| Abdomen 1 View (74018) |
$234 |
$234 |
2.7× |
| Abdomen 2 views (74019) |
$318 |
$318 |
3.0× |
| Chest 1 view (71045) |
$234 |
$234 |
2.7× |
| Chest 2 views (71046) |
$234 |
$234 |
2.7× |
| Clavicle complete (73000) |
$234 |
$234 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,077 |
$1,077 |
3.1× |
| CT abdomen and pelvis without contrast (74176) |
$672 |
$672 |
2.8× |
| CT abdomen w contrast (74160) |
$522 |
$522 |
3.0× |
| CT abdomen w wo contrast (74170) |
$522 |
$522 |
3.0× |
| CT abdomen w/o contrast (74150) |
$318 |
$318 |
3.0× |
| CT Angio Abdomen and Pelvis (74174) |
$1,077 |
$1,077 |
3.1× |
| CT Angio Chest (71275) |
$522 |
$522 |
3.0× |
| CT Angio Head (70496) |
$522 |
$522 |
3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$789 |
$789 |
4.5× |
| CT Angio Neck (70498) |
$522 |
$522 |
3.0× |
| CT cervical spine w/ contrast (72126) |
$1,077 |
$1,077 |
3.1× |
| CT cervical spine w/o contrast (72125) |
$318 |
$318 |
3.0× |
| CT cervical spine w/wo cont (72127) |
$522 |
$522 |
3.0× |
| CT chest w contrast (71260) |
$522 |
$522 |
3.0× |
| CT chest w/wo contrast (71270) |
$522 |
$522 |
3.0× |
| CT head/brain with contrast (70460) |
$519 |
$519 |
2.9× |
| CT head/brain without and with contrast (70470) |
$522 |
$522 |
3.0× |
| CT iac w contrast (70481) |
$522 |
$522 |
3.0× |
| CT l-spine w&w/o contrast (72133) |
$522 |
$522 |
3.0× |
| CT lower ext w/o (73700) |
$318 |
$318 |
3.0× |
| CT lower extremity w/contrast material (73701) |
$522 |
$522 |
3.0× |
| CT lumbar spine w contrast (72132) |
$1,077 |
$1,077 |
3.1× |
| CT lumbar spine w/o contrast (72131) |
$318 |
$318 |
3.0× |
| CT maxillofacial wo contrast (70486) |
$318 |
$318 |
3.0× |
| CT neck tissue combo (70492) |
$522 |
$522 |
3.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$522 |
$522 |
3.0× |
| CT orbits w/o contrast (70480) |
$318 |
$318 |
3.0× |
| CT pelvis w&w/o contrast (72194) |
$522 |
$522 |
3.0× |
| CT pelvis w/o contrast (72192) |
$318 |
$318 |
3.0× |
| CT scan of leg combo (73702) |
$522 |
$522 |
3.0× |
| CT scans face/jaw combo (70488) |
$575 |
$575 |
3.3× |
| CT soft tissue neck w contrast (70491) |
$522 |
$522 |
3.0× |
| CT soft tissue neck w/o contrast (70490) |
$318 |
$318 |
3.0× |
| CT thoracic spine w contrast (72129) |
$522 |
$522 |
3.0× |
| CT thoracic spine w/o contrast (72128) |
$318 |
$318 |
3.0× |
| CT thoracic spine w/wo cont (72130) |
$522 |
$522 |
3.0× |
| CT thorax w/o contrast (71250) |
$318 |
$318 |
3.0× |
| CT upper ext wo (73200) |
$318 |
$318 |
3.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$522 |
$522 |
3.0× |
| CT upper extremity with contrast (73201) |
$1,077 |
$1,077 |
3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$522 |
$522 |
3.0× |
| Cta Abdomen (74175) |
$522 |
$522 |
3.0× |
| Esophagram (74220) |
$522 |
$522 |
3.0× |
| Foot 2 views (73620) |
$234 |
$234 |
2.7× |
| Forearm 2 views (73090) |
$234 |
$234 |
2.7× |
| Hand 2 views (73120) |
$318 |
$318 |
3.0× |
| Knee 3 Views (73562) |
$237 |
$237 |
2.7× |
| Neck soft tissue (70360) |
$234 |
$234 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$318 |
$318 |
3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$318 |
$318 |
3.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$237 |
$237 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$234 |
$234 |
2.7× |
| Radex elbow complete minimum 3 views (73080) |
$234 |
$234 |
2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$318 |
$318 |
3.0× |
| Radex fingr minimum 2 views (73140) |
$237 |
$237 |
2.7× |
| Radex foot complete minimum 3 views (73630) |
$237 |
$237 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$237 |
$237 |
2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$318 |
$318 |
3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$237 |
$237 |
2.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$237 |
$237 |
2.7× |
| Radex shoulder complete minimum 2 views (73030) |
$237 |
$237 |
2.7× |
| Radex Sternum Minimum 2 Views (71120) |
$234 |
$234 |
2.7× |
| Radex Toe Minimum 2 Views (73660) |
$234 |
$234 |
2.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$234 |
$234 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$293 |
$293 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$318 |
$318 |
3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$318 |
$318 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$234 |
$234 |
2.7× |
| Radiologic examination knee 1/2 views (73560) |
$237 |
$237 |
2.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$234 |
$234 |
2.7× |
| Scapula (73010) |
$318 |
$318 |
3.0× |
| Sella turcica (70240) |
$234 |
$234 |
2.7× |
| Shoulder 1 view (73020) |
$234 |
$234 |
2.7× |
| Skull less than 4 views (70250) |
$318 |
$318 |
3.0× |
| Thoracic spine 2 views (72070) |
$318 |
$318 |
3.0× |
| Thoracic spine 3 views (72072) |
$318 |
$318 |
3.0× |
| Wrist 2 views (73100) |
$237 |
$237 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$234 |
$234 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$234 |
$234 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$318 |
$318 |
3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$234 |
$234 |
2.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$234 |
$234 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$234 |
$234 |
2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$318 |
$318 |
3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$258 |
$258 |
3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$318 |
$318 |
3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$318 |
$318 |
3.0× |
| X-ray eye for foreign body (70030) |
$234 |
$234 |
2.7× |
| X-ray humerus (73060) |
$234 |
$234 |
2.7× |
| X-ray IV pyelogram (ivp) (74400) |
$522 |
$522 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$237 |
$237 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$318 |
$318 |
3.0× |
| X-ray nose-rectum child f.b. (76010) |
$234 |
$234 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$315 |
$315 |
3.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$318 |
$318 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$234 |
$234 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$237 |
$237 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$318 |
$318 |
3.0× |
| X-Ray Tmj Unilat (70328) |
$237 |
$237 |
2.7× |
| X-Rays Bone Survey Complete (77075) |
$318 |
$318 |
3.0× |
| Xr c-spine 4 or 5 views (72050) |
$318 |
$318 |
3.0× |
| Xr facial bones less than 3 views (70140) |
$234 |
$234 |
2.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$318 |
$318 |
3.0× |
| Xr orbits complete 4 views (70200) |
$318 |
$318 |
3.0× |