| Abdomen 2 views (74019) |
$55.90 |
$223.60 |
0.6× |
| Ankle 2 views (73600) |
$78.31 |
$313.25 |
1.0× |
| Bone age studies (77072) |
$49.66 |
$198.64 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$71.24 |
$284.96 |
0.9× |
| Chest 1 view (71045) |
$29.38 |
$117.52 |
0.4× |
| Chest 3 views (71047) |
$40.04 |
$160.16 |
0.5× |
| Clavicle complete (73000) |
$45.13 |
$180.51 |
0.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$689.78 |
$2,759.12 |
2.2× |
| CT abdomen and pelvis without contrast (74176) |
$652.07 |
$2,608.26 |
3.0× |
| CT abdomen w contrast (74160) |
$571.22 |
$2,284.88 |
3.6× |
| CT abdomen w wo contrast (74170) |
$693.42 |
$2,773.68 |
4.3× |
| CT abdomen w/o contrast (74150) |
$490.36 |
$1,961.44 |
5.2× |
| CT c-spine w/o contrast (72125) |
$505.69 |
$2,022.76 |
5.3× |
| CT chest w/wo contrast (71270) |
$778.44 |
$3,113.76 |
4.9× |
| CT chest with contrast (71260) |
$555.36 |
$2,221.44 |
3.5× |
| CT head/brain with contrast (70460) |
$495.82 |
$1,983.28 |
3.1× |
| CT head/brain without and with contrast (70470) |
$548.34 |
$2,193.36 |
3.4× |
| CT iac w contrast (70481) |
$691.34 |
$2,765.36 |
4.3× |
| CT lower ext w/o (73700) |
$319.02 |
$1,276.08 |
3.4× |
| CT lower extremity with contrast (73701) |
$380.12 |
$1,520.48 |
2.4× |
| CT lumbar spine w & w/o contrast (72133) |
$384.28 |
$1,537.12 |
2.4× |
| CT lumbar spine w/o contrast (72131) |
$505.70 |
$2,022.80 |
5.3× |
| CT maxillofacial w contrast (70487) |
$516.10 |
$2,064.40 |
3.2× |
| CT maxillofacial w/o contrast (70486) |
$443.56 |
$1,774.24 |
4.7× |
| CT maxillofacial w/wo contrast (70488) |
$894.66 |
$3,578.64 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$495.82 |
$1,983.28 |
3.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$829.14 |
$3,316.56 |
5.2× |
| CT orbits w/o contrast (70480) |
$817.70 |
$3,270.80 |
8.6× |
| CT pelvis w & w/o contrast (72194) |
$715 |
$2,860 |
4.5× |
| CT pelvis w/o contrast (72192) |
$650 |
$2,600 |
6.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$548.34 |
$2,193.36 |
3.4× |
| CT soft tissue neck w/o contrast (70490) |
$443.56 |
$1,774.24 |
4.7× |
| CT thoracic spine w/o contrast (72128) |
$585 |
$2,340 |
6.1× |
| CT thorax w/o contrast (71250) |
$481.25 |
$1,924.99 |
5.1× |
| CT upper extremity w/o contrast rt (73200) |
$353.86 |
$1,415.44 |
3.7× |
| CT upper extremity with contrast (73201) |
$426.40 |
$1,705.60 |
1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$390 |
$1,560 |
2.4× |
| Cta Abdomen (74175) |
$444.86 |
$1,779.44 |
2.8× |
| CTA abdomen pelvis (74174) |
$598.52 |
$2,394.08 |
1.9× |
| CTA chest (71275) |
$582.40 |
$2,329.60 |
3.6× |
| Cta Head (70496) |
$518.96 |
$2,075.84 |
3.2× |
| CTA lwr ext w&w/o contrast (73706) |
$652.86 |
$2,611.44 |
4.1× |
| Cta Neck (70498) |
$518.96 |
$2,075.84 |
3.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$97.50 |
$390 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$96.46 |
$385.84 |
1.0× |
| Foot 2 views (73620) |
$48 |
$191.99 |
0.6× |
| Forearm 2 views (73090) |
$64.22 |
$256.88 |
0.8× |
| Hand 2 views (73120) |
$58.55 |
$234.18 |
0.6× |
| Hand 3 views (73130) |
$58.20 |
$232.78 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$60.06 |
$240.24 |
0.8× |
| Knee 3 views (73562) |
$87.74 |
$350.96 |
1.1× |
| MRA head w & w/o contrast (70546) |
$842.92 |
$3,371.68 |
2.7× |
| MRA head w/o contrast (70544) |
$604.50 |
$2,418 |
2.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$842.92 |
$3,371.68 |
2.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$832.78 |
$3,331.12 |
2.6× |
| MRI abdomen w/o contrast (74181) |
$724.88 |
$2,899.52 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$645.06 |
$2,580.24 |
3.0× |
| MRI chest w/o contrast (71550) |
$347.49 |
$1,389.96 |
1.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$624 |
$2,496 |
2.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$588.12 |
$2,352.48 |
2.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$842.92 |
$3,371.68 |
2.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$832.78 |
$3,331.12 |
2.6× |
| MRI pelvis w/o contrast (72195) |
$565.24 |
$2,260.96 |
2.6× |
| MRI scan of arm joint before and after contrast (73223) |
$706.28 |
$2,825.10 |
2.2× |
| MRI scan of leg joint before and after contrast (73723) |
$859.30 |
$3,437.20 |
2.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$864.76 |
$3,459.04 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$864.76 |
$3,459.04 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$759.98 |
$3,039.92 |
2.4× |
| MRI thoracic spine w/o contrast (72146) |
$645.06 |
$2,580.24 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$530.40 |
$2,121.60 |
2.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$818.22 |
$3,272.88 |
2.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$728.78 |
$2,915.12 |
3.4× |
| Neck soft tissue (70360) |
$41.34 |
$165.36 |
0.5× |
| Osseous survey infant (77076) |
$73.84 |
$295.36 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$58.76 |
$235.04 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$655.20 |
$2,620.80 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$52.78 |
$211.12 |
0.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$52.78 |
$211.12 |
0.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$78 |
$312 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$86.58 |
$346.32 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$29.38 |
$117.52 |
0.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$36.14 |
$144.56 |
0.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$32.60 |
$130.41 |
0.4× |
| Ribs bilateral 3 views (71110) |
$102.44 |
$409.76 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$86.06 |
$344.24 |
0.9× |
| Scapula complete (73010) |
$62.40 |
$249.60 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$29.38 |
$117.52 |
1.3× |
| Thoracolumbar 2 views (72080) |
$101.92 |
$407.68 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$152.36 |
$609.44 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$54.34 |
$217.36 |
0.6× |
| Us chest (76604) |
$114.92 |
$459.68 |
1.2× |
| Us ob transvaginal (76817) |
$137.02 |
$548.08 |
1.4× |
| Us pelvic non ob complete (76856) |
$158.08 |
$632.32 |
1.7× |
| Us pregnancy ltd (76815) |
$118.04 |
$472.16 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$93.60 |
$374.40 |
1.0× |
| Us retroperitoneal limited (76775) |
$147.68 |
$590.72 |
1.6× |
| Us scrotum and contents (76870) |
$150.80 |
$603.20 |
1.6× |
| Us soft tissue head/neck (76536) |
$143 |
$572 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$161.98 |
$647.92 |
1.7× |
| Wrist 2 views (73100) |
$48.88 |
$195.52 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$116.48 |
$465.92 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$72.02 |
$288.08 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$91.78 |
$367.12 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$53.30 |
$213.20 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$60.32 |
$241.28 |
0.8× |
| X-ray exam hip uni 1 view (73501) |
$31.98 |
$127.92 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$42.12 |
$168.48 |
0.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$59.02 |
$236.08 |
0.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$100.62 |
$402.48 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$69.42 |
$277.68 |
0.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$75.14 |
$300.56 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$91.48 |
$365.90 |
1.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$43.68 |
$174.72 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$105.82 |
$423.28 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$82.16 |
$328.64 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$90.74 |
$362.96 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$133.90 |
$535.60 |
1.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$75.14 |
$300.56 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$69.42 |
$277.68 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$100.62 |
$402.48 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$88.92 |
$355.68 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$63.44 |
$253.76 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$68.38 |
$273.52 |
0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$74.62 |
$298.48 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$41.34 |
$165.36 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$49.35 |
$197.40 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$69.42 |
$277.68 |
0.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$58.24 |
$232.96 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$116.74 |
$466.96 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$81.12 |
$324.48 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$41.34 |
$165.36 |
0.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$63.44 |
$253.76 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$65.52 |
$262.08 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$45.76 |
$183.04 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$56.57 |
$226.27 |
0.7× |
| Xr c-spine 6 or more views (72052) |
$131.30 |
$525.20 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$52.52 |
$210.08 |
0.7× |
| Xr shoulder 1 view (73020) |
$41.34 |
$165.36 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$78.52 |
$314.08 |
0.8× |
| Xr tibia/fibula 2 views (73590) |
$81.70 |
$326.81 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$73.20 |
$292.80 |
0.9× |