| Abdomen 2 views (74019) |
$163.80 |
$273 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$208.80 |
$348 |
2.5× |
| Chest 1 view (71045) |
$132.60 |
$221 |
1.6× |
| Clavicle complete (73000) |
$156 |
$260 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$226.77 |
$377.95 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,838.60 |
$4,731 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,749 |
$2,915 |
7.6× |
| CT abdomen w contrast (74160) |
$1,374 |
$2,290 |
8.1× |
| CT abdomen w wo contrast (74170) |
$1,548.60 |
$2,581 |
9.2× |
| CT abdomen w/o contrast (74150) |
$1,032 |
$1,720 |
10.3× |
| CT c-spine w/o contrast (72125) |
$783 |
$1,305 |
7.8× |
| CT chest w/wo contrast (71270) |
$1,374 |
$2,290 |
8.1× |
| CT chest with contrast (71260) |
$1,203 |
$2,005 |
7.1× |
| CT head/brain with contrast (70460) |
$1,193.40 |
$1,989 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,548.60 |
$2,581 |
9.2× |
| CT lower ext w/o (73700) |
$774 |
$1,290 |
7.7× |
| CT lumbar spine w/o contrast (72131) |
$687 |
$1,145 |
6.8× |
| CT maxillofacial w/o contrast (70486) |
$687 |
$1,145 |
6.8× |
| CT neck soft tissue w contrast (70491) |
$1,119.60 |
$1,866 |
6.6× |
| CT orbits w/o contrast (70480) |
$1,237.96 |
$2,063.26 |
12.3× |
| CT pelvis w & w/o contrast (72194) |
$1,122 |
$1,870 |
6.7× |
| CT pelvis w/o contrast (72192) |
$774 |
$1,290 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$956.40 |
$1,594 |
9.5× |
| CT thoracic spine w/o contrast (72128) |
$687 |
$1,145 |
6.8× |
| CT thorax w/o contrast (71250) |
$861.60 |
$1,436 |
8.6× |
| CT upper extremity w/o contrast rt (73200) |
$774 |
$1,290 |
7.7× |
| Cta Abdomen (74175) |
$2,322.11 |
$3,870.18 |
13.8× |
| CTA abdomen pelvis (74174) |
$2,067.06 |
$3,445.10 |
6.2× |
| CTA chest (71275) |
$2,315.56 |
$3,859.26 |
13.7× |
| Cta Head (70496) |
$1,543.50 |
$2,572.50 |
9.1× |
| Cta Neck (70498) |
$1,537.31 |
$2,562.19 |
9.1× |
| Forearm 2 views (73090) |
$132.60 |
$221 |
1.6× |
| Hand 2 views (73120) |
$106.20 |
$177 |
1.1× |
| Hand 3 views (73130) |
$171 |
$285 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$132.60 |
$221 |
1.6× |
| Neck soft tissue (70360) |
$132.60 |
$221 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$132.60 |
$221 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$246.60 |
$411 |
2.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$138 |
$230 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$197.40 |
$329 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$132.60 |
$221 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$171 |
$285 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$171 |
$285 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$156 |
$260 |
1.9× |
| Ribs bilateral 3 views (71110) |
$237.60 |
$396 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$144 |
$240 |
1.4× |
| Scapula complete (73010) |
$151.80 |
$253 |
1.5× |
| Thoracolumbar 2 views (72080) |
$182.40 |
$304 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$156 |
$260 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$200.40 |
$334 |
2.0× |
| Us pelvic non ob complete (76856) |
$214.20 |
$357 |
2.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$138 |
$230 |
1.4× |
| Us retroperitoneal complete (76770) |
$409.20 |
$682 |
4.1× |
| Us retroperitoneal limited (76775) |
$163.80 |
$273 |
1.6× |
| Us scrotum and contents (76870) |
$258 |
$430 |
2.6× |
| Us soft tissue head/neck (76536) |
$160.80 |
$268 |
1.6× |
| Us xtr non-vasc lmtd (76882) |
$338.56 |
$564.27 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$342 |
$570 |
3.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$171 |
$285 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$147.60 |
$246 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$132.60 |
$221 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$171 |
$285 |
2.0× |
| X-ray exam of femur 1 (73551) |
$99 |
$165 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$241.20 |
$402 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$132 |
$220 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$171 |
$285 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$115.80 |
$193 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$175.20 |
$292 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$305.40 |
$509 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$148.80 |
$248 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$182.40 |
$304 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$140.40 |
$234 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$152.40 |
$254 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$171 |
$285 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$216 |
$360 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$175.20 |
$292 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$171 |
$285 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$147.60 |
$246 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$224.40 |
$374 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$159 |
$265 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$114 |
$190 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$134.40 |
$224 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$182.40 |
$304 |
1.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$231 |
$385 |
2.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$132.60 |
$221 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$171 |
$285 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$147.60 |
$246 |
1.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$105 |
$175 |
1.0× |
| Xr optic foramina (70190) |
$75 |
$125 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$246.60 |
$411 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$156 |
$260 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$156 |
$260 |
1.9× |