| Abdomen 2 views (74019) |
$61.10 |
$244.40 |
0.6× |
| Ankle 2 views (73600) |
$101.51 |
$406.02 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$89.96 |
$359.84 |
1.1× |
| Chest 1 view (71045) |
$44.72 |
$178.88 |
0.5× |
| Clavicle complete (73000) |
$71.24 |
$284.96 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$384.28 |
$1,537.12 |
1.2× |
| CT abdomen and pelvis without contrast (74176) |
$384.28 |
$1,537.12 |
1.7× |
| CT abdomen w contrast (74160) |
$384.28 |
$1,537.12 |
2.3× |
| CT abdomen w wo contrast (74170) |
$384.28 |
$1,537.12 |
2.3× |
| CT abdomen w/o contrast (74150) |
$384.28 |
$1,537.12 |
3.8× |
| CT c-spine w/o contrast (72125) |
$384.28 |
$1,537.10 |
3.8× |
| CT cervical spine w&w/o contrast (72127) |
$384.28 |
$1,537.12 |
2.3× |
| CT chest w/wo contrast (71270) |
$384.28 |
$1,537.12 |
2.3× |
| CT chest with contrast (71260) |
$384.28 |
$1,537.12 |
2.3× |
| CT head/brain without and with contrast (70470) |
$384.28 |
$1,537.12 |
2.3× |
| CT lower ext w/o (73700) |
$384.28 |
$1,537.12 |
3.8× |
| CT lower extremity w wo contrast (73702) |
$384.28 |
$1,537.12 |
2.3× |
| CT lower extremity with contrast (73701) |
$384.28 |
$1,537.12 |
2.3× |
| CT lumbar spine w & w/o contrast (72133) |
$384.28 |
$1,537.12 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$384.28 |
$1,537.12 |
3.8× |
| CT maxillofacial w contrast (70487) |
$384.28 |
$1,537.12 |
2.3× |
| CT maxillofacial w/o contrast (70486) |
$384.28 |
$1,537.12 |
3.8× |
| CT maxillofacial w/wo contrast (70488) |
$384.28 |
$1,537.12 |
2.3× |
| CT neck soft tissue w contrast (70491) |
$384.28 |
$1,537.12 |
2.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$384.28 |
$1,537.12 |
2.3× |
| CT orbits w/o contrast (70480) |
$384.28 |
$1,537.12 |
3.8× |
| CT pelvis w & w/o contrast (72194) |
$384.28 |
$1,537.12 |
2.3× |
| CT pelvis w/o contrast (72192) |
$384.28 |
$1,537.12 |
3.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$384.28 |
$1,537.12 |
2.3× |
| CT soft tissue neck w/o contrast (70490) |
$384.28 |
$1,537.12 |
3.8× |
| CT thoracic spine w/o contrast (72128) |
$384.28 |
$1,537.12 |
3.8× |
| CT thorax w/o contrast (71250) |
$384.28 |
$1,537.12 |
3.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$384.28 |
$1,537.12 |
2.3× |
| CT upper extremity w/o contrast rt (73200) |
$384.28 |
$1,537.12 |
3.8× |
| CT upper extremity with contrast (73201) |
$384.28 |
$1,537.12 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$384.28 |
$1,537.12 |
2.3× |
| Cta Abdomen (74175) |
$384.28 |
$1,537.12 |
2.3× |
| CTA abdomen pelvis (74174) |
$384.28 |
$1,537.12 |
1.2× |
| CTA chest (71275) |
$384.28 |
$1,537.12 |
2.3× |
| Cta Head (70496) |
$384.28 |
$1,537.12 |
2.3× |
| CTA lwr ext w&w/o contrast (73706) |
$384.28 |
$1,537.12 |
2.3× |
| Cta Neck (70498) |
$384.28 |
$1,537.12 |
2.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$103.74 |
$414.96 |
1.0× |
| Foot 2 views (73620) |
$61.36 |
$245.44 |
0.7× |
| Forearm 2 views (73090) |
$74.10 |
$296.40 |
0.9× |
| Hand 2 views (73120) |
$63.70 |
$254.78 |
0.6× |
| Hand 3 views (73130) |
$70.06 |
$280.25 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$72.28 |
$289.12 |
0.9× |
| Knee 3 views (73562) |
$104.52 |
$418.08 |
1.3× |
| MRA head w/o contrast (70544) |
$583.70 |
$2,334.80 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$583.70 |
$2,334.80 |
1.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$583.70 |
$2,334.80 |
1.7× |
| MRI abdomen w/o contrast (74181) |
$583.70 |
$2,334.80 |
2.6× |
| MRI cervical spine w/o contrast (72141) |
$583.70 |
$2,334.80 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$583.70 |
$2,334.80 |
2.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$583.70 |
$2,334.80 |
2.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$583.70 |
$2,334.80 |
1.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$583.70 |
$2,334.80 |
1.7× |
| MRI pelvis w/o contrast (72195) |
$583.70 |
$2,334.80 |
2.6× |
| MRI scan of arm joint before and after contrast (73223) |
$583.70 |
$2,334.80 |
1.7× |
| MRI scan of leg joint before and after contrast (73723) |
$583.70 |
$2,334.80 |
1.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$583.70 |
$2,334.80 |
1.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$583.70 |
$2,334.80 |
1.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$583.70 |
$2,334.80 |
1.7× |
| MRI thoracic spine w/o contrast (72146) |
$583.70 |
$2,334.80 |
2.6× |
| MRI upper ext joint w/o contrast (73221) |
$583.70 |
$2,334.80 |
2.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$583.70 |
$2,334.80 |
1.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$583.70 |
$2,334.80 |
2.6× |
| Neck soft tissue (70360) |
$43.94 |
$175.76 |
0.5× |
| Pelvis 1 or 2 views (72170) |
$84.76 |
$339.04 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$583.70 |
$2,334.80 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$46.28 |
$185.12 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$54.60 |
$218.40 |
0.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$54.60 |
$218.40 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$101.14 |
$404.56 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$46.54 |
$186.16 |
0.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$45.24 |
$180.96 |
0.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$46.70 |
$186.80 |
0.6× |
| Ribs bilateral 3 views (71110) |
$88.40 |
$353.60 |
0.9× |
| Sacroiliac Joints < 3 Views (72200) |
$85.80 |
$343.20 |
0.9× |
| Scapula complete (73010) |
$77.22 |
$308.88 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$67.08 |
$268.32 |
2.9× |
| Spine thoracic 3 views (72072) |
$92.56 |
$370.24 |
0.9× |
| Thoracolumbar 2 views (72080) |
$76.18 |
$304.72 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$61.62 |
$246.48 |
0.6× |
| Upper Extremity Infant (73092) |
$78.78 |
$315.12 |
0.8× |
| Us abdl aorta screen aaa (76706) |
$54.08 |
$216.32 |
0.5× |
| Us chest (76604) |
$150.54 |
$602.16 |
1.5× |
| Us ob transvaginal (76817) |
$157.04 |
$628.16 |
1.6× |
| Us pelvic non ob complete (76856) |
$169.26 |
$677.04 |
1.7× |
| Us pregnancy ltd (76815) |
$127.14 |
$508.56 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$96.98 |
$387.92 |
1.0× |
| Us retroperitoneal limited (76775) |
$52.26 |
$209.04 |
0.5× |
| Us scrotum and contents (76870) |
$174.72 |
$698.88 |
1.7× |
| Us soft tissue head/neck (76536) |
$174.20 |
$696.80 |
1.7× |
| Us xtr non-vasc lmtd (76882) |
$105.30 |
$421.20 |
1.1× |
| Wrist 2 views (73100) |
$50.70 |
$202.80 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$152.10 |
$608.40 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$103.47 |
$413.88 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$61.36 |
$245.44 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$66.04 |
$264.16 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$47.58 |
$190.32 |
0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$60.06 |
$240.24 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$77.48 |
$309.92 |
0.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$107.60 |
$430.41 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$55.90 |
$223.60 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$93.60 |
$374.40 |
0.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$83.46 |
$333.84 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$103.74 |
$414.96 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$124.80 |
$499.20 |
1.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$83.20 |
$332.80 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$88.66 |
$354.64 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$81.90 |
$327.60 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$90.22 |
$360.88 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$82.16 |
$328.64 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$78.32 |
$313.27 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$98.02 |
$392.08 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$73.32 |
$293.28 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$72.54 |
$290.16 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$60.32 |
$241.28 |
0.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$64.10 |
$256.40 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$59.02 |
$236.08 |
0.7× |
| Xr shoulder 1 view (73020) |
$57.98 |
$231.92 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$95.16 |
$380.64 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$90.31 |
$361.24 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$90.76 |
$363.04 |
1.1× |