| Abdomen 2 views (74019) |
$388.80 |
$648 |
4.0× |
| Ankle 2 views (73600) |
$265.80 |
$443 |
3.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,056.60 |
$1,761 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,265.40 |
$2,109 |
3.4× |
| Bone age studies (77072) |
$247.80 |
$413 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,170 |
$1,950 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$280.20 |
$467 |
3.4× |
| Chest 1 view (71045) |
$213.60 |
$356 |
2.6× |
| Clavicle complete (73000) |
$247.80 |
$413 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,773 |
$2,955 |
18.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,270.40 |
$8,784 |
16.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,231 |
$5,385 |
14.4× |
| CT abdomen w contrast (74160) |
$1,892.40 |
$3,154 |
11.5× |
| CT abdomen w wo contrast (74170) |
$2,256.60 |
$3,761 |
13.7× |
| CT abdomen w/o contrast (74150) |
$1,533 |
$2,555 |
15.6× |
| CT angiography upper extremity lt (73206) |
$2,098.20 |
$3,497 |
12.7× |
| CT c-spine w/o contrast (72125) |
$2,537.40 |
$4,229 |
25.9× |
| CT chest w/wo contrast (71270) |
$2,899.80 |
$4,833 |
17.6× |
| CT chest with contrast (71260) |
$2,422.80 |
$4,038 |
14.7× |
| CT head/brain with contrast (70460) |
$1,577.40 |
$2,629 |
9.6× |
| CT head/brain without and with contrast (70470) |
$2,240.40 |
$3,734 |
13.6× |
| CT iac w contrast (70481) |
$2,067.60 |
$3,446 |
12.6× |
| CT lower ext w/o (73700) |
$1,587.60 |
$2,646 |
16.2× |
| CT lower extremity with contrast (73701) |
$2,067.60 |
$3,446 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$2,088.60 |
$3,481 |
21.3× |
| CT maxillofacial w contrast (70487) |
$1,999.80 |
$3,333 |
12.2× |
| CT maxillofacial w/o contrast (70486) |
$1,587.60 |
$2,646 |
16.2× |
| CT neck soft tissue w contrast (70491) |
$2,067.60 |
$3,446 |
12.6× |
| CT orbits w/o contrast (70480) |
$1,636.20 |
$2,727 |
16.7× |
| CT pelvis w & w/o contrast (72194) |
$2,918.40 |
$4,864 |
17.7× |
| CT pelvis w/o contrast (72192) |
$1,700.40 |
$2,834 |
17.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,346.60 |
$3,911 |
14.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,636.20 |
$2,727 |
16.7× |
| CT thoracic spine w/o contrast (72128) |
$2,247 |
$3,745 |
22.9× |
| CT thorax w/o contrast (71250) |
$1,773 |
$2,955 |
18.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,636.20 |
$2,727 |
16.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,219.40 |
$3,699 |
13.5× |
| Cta Abdomen (74175) |
$2,098.20 |
$3,497 |
12.7× |
| CTA abdomen pelvis (74174) |
$4,195.20 |
$6,992 |
12.8× |
| CTA chest (71275) |
$2,693.40 |
$4,489 |
16.4× |
| Cta Head (70496) |
$2,098.20 |
$3,497 |
12.7× |
| CTA lwr ext w&w/o contrast (73706) |
$2,098.20 |
$3,497 |
12.7× |
| Cta Neck (70498) |
$2,098.20 |
$3,497 |
12.7× |
| Cta Pelvis (72191) |
$2,098.20 |
$3,497 |
12.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$579.60 |
$966 |
5.9× |
| Dxa bone density study axial skeleton (77085) |
$279.60 |
$466 |
2.9× |
| Foot 2 views (73620) |
$231.60 |
$386 |
2.8× |
| Forearm 2 views (73090) |
$285.60 |
$476 |
3.5× |
| Hand 2 views (73120) |
$465.60 |
$776 |
4.7× |
| Hand 3 views (73130) |
$300.60 |
$501 |
3.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,268.40 |
$2,114 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$664.20 |
$1,107 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$294 |
$490 |
3.6× |
| Knee 3 views (73562) |
$264.60 |
$441 |
3.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,328.40 |
$2,214 |
3.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$188.40 |
$314 |
2.3× |
| MRA head w/o contrast (70544) |
$2,646.60 |
$4,411 |
11.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,667 |
$4,445 |
8.1× |
| MRI abdomen w/o contrast (74181) |
$2,166.60 |
$3,611 |
9.7× |
| MRI cervical spine w/o contrast (72141) |
$3,052.20 |
$5,087 |
13.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,052.20 |
$5,087 |
13.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,205.20 |
$5,342 |
9.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,754.80 |
$6,258 |
11.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,010.20 |
$5,017 |
13.4× |
| MRI upper ext joint w/o contrast (73221) |
$3,205.20 |
$5,342 |
14.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,306.40 |
$3,844 |
10.3× |
| Neck soft tissue (70360) |
$265.80 |
$443 |
3.3× |
| Nm gastric emptying study (78264) |
$1,290 |
$2,150 |
3.4× |
| Osseous survey infant (77076) |
$339 |
$565 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$294 |
$490 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,406.40 |
$2,344 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$478.20 |
$797 |
4.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$573.90 |
$956.50 |
5.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$668.40 |
$1,114 |
6.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$477.60 |
$796 |
4.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$294 |
$490 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$397.80 |
$663 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$251.40 |
$419 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$294 |
$490 |
3.6× |
| Ribs bilateral 3 views (71110) |
$581.40 |
$969 |
5.9× |
| Sacroiliac Joints < 3 Views (72200) |
$161.40 |
$269 |
1.6× |
| Scapula complete (73010) |
$247.80 |
$413 |
2.5× |
| Spine thoracic 3 views (72072) |
$449.40 |
$749 |
4.6× |
| Thoracolumbar 2 views (72080) |
$315 |
$525 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$574.80 |
$958 |
5.9× |
| Us abdl aorta screen aaa (76706) |
$405 |
$675 |
4.1× |
| Us breast unilateral complete (76641) |
$462.60 |
$771 |
4.7× |
| Us breast unilateral limited (76642) |
$231.60 |
$386 |
2.8× |
| Us chest (76604) |
$857.40 |
$1,429 |
8.7× |
| Us kidney transplant (76776) |
$289.20 |
$482 |
2.9× |
| Us ob transvaginal (76817) |
$809.40 |
$1,349 |
8.3× |
| Us pelvic non ob complete (76856) |
$918.60 |
$1,531 |
9.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$574.80 |
$958 |
5.9× |
| Us pregnancy ltd (76815) |
$643.20 |
$1,072 |
6.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$809.40 |
$1,349 |
8.3× |
| Us retroperitoneal limited (76775) |
$429 |
$715 |
4.4× |
| Us scrotum and contents (76870) |
$907.20 |
$1,512 |
9.2× |
| Us soft tissue head/neck (76536) |
$723.60 |
$1,206 |
7.4× |
| Us xtr non-vasc lmtd (76882) |
$149.40 |
$249 |
1.5× |
| Wrist 2 views (73100) |
$285.60 |
$476 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$684.60 |
$1,141 |
7.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$325.80 |
$543 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$317.40 |
$529 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$252.60 |
$421 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$333 |
$555 |
4.1× |
| X-ray exam hip uni 1 view (73501) |
$243.60 |
$406 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$247.80 |
$413 |
3.0× |
| X-ray exam hip uni 4/> views (73503) |
$255.60 |
$426 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$571.80 |
$953 |
5.8× |
| X-ray exam of femur 1 (73551) |
$280.20 |
$467 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$432.60 |
$721 |
4.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$259.80 |
$433 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$301.20 |
$502 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$427.80 |
$713 |
5.2× |
| X-ray IV pyelogram+drip infusn (74410) |
$924 |
$1,540 |
5.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$230.40 |
$384 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$364.80 |
$608 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$239.40 |
$399 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$180.60 |
$301 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$348 |
$580 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$648 |
$1,080 |
6.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$294 |
$490 |
3.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$495 |
$825 |
5.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$304.20 |
$507 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$383.40 |
$639 |
4.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$468.60 |
$781 |
4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$664.20 |
$1,107 |
6.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$364.80 |
$608 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$280.20 |
$467 |
3.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$247.80 |
$413 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$477 |
$795 |
5.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$477.60 |
$796 |
4.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$259.80 |
$433 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$247.80 |
$413 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$247.80 |
$413 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$315 |
$525 |
3.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$444 |
$740 |
4.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$189 |
$315 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$331.20 |
$552 |
4.1× |
| Xr c-spine 6 or more views (72052) |
$492 |
$820 |
5.0× |
| Xr chest 4+ views (71048) |
$251.40 |
$419 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$238.20 |
$397 |
2.9× |
| Xr shoulder 1 view (73020) |
$216.60 |
$361 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$367.20 |
$612 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$252.60 |
$421 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$238.20 |
$397 |
2.9× |