| Abdomen 2 views (74019) |
$499 |
$499 |
4.8× |
| Ankle 2 views (73600) |
$330 |
$330 |
3.8× |
| Bone age studies (77072) |
$519 |
$519 |
4.9× |
| Cervical spine 2 or 3 views (72040) |
$457 |
$457 |
5.2× |
| Chest 1 view (71045) |
$375 |
$375 |
4.3× |
| Clavicle complete (73000) |
$390 |
$390 |
4.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$313 |
$313 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,433 |
$5,433 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,982 |
$3,982 |
16.6× |
| CT abdomen w contrast (74160) |
$2,935 |
$2,935 |
16.7× |
| CT abdomen w wo contrast (74170) |
$3,374 |
$3,374 |
19.1× |
| CT abdomen w/o contrast (74150) |
$2,431 |
$2,431 |
23.1× |
| CT angiography upper extremity lt (73206) |
$1,746 |
$1,746 |
9.9× |
| CT c-spine w/o contrast (72125) |
$2,823 |
$2,823 |
26.9× |
| CT chest w/wo contrast (71270) |
$3,093 |
$3,093 |
17.6× |
| CT chest with contrast (71260) |
$2,732 |
$2,732 |
15.5× |
| CT head/brain with contrast (70460) |
$2,336 |
$2,336 |
13.3× |
| CT head/brain without and with contrast (70470) |
$2,949 |
$2,949 |
16.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$415 |
$415 |
4.7× |
| CT lower ext w/o (73700) |
$2,008 |
$2,008 |
19.1× |
| CT lower extremity with contrast (73701) |
$2,111 |
$2,111 |
12.0× |
| CT lumbar spine w & w/o contrast (72133) |
$2,430 |
$2,430 |
13.8× |
| CT lumbar spine w/o contrast (72131) |
$2,478 |
$2,478 |
23.6× |
| CT lumbar spine with contrast (72132) |
$2,665 |
$2,665 |
7.6× |
| CT maxillofacial w contrast (70487) |
$2,335 |
$2,335 |
13.3× |
| CT maxillofacial w/o contrast (70486) |
$2,166 |
$2,166 |
20.6× |
| CT neck soft tissue w contrast (70491) |
$2,458 |
$2,458 |
14.0× |
| CT orbits w/o contrast (70480) |
$1,798 |
$1,798 |
17.1× |
| CT pelvis w & w/o contrast (72194) |
$2,665 |
$2,665 |
15.1× |
| CT pelvis w/o contrast (72192) |
$2,269 |
$2,269 |
21.6× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$313 |
$313 |
3.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,589 |
$2,589 |
14.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,170 |
$2,170 |
20.7× |
| CT thoracic spine w/o contrast (72128) |
$2,545 |
$2,545 |
24.2× |
| CT thorax w/o contrast (71250) |
$2,321 |
$2,321 |
22.1× |
| CT upper extremity w/o contrast rt (73200) |
$2,131 |
$2,131 |
20.3× |
| CT upper extremity with contrast (73201) |
$2,422 |
$2,422 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,491 |
$3,491 |
19.8× |
| Cta Abdomen (74175) |
$3,982 |
$3,982 |
22.6× |
| CTA chest (71275) |
$2,978 |
$2,978 |
16.9× |
| Cta Head (70496) |
$2,773 |
$2,773 |
15.7× |
| Cta Neck (70498) |
$2,875 |
$2,875 |
16.3× |
| Cystography minimum 3 views rs&i (74430) |
$943 |
$943 |
2.7× |
| Fetal biophysical profile non-stress testing (76818) |
$685 |
$685 |
6.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$487 |
$487 |
4.6× |
| Foot 2 views (73620) |
$323 |
$323 |
3.7× |
| Forearm 2 views (73090) |
$387 |
$387 |
4.4× |
| Hand 2 views (73120) |
$323 |
$323 |
3.1× |
| Hand 3 views (73130) |
$398 |
$398 |
4.6× |
| Humerus Min 2 Views Left (73060) |
$381 |
$381 |
4.4× |
| Knee 3 views (73562) |
$400 |
$400 |
4.6× |
| MRA head w/o contrast (70544) |
$2,859 |
$2,859 |
11.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,601 |
$3,601 |
10.3× |
| MRA neck w/o contrast (70547) |
$2,804 |
$2,804 |
11.7× |
| MRI abdomen w contrast (74182) |
$3,485 |
$3,485 |
9.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,655 |
$4,655 |
13.3× |
| MRI abdomen w/o contrast (74181) |
$3,310 |
$3,310 |
13.8× |
| MRI any jnt lwr ext with con lt (73722) |
$3,392 |
$3,392 |
4.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,644 |
$3,644 |
4.6× |
| MRI c-spine with contrast (72142) |
$4,236 |
$4,236 |
12.1× |
| MRI cervical spine w/o contrast (72141) |
$3,545 |
$3,545 |
14.8× |
| MRI chest w/o & w/contrast material (71552) |
$3,945 |
$3,945 |
11.3× |
| MRI chest w/o contrast (71550) |
$3,128 |
$3,128 |
13.1× |
| MRI chest with contrast (71551) |
$2,988 |
$2,988 |
3.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,563 |
$2,563 |
7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,059 |
$3,059 |
8.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,200 |
$3,200 |
13.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,452 |
$3,452 |
14.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,406 |
$4,406 |
12.6× |
| MRI orbit/face/neck w/contrast (70542) |
$3,287 |
$3,287 |
9.4× |
| MRI pelvis w contrast (72196) |
$3,331 |
$3,331 |
9.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,412 |
$4,412 |
12.6× |
| MRI pelvis w/o contrast (72195) |
$2,563.50 |
$2,563.50 |
10.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,849 |
$3,849 |
11.0× |
| MRI scan of leg joint before and after contrast (73723) |
$4,142 |
$4,142 |
11.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,811 |
$4,811 |
13.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,699 |
$3,699 |
10.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,867 |
$4,867 |
13.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,660 |
$3,660 |
10.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,144 |
$4,144 |
11.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,247 |
$3,247 |
13.5× |
| MRI tmj (70336) |
$1,725 |
$1,725 |
7.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,853 |
$2,853 |
11.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,363 |
$4,363 |
12.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,897 |
$2,897 |
12.1× |
| Neck soft tissue (70360) |
$350 |
$350 |
4.0× |
| Pelvis 1 or 2 views (72170) |
$404.50 |
$404.50 |
3.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,162 |
$4,162 |
11.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$597 |
$597 |
1.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$552 |
$552 |
6.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$267 |
$267 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$706 |
$706 |
6.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$359 |
$359 |
4.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$557 |
$557 |
5.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$430 |
$430 |
4.9× |
| Radiologic exam colon single contrast study (74270) |
$756 |
$756 |
4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$429 |
$429 |
4.9× |
| Ribs bilateral 3 views (71110) |
$416 |
$416 |
4.0× |
| Scapula complete (73010) |
$222.50 |
$222.50 |
2.1× |
| Spine thoracic 3 views (72072) |
$559 |
$559 |
5.3× |
| Therapeutic Enema (74283) |
$549 |
$549 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$892 |
$892 |
8.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$256 |
$256 |
2.9× |
| Unlisted Ultrasound Procedure (76999) |
$409 |
$409 |
4.7× |
| Upper Extremity Infant (73092) |
$200 |
$200 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$268 |
$268 |
2.6× |
| Us breast unilateral complete (76641) |
$364 |
$364 |
3.5× |
| Us compl joint r-t w/image documentation (76881) |
$764 |
$764 |
7.3× |
| Us ob detailed single fetus (76811) |
$620 |
$620 |
2.6× |
| Us ob transvaginal (76817) |
$641 |
$641 |
6.1× |
| Us pelvic non ob complete (76856) |
$1,017 |
$1,017 |
9.7× |
| Us pregnancy ltd (76815) |
$538 |
$538 |
5.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,017 |
$1,017 |
9.7× |
| Us retroperitoneal complete (76770) |
$942 |
$942 |
9.0× |
| Us retroperitoneal limited (76775) |
$593 |
$593 |
5.6× |
| Us scrotum and contents (76870) |
$891 |
$891 |
8.5× |
| Us soft tissue head/neck (76536) |
$803 |
$803 |
7.6× |
| Us transrectal (76872) |
$700 |
$700 |
6.7× |
| Us xtr non-vasc lmtd (76882) |
$383 |
$383 |
3.6× |
| Wrist 2 views (73100) |
$213 |
$213 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$539 |
$539 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$405 |
$405 |
4.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$438 |
$438 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$366 |
$366 |
4.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$452 |
$452 |
5.2× |
| X-ray exam hip uni 1 view (73501) |
$306 |
$306 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$404 |
$404 |
4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$920 |
$920 |
8.8× |
| X-ray exam of femur 1 (73551) |
$409 |
$409 |
4.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$438 |
$438 |
2.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$385 |
$385 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$214 |
$214 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$403 |
$403 |
4.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$301 |
$301 |
3.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$1,613 |
$1,613 |
9.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$540 |
$540 |
5.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$371 |
$371 |
4.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$200 |
$200 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$494 |
$494 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$400 |
$400 |
4.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$438 |
$438 |
5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$513 |
$513 |
4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$332 |
$332 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$414 |
$414 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$405 |
$405 |
4.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$472 |
$472 |
5.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$364 |
$364 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$699 |
$699 |
6.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$363 |
$363 |
3.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$366 |
$366 |
4.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$215 |
$215 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$312 |
$312 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$453 |
$453 |
4.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$621 |
$621 |
5.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$316 |
$316 |
3.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$415 |
$415 |
4.7× |
| Xr finger(s) 2+ views (73140) |
$339 |
$339 |
3.9× |
| Xr optic foramina (70190) |
$329 |
$329 |
3.8× |
| Xr shoulder 1 view (73020) |
$384 |
$384 |
4.4× |
| Xr spine cervical 4 or 5 views (72050) |
$693 |
$693 |
6.6× |
| Xr tibia/fibula 2 views (73590) |
$403 |
$403 |
4.6× |
| Xr tmj bilateral (70330) |
$242 |
$242 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$358 |
$358 |
4.1× |