
2.4× |
| Us spinal canal and contents (76800) |
$133.54 |
$178.05 |
1.4× |
| Us transrectal (76872) |
$75.20 |
$100.26 |
0.8× |
| Us transrectal prostate volume (76873) |
$175.21 |
$233.61 |
1.9× |
| Us xtr non-vasc lmtd (76882) |
$392.81 |
$523.75 |
4.1× |
| Wrist 2 views (73100) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$135.63 |
$180.84 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$108.08 |
$144.10 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$194.81 |
$259.74 |
2.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$138.42 |
$184.56 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$108.08 |
$144.10 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$194.81 |
$259.74 |
2.5× |
| X-ray exam hip uni 4/> views (73503) |
$30.80 |
$41.07 |
0.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$33.12 |
$44.16 |
0.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$35.44 |
$47.25 |
0.4× |
| X-ray exam of femur 1 (73551) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$132.84 |
$177.12 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$108.84 |
$145.11 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$107.72 |
$143.62 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$235.69 |
$314.25 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$107.26 |
$143.01 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$130.50 |
$174 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$134.82 |
$179.76 |
1.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$25.31 |
$33.75 |
0.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$107.32 |
$143.08 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$20.63 |
$27.51 |
0.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$133.65 |
$178.20 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$132.08 |
$176.10 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$132.88 |
$177.18 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$135.98 |
$181.30 |
1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$26.10 |
$34.80 |
0.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$107.32 |
$143.08 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$194.81 |
$259.74 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$110.06 |
$146.74 |
1.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$107.32 |
$143.08 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$134 |
$178.66 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$235.69 |
$314.25 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$106.55 |
$142.06 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$110.06 |
$146.74 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$108.79 |
$145.05 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$129.33 |
$172.44 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$131.72 |
$175.62 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$104.98 |
$139.96 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$194.81 |
$259.74 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$134.82 |
$179.76 |
1.4× |
| Xr chest 4+ views (71048) |
$135.94 |
$181.24 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$194.81 |
$259.74 |
2.5× |
| Xr internal auditory meati complete (70134) |
$39.33 |
$52.44 |
0.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$128.16 |
$170.88 |
1.4× |
| Xr optic foramina (70190) |
$194.81 |
$259.74 |
2.5× |
| Xr shoulder 1 view (73020) |
$194.81 |
$259.74 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$133.24 |
$177.66 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$194.81 |
$259.74 |
2.5× |
| Xr tmj bilateral (70330) |
$111.23 |
$148.30 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$194.81 |
$259.74 |
2.5× |