| Abdomen 2 views (74019) |
$144.81 |
$144.81 |
1.6× |
| Ankle 2 views (73600) |
$252.69 |
$252.69 |
3.4× |
| Bone age studies (77072) |
$150.15 |
$150.15 |
1.7× |
| Bone survey complete (77075) |
$221.98 |
$221.98 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$133.30 |
$133.30 |
1.8× |
| Chest 1 view (71045) |
$272.22 |
$272.22 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$576.19 |
$576.19 |
3.8× |
| Clavicle complete (73000) |
$133.30 |
$133.30 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$333.57 |
$333.57 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,558.60 |
$3,558.60 |
11.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,028.85 |
$2,028.85 |
9.9× |
| CT abdomen w contrast (74160) |
$2,262.33 |
$2,262.33 |
15.0× |
| CT abdomen w wo contrast (74170) |
$2,386.72 |
$2,386.72 |
15.8× |
| CT abdomen w/o contrast (74150) |
$1,360.73 |
$1,360.73 |
15.1× |
| CT angiography upper extremity lt (73206) |
$2,586.17 |
$2,586.17 |
17.1× |
| CT c-spine w/o contrast (72125) |
$2,071.72 |
$2,071.72 |
23.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,506.60 |
$2,506.60 |
16.6× |
| CT cervical spine with contrast (72126) |
$2,262.33 |
$2,262.33 |
7.5× |
| CT chest w/wo contrast (71270) |
$1,562 |
$1,562 |
10.3× |
| CT chest with contrast (71260) |
$2,154.60 |
$2,154.60 |
14.2× |
| CT head/brain with contrast (70460) |
$2,262.33 |
$2,262.33 |
15.0× |
| CT head/brain without and with contrast (70470) |
$2,506.06 |
$2,506.06 |
16.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$100 |
$100 |
1.3× |
| CT iac w contrast (70481) |
$2,262.33 |
$2,262.33 |
15.0× |
| CT lower ext w/o (73700) |
$1,428.77 |
$1,428.77 |
15.9× |
| CT lower extremity w wo contrast (73702) |
$2,506.06 |
$2,506.06 |
16.6× |
| CT lower extremity with contrast (73701) |
$1,606.25 |
$1,606.25 |
10.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,506.06 |
$2,506.06 |
16.6× |
| CT lumbar spine w/o contrast (72131) |
$2,071.72 |
$2,071.72 |
23.0× |
| CT lumbar spine with contrast (72132) |
$2,262.33 |
$2,262.33 |
7.5× |
| CT maxillofacial w contrast (70487) |
$1,606.25 |
$1,606.25 |
10.6× |
| CT maxillofacial w/o contrast (70486) |
$1,014.43 |
$1,014.43 |
11.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,779.30 |
$1,779.30 |
11.8× |
| CT neck soft tissue w contrast (70491) |
$3,280.38 |
$3,280.38 |
21.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,506.06 |
$2,506.06 |
16.6× |
| CT orbits w/o contrast (70480) |
$1,014.43 |
$1,014.43 |
11.3× |
| CT pelvis w & w/o contrast (72194) |
$2,506.06 |
$2,506.06 |
16.6× |
| CT pelvis w/o contrast (72192) |
$1,428.77 |
$1,428.77 |
15.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,014.43 |
$1,014.43 |
11.3× |
| CT thoracic spine w/contrast (72129) |
$2,262.33 |
$2,262.33 |
15.0× |
| CT thoracic spine w/o contrast (72128) |
$1,014.43 |
$1,014.43 |
11.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,506.06 |
$2,506.06 |
16.6× |
| CT thorax w/o contrast (71250) |
$2,071.72 |
$2,071.72 |
23.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,506.60 |
$2,506.60 |
16.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,428.77 |
$1,428.77 |
15.9× |
| CT upper extremity with contrast (73201) |
$2,262.33 |
$2,262.33 |
7.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,607.24 |
$3,607.24 |
23.9× |
| Cta Abdomen (74175) |
$2,586.17 |
$2,586.17 |
17.1× |
| CTA abdomen pelvis (74174) |
$5,892.48 |
$5,892.48 |
19.6× |
| CTA chest (71275) |
$3,607.89 |
$3,607.89 |
23.9× |
| Cta Head (70496) |
$3,607.24 |
$3,607.24 |
23.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,067 |
$2,067 |
6.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,586.17 |
$2,586.17 |
17.1× |
| Cta Neck (70498) |
$2,061.28 |
$2,061.28 |
13.6× |
| Cta Pelvis (72191) |
$2,586.17 |
$2,586.17 |
17.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$235 |
$235 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$410.63 |
$410.63 |
4.6× |
| Foot 2 views (73620) |
$250.95 |
$250.95 |
3.3× |
| Forearm 2 views (73090) |
$133.30 |
$133.30 |
1.8× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$293.91 |
$293.91 |
1.4× |
| Hand 2 views (73120) |
$133.30 |
$133.30 |
1.5× |
| Hand 3 views (73130) |
$133.30 |
$133.30 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$272.22 |
$272.22 |
3.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$221.98 |
$221.98 |
2.5× |
| Knee 3 views (73562) |
$133.30 |
$133.30 |
1.8× |
| Neck soft tissue (70360) |
$133.30 |
$133.30 |
1.8× |
| Osseous survey infant (77076) |
$221.98 |
$221.98 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$289.62 |
$289.62 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$453.34 |
$453.34 |
5.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$187.74 |
$187.74 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$144.81 |
$144.81 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$133.30 |
$133.30 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$311.01 |
$311.01 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$187.74 |
$187.74 |
2.5× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$293.91 |
$293.91 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$272.22 |
$272.22 |
3.6× |
| Sacroiliac Joints < 3 Views (72200) |
$289.62 |
$289.62 |
3.2× |
| Scapula complete (73010) |
$144.81 |
$144.81 |
1.6× |
| Speech evaluation complex (70371) |
$349.48 |
$349.48 |
1.7× |
| Spine thoracic 3 views (72072) |
$144.81 |
$144.81 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$291.55 |
$291.55 |
3.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$730.80 |
$730.80 |
4.8× |
| Us breast unilateral complete (76641) |
$337.53 |
$337.53 |
3.7× |
| Us chest (76604) |
$490.38 |
$490.38 |
5.4× |
| Us compl joint r-t w/image documentation (76881) |
$595.41 |
$595.41 |
6.6× |
| Us pelvic non ob complete (76856) |
$133.88 |
$133.88 |
1.5× |
| Us pregnancy ltd (76815) |
$262.50 |
$262.50 |
2.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$291.55 |
$291.55 |
3.2× |
| Us retroperitoneal complete (76770) |
$595.41 |
$595.41 |
6.6× |
| Us retroperitoneal limited (76775) |
$595.41 |
$595.41 |
6.6× |
| Us scrotum and contents (76870) |
$586.35 |
$586.35 |
6.5× |
| Us soft tissue head/neck (76536) |
$595.41 |
$595.41 |
6.6× |
| Wrist 2 views (73100) |
$133.30 |
$133.30 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$221.98 |
$221.98 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$187.74 |
$187.74 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$133.30 |
$133.30 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$281.82 |
$281.82 |
3.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$133.30 |
$133.30 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$272.22 |
$272.22 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$272.22 |
$272.22 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$144.81 |
$144.81 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$144.81 |
$144.81 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$133.30 |
$133.30 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$187.74 |
$187.74 |
2.5× |
| X-ray IV pyelogram+drip infusn (74410) |
$730.80 |
$730.80 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$144.81 |
$144.81 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$306.99 |
$306.99 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$144.81 |
$144.81 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$133.30 |
$133.30 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$144.81 |
$144.81 |
1.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$2,586.17 |
$2,586.17 |
28.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$187.74 |
$187.74 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$245.28 |
$245.28 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$272.22 |
$272.22 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$272.22 |
$272.22 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$187.74 |
$187.74 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$221.98 |
$221.98 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$187.74 |
$187.74 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$187.74 |
$187.74 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$187.74 |
$187.74 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$272.22 |
$272.22 |
3.6× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$128.02 |
$128.02 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$144.81 |
$144.81 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$312.75 |
$312.75 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$133.30 |
$133.30 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$133.30 |
$133.30 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$453.34 |
$453.34 |
5.0× |
| Xr finger(s) 2+ views (73140) |
$133.30 |
$133.30 |
1.8× |
| Xr shoulder 1 view (73020) |
$272.22 |
$272.22 |
3.6× |
| Xr spine cervical 4 or 5 views (72050) |
$228.78 |
$228.78 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$133.30 |
$133.30 |
1.8× |
| Xr tmj bilateral (70330) |
$272.22 |
$272.22 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$251.94 |
$251.94 |
3.4× |