| Abdomen 2 views (74019) |
$379 |
$379 |
3.6× |
| Ankle 2 views (73600) |
$379 |
$379 |
4.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,782 |
$1,782 |
4.5× |
| Cervical spine 2 or 3 views (72040) |
$379 |
$379 |
4.3× |
| Chest 1 view (71045) |
$215 |
$215 |
2.5× |
| Clavicle complete (73000) |
$379 |
$379 |
4.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,400 |
$3,400 |
9.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,600 |
$2,600 |
10.9× |
| CT abdomen w contrast (74160) |
$1,500 |
$1,500 |
8.5× |
| CT abdomen w wo contrast (74170) |
$1,800 |
$1,800 |
10.2× |
| CT c-spine w/o contrast (72125) |
$1,400 |
$1,400 |
13.4× |
| CT chest w/wo contrast (71270) |
$1,850 |
$1,850 |
10.5× |
| CT chest with contrast (71260) |
$1,650 |
$1,650 |
9.4× |
| CT head/brain without and with contrast (70470) |
$1,850 |
$1,850 |
10.5× |
| CT lower ext w/o (73700) |
$1,200 |
$1,200 |
11.5× |
| CT lower extremity w wo contrast (73702) |
$1,800 |
$1,800 |
10.2× |
| CT lumbar spine w/o contrast (72131) |
$1,400 |
$1,400 |
13.4× |
| CT maxillofacial w contrast (70487) |
$1,550 |
$1,550 |
8.8× |
| CT maxillofacial w/o contrast (70486) |
$1,350 |
$1,350 |
12.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,850 |
$1,850 |
10.5× |
| CT neck soft tissue w contrast (70491) |
$1,650 |
$1,650 |
9.4× |
| CT orbits w/o contrast (70480) |
$1,200 |
$1,200 |
11.5× |
| CT pelvis w & w/o contrast (72194) |
$1,850 |
$1,850 |
10.5× |
| CT pelvis w/o contrast (72192) |
$1,200 |
$1,200 |
11.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,850 |
$1,850 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,200 |
$1,200 |
11.5× |
| CT thoracic spine w/o contrast (72128) |
$1,400 |
$1,400 |
13.4× |
| CT thorax w/o contrast (71250) |
$1,450 |
$1,450 |
13.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,200 |
$1,200 |
11.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,600 |
$1,600 |
9.1× |
| CTA abdomen pelvis (74174) |
$2,600 |
$2,600 |
7.4× |
| CTA chest (71275) |
$1,950 |
$1,950 |
11.1× |
| Cta Head (70496) |
$1,750 |
$1,750 |
10.0× |
| Cta Neck (70498) |
$1,950 |
$1,950 |
11.1× |
| Fluoroscopy up to 1 hr (76000) |
$862 |
$862 |
3.6× |
| Foot 2 views (73620) |
$315 |
$315 |
3.6× |
| Forearm 2 views (73090) |
$379 |
$379 |
4.3× |
| Hand 3 views (73130) |
$379 |
$379 |
4.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,118 |
$1,118 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$379 |
$379 |
4.3× |
| Knee 3 views (73562) |
$379 |
$379 |
4.3× |
| MRA head w/o contrast (70544) |
$1,950 |
$1,950 |
8.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,250 |
$3,250 |
9.3× |
| MRI cervical spine w/o contrast (72141) |
$1,950 |
$1,950 |
8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,950 |
$1,950 |
8.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,250 |
$3,250 |
9.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,250 |
$3,250 |
9.3× |
| MRI pelvis w/o contrast (72195) |
$1,950 |
$1,950 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$3,250 |
$3,250 |
9.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,250 |
$3,250 |
9.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,250 |
$3,250 |
9.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,250 |
$3,250 |
9.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,950 |
$1,950 |
8.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,950 |
$1,950 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,950 |
$1,950 |
8.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,153 |
$4,153 |
3.2× |
| Neck soft tissue (70360) |
$379 |
$379 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$315 |
$315 |
3.0× |
| PET image w/CT, skull-thigh (78815) |
$3,932 |
$3,932 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,932 |
$3,932 |
2.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,250 |
$3,250 |
9.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$244 |
$244 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$379 |
$379 |
4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$379 |
$379 |
4.3× |
| Scapula complete (73010) |
$379 |
$379 |
3.6× |
| Spine thoracic 3 views (72072) |
$386 |
$386 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$888 |
$888 |
8.5× |
| Unlisted Ultrasound Procedure (76999) |
$270 |
$270 |
3.1× |
| Us abdl aorta screen aaa (76706) |
$740 |
$740 |
7.1× |
| Us breast unilateral complete (76641) |
$483 |
$483 |
4.6× |
| Us breast unilateral limited (76642) |
$375 |
$375 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$888 |
$888 |
8.5× |
| Us pelvic non ob complete (76856) |
$888 |
$888 |
8.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$594 |
$594 |
5.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$888 |
$888 |
8.5× |
| Us retroperitoneal complete (76770) |
$740 |
$740 |
7.1× |
| Us scrotum and contents (76870) |
$888 |
$888 |
8.5× |
| Us soft tissue head/neck (76536) |
$888 |
$888 |
8.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$500 |
$500 |
4.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$379 |
$379 |
4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$309 |
$309 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$379 |
$379 |
4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$315 |
$315 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$415 |
$415 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$415 |
$415 |
4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$516 |
$516 |
4.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$500 |
$500 |
4.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$379 |
$379 |
4.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$379 |
$379 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$458 |
$458 |
5.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$315 |
$315 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$315 |
$315 |
3.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$315 |
$315 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$500 |
$500 |
4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$500 |
$500 |
4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$315 |
$315 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$315 |
$315 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$379 |
$379 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$315 |
$315 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$315 |
$315 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$379 |
$379 |
4.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$379 |
$379 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$600 |
$600 |
5.7× |
| Xr finger(s) 2+ views (73140) |
$379 |
$379 |
4.3× |
| Xr spine cervical 4 or 5 views (72050) |
$600 |
$600 |
5.7× |
| Xr tibia/fibula 2 views (73590) |
$379 |
$379 |
4.3× |
| Xray knee 1 or 2 views rt (73560) |
$229 |
$229 |
2.6× |