| Abdomen 2 views (74019) |
$302 |
$302 |
2.6× |
| Ankle 2 views (73600) |
$205 |
$205 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,242 |
$1,242 |
2.8× |
| Bone survey complete (77075) |
$729 |
$729 |
6.3× |
| Cervical spine 2 or 3 views (72040) |
$276 |
$276 |
2.8× |
| Chest 1 view (71045) |
$169 |
$169 |
1.7× |
| Chest xray 3 views (71047) |
$346 |
$346 |
3.6× |
| Clavicle complete (73000) |
$223 |
$223 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$947 |
$947 |
8.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,325 |
$3,325 |
8.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,871 |
$1,871 |
7.0× |
| CT abdomen w contrast (74160) |
$2,397 |
$2,397 |
12.3× |
| CT abdomen w wo contrast (74170) |
$2,833 |
$2,833 |
14.5× |
| CT abdomen w/o contrast (74150) |
$2,073 |
$2,073 |
17.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,863 |
$2,863 |
14.6× |
| CT angiography upper extremity lt (73206) |
$2,961 |
$2,961 |
15.1× |
| CT c-spine w/contrast (72126) |
$2,573 |
$2,573 |
6.6× |
| CT c-spine w/o contrast (72125) |
$2,225 |
$2,225 |
19.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,174 |
$3,174 |
16.2× |
| CT chest w contrast (71260) |
$2,376 |
$2,376 |
12.2× |
| CT chest w/wo contrast (71270) |
$2,889 |
$2,889 |
14.8× |
| CT head/brain with contrast (70460) |
$2,139 |
$2,139 |
10.9× |
| CT head/brain without and with contrast (70470) |
$2,617 |
$2,617 |
13.4× |
| CT iac w contrast (70481) |
$2,397 |
$2,397 |
12.3× |
| CT lower ext w/o (73700) |
$1,624 |
$1,624 |
13.9× |
| CT lower extremity w wo contrast (73702) |
$2,166 |
$2,166 |
11.1× |
| CT lower extremity w/contrast material (73701) |
$1,775 |
$1,775 |
9.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,050 |
$3,050 |
15.6× |
| CT lumbar spine w/contrast (72132) |
$2,513 |
$2,513 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$2,213 |
$2,213 |
19.0× |
| CT maxillofacial w contrast (70487) |
$2,259 |
$2,259 |
11.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,673 |
$2,673 |
13.7× |
| CT maxillofacial wo contrast (70486) |
$1,986 |
$1,986 |
17.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,718 |
$2,718 |
13.9× |
| CT orbits w/o contrast (70480) |
$2,122 |
$2,122 |
18.2× |
| CT pelvis w/o contrast (72192) |
$1,970 |
$1,970 |
16.9× |
| CT pelvis w/wo contrast (72194) |
$2,674 |
$2,674 |
13.7× |
| CT scan of arm combo (73202) |
$2,149 |
$2,149 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$2,306 |
$2,306 |
11.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,704 |
$2,704 |
13.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,100 |
$2,100 |
18.0× |
| CT thoracic spine w/contrast (72129) |
$2,553 |
$2,553 |
13.1× |
| CT thoracic spine w/o contrast (72128) |
$2,221 |
$2,221 |
19.1× |
| CT thoracic spine w/wo contrast (72130) |
$3,134 |
$3,134 |
16.0× |
| CT thorax w/o contrast (71250) |
$2,162 |
$2,162 |
18.6× |
| CT upper ext wo (73200) |
$1,693 |
$1,693 |
14.5× |
| CT upper extremity with contrast (73201) |
$1,881 |
$1,881 |
4.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$5,134 |
$5,134 |
26.3× |
| Cta Abdomen (74175) |
$3,493 |
$3,493 |
17.9× |
| CTA abdomen pelvis (74174) |
$4,165 |
$4,165 |
10.7× |
| CTA chest (71275) |
$3,631 |
$3,631 |
18.6× |
| Cta Head (70496) |
$3,449 |
$3,449 |
17.6× |
| Cta Neck (70498) |
$3,445 |
$3,445 |
17.6× |
| Cta Pelvis (72191) |
$3,445 |
$3,445 |
17.6× |
| Facial bones min 3 views (70150) |
$321 |
$321 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$716 |
$716 |
6.1× |
| Foot 2 views (73620) |
$204 |
$204 |
2.1× |
| Forearm 2 views (73090) |
$216 |
$216 |
2.2× |
| Hand 2 views (73120) |
$202 |
$202 |
1.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$298 |
$298 |
2.6× |
| Knee 3 views (73562) |
$246 |
$246 |
2.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,609 |
$3,609 |
4.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,327 |
$3,327 |
8.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,084 |
$4,084 |
10.5× |
| MRA head w & w/o contrast (70546) |
$4,951 |
$4,951 |
12.7× |
| MRA head w/o contrast (70544) |
$3,486 |
$3,486 |
13.1× |
| MRA head with contrast (70545) |
$3,825 |
$3,825 |
9.8× |
| MRA neck w contrast (70548) |
$3,868 |
$3,868 |
9.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,951 |
$4,951 |
12.7× |
| MRA neck w/o contrast (70547) |
$3,435 |
$3,435 |
12.9× |
| MRI abdomen w contrast (74182) |
$4,361 |
$4,361 |
11.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,307 |
$5,307 |
13.7× |
| MRI abdomen w/o contrast (74181) |
$3,737 |
$3,737 |
14.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,573 |
$3,573 |
4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,364 |
$4,364 |
11.2× |
| MRI c-spine with contrast (72142) |
$4,334 |
$4,334 |
11.1× |
| MRI cervical spine w/o contrast (72141) |
$3,823 |
$3,823 |
14.4× |
| MRI chest w/o & w/contrast material (71552) |
$5,982 |
$5,982 |
15.4× |
| MRI chest w/o contrast (71550) |
$4,033 |
$4,033 |
15.2× |
| MRI chest with contrast (71551) |
$4,499 |
$4,499 |
5.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,603 |
$3,603 |
9.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,427 |
$4,427 |
11.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,143 |
$3,143 |
11.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,963 |
$3,963 |
14.9× |
| MRI orbit face neck w contrast (70542) |
$4,616 |
$4,616 |
11.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,599 |
$5,599 |
14.4× |
| MRI pelvis w/contrast (72196) |
$4,367 |
$4,367 |
11.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,367 |
$5,367 |
13.8× |
| MRI pelvis w/o contrast (72195) |
$3,768 |
$3,768 |
14.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,426 |
$5,426 |
14.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,407 |
$4,407 |
11.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,519 |
$5,519 |
14.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,553 |
$4,553 |
11.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,668 |
$5,668 |
14.6× |
| MRI temporomandibular joint (70336) |
$2,969 |
$2,969 |
11.2× |
| MRI thoracic spine w/o contrast (72146) |
$4,023 |
$4,023 |
15.1× |
| MRI up ext w/o contrast (73218) |
$2,789 |
$2,789 |
10.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,104 |
$3,104 |
11.7× |
| MRI, joint upper extrem combo (73223) |
$4,494 |
$4,494 |
11.6× |
| Neck soft tissue (70360) |
$218 |
$218 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$273 |
$273 |
2.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$230 |
$230 |
2.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$200 |
$200 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$242 |
$242 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$239 |
$239 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$344 |
$344 |
3.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$598 |
$598 |
5.1× |
| Radex fingr minimum 2 views (73140) |
$173 |
$173 |
1.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$227 |
$227 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$231 |
$231 |
2.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$263 |
$263 |
2.7× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$380 |
$380 |
3.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$397 |
$397 |
3.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$545 |
$545 |
4.7× |
| Radex Humerus Minimum 2 Views (73060) |
$246 |
$246 |
2.5× |
| Radex Kne 1/2 Views (73560) |
$223 |
$223 |
2.3× |
| Radex Kne Compl 4/More Views (73564) |
$292 |
$292 |
2.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$290 |
$290 |
2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$198 |
$198 |
2.0× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$339 |
$339 |
2.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$269 |
$269 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$218 |
$218 |
2.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$491 |
$491 |
4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$367 |
$367 |
3.8× |
| Radex Toe Minimum 2 Views (73660) |
$182 |
$182 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$209 |
$209 |
1.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$233 |
$233 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$626 |
$626 |
5.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$243.30 |
$243.30 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$315 |
$315 |
2.7× |
| Radiologic exam chest 2 views (71046) |
$283 |
$283 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$260 |
$260 |
2.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$221 |
$221 |
2.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$296 |
$296 |
0.5× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$357 |
$357 |
3.1× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$217 |
$217 |
1.9× |
| Ribs bilateral 3 views (71110) |
$361 |
$361 |
3.1× |
| Sacroiliac Joints < 3 Views (72200) |
$260 |
$260 |
2.2× |
| Scapula (73010) |
$252 |
$252 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$123 |
$123 |
5.3× |
| Shoulder 1 view (73020) |
$197 |
$197 |
2.0× |
| Spine thoracic 3 views (72072) |
$308 |
$308 |
2.6× |
| Thoracolumbar 2 views (72080) |
$294 |
$294 |
3.0× |
| Tmj unilateral (70328) |
$258 |
$258 |
2.7× |
| Ultrasound breast complete (76641) |
$307 |
$307 |
2.6× |
| Ultrasound Exam Aaa Screen (76706) |
$818 |
$818 |
7.0× |
| Ultrasound, abdomen limited (76705) |
$683 |
$683 |
5.9× |
| Us breast unilateral limited (76642) |
$236 |
$236 |
2.4× |
| Us chest (76604) |
$763 |
$763 |
6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$285 |
$285 |
2.4× |
| Us ob detailed single fetus (76811) |
$1,617 |
$1,617 |
6.1× |
| Us ob limited (76815) |
$543 |
$543 |
4.7× |
| Us ob transvaginal (76817) |
$632 |
$632 |
5.4× |
| Us pelvic non ob complete (76856) |
$736 |
$736 |
6.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$614 |
$614 |
5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$778 |
$778 |
6.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$533 |
$533 |
4.6× |
| Us retroperitoneal complete (76770) |
$894 |
$894 |
7.7× |
| Us retroperitoneal limited (76775) |
$478 |
$478 |
4.1× |
| Us scrotum and contents (76870) |
$677 |
$677 |
5.8× |
| Us soft tissue head/neck (76536) |
$661 |
$661 |
5.7× |
| Wrist 2 views (73100) |
$206 |
$206 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$394 |
$394 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$283 |
$283 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$211 |
$211 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$329 |
$329 |
3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$471 |
$471 |
4.0× |
| X-ray exam of femur 2/> (73552) |
$308 |
$308 |
3.2× |
| X-ray eye for foreign body (70030) |
$377 |
$377 |
3.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$254 |
$254 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$205 |
$205 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$218 |
$218 |
2.2× |
| X-ray leg, infant (73592) |
$207 |
$207 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$281 |
$281 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$508 |
$508 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$292 |
$292 |
3.0× |
| X-ray optic foramen (70190) |
$270 |
$270 |
2.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$332 |
$332 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$279 |
$279 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$332 |
$332 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$409 |
$409 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$319 |
$319 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$285 |
$285 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$353 |
$353 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$370 |
$370 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$272 |
$272 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$192 |
$192 |
2.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$308 |
$308 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$279 |
$279 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$278 |
$278 |
2.4× |
| Xr c-spine 4 or 5 views (72050) |
$388 |
$388 |
3.3× |
| Xr c-spine 6 or more views (72052) |
$458 |
$458 |
3.9× |
| Xr chest 4+ views (71048) |
$212 |
$212 |
1.8× |