| Abdomen 1 View (74018) |
$120.50 |
$241 |
1.4× |
| Abdomen 2 views (74019) |
$159 |
$318 |
1.5× |
| Ankle 2 views (73600) |
$124.50 |
$249 |
1.4× |
| Bone age studies (77072) |
$90 |
$180 |
0.9× |
| Chest 1 view (71045) |
$112.50 |
$225 |
1.3× |
| Chest 2 views (71046) |
$150 |
$300 |
1.7× |
| Clavicle complete (73000) |
$135 |
$270 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,600 |
$3,200 |
15.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,375 |
$2,750 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$787.50 |
$1,575 |
3.3× |
| CT abdomen w contrast (74160) |
$795.50 |
$1,591 |
4.5× |
| CT abdomen w wo contrast (74170) |
$1,428.50 |
$2,857 |
8.1× |
| CT Angio Abdomen and Pelvis (74174) |
$1,650 |
$3,300 |
4.7× |
| CT Angio Chest (71275) |
$1,000 |
$2,000 |
5.7× |
| CT Angio Head (70496) |
$762.50 |
$1,525 |
4.3× |
| CT Angio Neck (70498) |
$1,225 |
$2,450 |
7.0× |
| CT cervical spine w/o contrast (72125) |
$1,080 |
$2,160 |
10.3× |
| CT chest w contrast (71260) |
$925 |
$1,850 |
5.2× |
| CT chest w/wo contrast (71270) |
$1,582 |
$3,164 |
9.0× |
| CT head/brain with contrast (70460) |
$788 |
$1,576 |
4.5× |
| CT head/brain without and with contrast (70470) |
$1,273 |
$2,546 |
7.2× |
| CT lower ext w/o (73700) |
$775 |
$1,550 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$800 |
$1,600 |
7.6× |
| CT maxillofacial wo contrast (70486) |
$750 |
$1,500 |
7.1× |
| CT pelvis w/o contrast (72192) |
$787.50 |
$1,575 |
7.5× |
| CT soft tissue neck w contrast (70491) |
$775 |
$1,550 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$955.50 |
$1,911 |
9.1× |
| CT thoracic spine w contrast (72129) |
$902 |
$1,804 |
5.1× |
| CT thoracic spine w/o contrast (72128) |
$750 |
$1,500 |
7.1× |
| CT thorax w/o contrast (71250) |
$775 |
$1,550 |
7.4× |
| CT upper ext wo (73200) |
$780 |
$1,560 |
7.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,988.50 |
$3,977 |
11.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$155.50 |
$311 |
1.5× |
| Foot 2 views (73620) |
$110 |
$220 |
1.3× |
| Forearm 2 views (73090) |
$137 |
$274 |
1.6× |
| Hand 2 views (73120) |
$90 |
$180 |
0.9× |
| Knee 3 Views (73562) |
$162.50 |
$325 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$150 |
$300 |
1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$221.50 |
$443 |
2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$162.50 |
$325 |
1.9× |
| Radex elbow complete minimum 3 views (73080) |
$127.50 |
$255 |
1.5× |
| Radex fingr minimum 2 views (73140) |
$113.50 |
$227 |
1.3× |
| Radex foot complete minimum 3 views (73630) |
$150 |
$300 |
1.7× |
| Radex Hand Minimum 3 Views (73130) |
$150 |
$300 |
1.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$139.50 |
$279 |
1.6× |
| Radex shoulder complete minimum 2 views (73030) |
$150 |
$300 |
1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$150 |
$300 |
1.7× |
| Radiologic examination femur minimum 2 views (73552) |
$137.50 |
$275 |
1.6× |
| Radiologic examination knee 1/2 views (73560) |
$110.50 |
$221 |
1.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$143 |
$286 |
1.6× |
| Shoulder 1 view (73020) |
$127.50 |
$255 |
1.5× |
| Thoracic spine 2 views (72070) |
$134 |
$268 |
1.3× |
| Thoracic spine 3 views (72072) |
$236 |
$472 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$325 |
$650 |
3.1× |
| Us ob transvaginal (76817) |
$292 |
$584 |
2.8× |
| Us pelvic non ob complete (76856) |
$341.50 |
$683 |
3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$318.50 |
$637 |
3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$100 |
$200 |
1.0× |
| Us retroperitoneal complete (76770) |
$396.50 |
$793 |
3.8× |
| Us scrotum and contents (76870) |
$414 |
$828 |
3.9× |
| Us thyroid (76536) |
$350 |
$700 |
3.3× |
| Wrist 2 views (73100) |
$90 |
$180 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$113.50 |
$227 |
1.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$105.50 |
$211 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$137.50 |
$275 |
1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$179 |
$358 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$255 |
$510 |
2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$136 |
$272 |
1.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$236 |
$472 |
2.2× |
| X-ray humerus (73060) |
$136 |
$272 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$175 |
$350 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$142 |
$284 |
1.6× |