| Abdomen 2 views (74019) |
$329.48 |
$439.30 |
3.1× |
| Ankle 2 views (73600) |
$228.60 |
$304.80 |
2.6× |
| Bone age studies (77072) |
$131.10 |
$174.80 |
1.2× |
| Bone survey complete (77075) |
$584.78 |
$779.70 |
5.5× |
| Cervical spine 2 or 3 views (72040) |
$220.80 |
$294.40 |
2.5× |
| Chest 1 view (71045) |
$225.15 |
$300.20 |
2.5× |
| Chest 3 views (71047) |
$361.42 |
$481.90 |
4.1× |
| Clavicle complete (73000) |
$153.52 |
$204.70 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,735.52 |
$4,980.70 |
10.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,548.72 |
$3,398.30 |
10.5× |
| CT abdomen w contrast (74160) |
$1,716.38 |
$2,288.50 |
9.6× |
| CT abdomen w wo contrast (74170) |
$2,070 |
$2,760 |
11.6× |
| CT abdomen w/o contrast (74150) |
$1,398.15 |
$1,864.20 |
13.1× |
| CT angiography upper extremity lt (73206) |
$1,967.40 |
$2,623.20 |
11.0× |
| CT c-spine w/o contrast (72125) |
$1,919.92 |
$2,559.90 |
18.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,203.72 |
$2,938.30 |
12.3× |
| CT cervical spine with contrast (72126) |
$1,938.08 |
$2,584.10 |
5.4× |
| CT chest w/wo contrast (71270) |
$2,116.16 |
$2,821.55 |
11.8× |
| CT chest with contrast (71260) |
$2,023.88 |
$2,698.50 |
11.3× |
| CT head/brain with contrast (70460) |
$1,643.10 |
$2,190.80 |
9.2× |
| CT head/brain without and with contrast (70470) |
$1,756.95 |
$2,342.60 |
9.8× |
| CT iac w contrast (70481) |
$1,823.32 |
$2,431.10 |
10.2× |
| CT limited/localized follow up study (76380) |
$950.48 |
$1,267.30 |
10.7× |
| CT lower ext w/o (73700) |
$1,493.85 |
$1,991.80 |
14.0× |
| CT lower extremity w wo contrast (73702) |
$1,914.75 |
$2,553 |
10.7× |
| CT lower extremity with contrast (73701) |
$1,679.32 |
$2,239.10 |
9.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,107.95 |
$2,810.60 |
11.8× |
| CT lumbar spine w/o contrast (72131) |
$1,938.08 |
$2,584.10 |
18.1× |
| CT lumbar spine with contrast (72132) |
$1,983.75 |
$2,645 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,805.25 |
$2,407 |
10.1× |
| CT maxillofacial w/o contrast (70486) |
$1,417.95 |
$1,890.60 |
13.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,032.05 |
$2,709.40 |
11.3× |
| CT neck soft tissue w contrast (70491) |
$1,764.68 |
$2,352.90 |
9.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,236.50 |
$2,982 |
12.5× |
| CT orbits w/o contrast (70480) |
$1,631.85 |
$2,175.80 |
15.3× |
| CT pelvis w & w/o contrast (72194) |
$1,914.75 |
$2,553 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,622.40 |
$2,163.20 |
15.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,082.98 |
$2,777.30 |
11.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,646.55 |
$2,195.40 |
15.4× |
| CT thoracic spine w/contrast (72129) |
$1,945.80 |
$2,594.40 |
10.9× |
| CT thoracic spine w/o contrast (72128) |
$1,823.32 |
$2,431.10 |
17.1× |
| CT thoracic spine w/wo contrast (72130) |
$2,105.40 |
$2,807.20 |
11.7× |
| CT thorax w/o contrast (71250) |
$1,666.35 |
$2,221.80 |
15.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,015.70 |
$2,687.60 |
11.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,083.30 |
$1,444.40 |
10.1× |
| CT upper extremity with contrast (73201) |
$1,343.78 |
$1,791.70 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,455.18 |
$4,606.90 |
19.3× |
| Cta Abdomen (74175) |
$4,226.25 |
$5,635 |
23.6× |
| CTA abdomen pelvis (74174) |
$4,136.55 |
$5,515.40 |
11.6× |
| CTA chest (71275) |
$2,415.90 |
$3,221.20 |
13.5× |
| Cta Head (70496) |
$2,252.85 |
$3,003.80 |
12.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,487.85 |
$1,983.80 |
8.3× |
| Cta Neck (70498) |
$2,111.40 |
$2,815.20 |
11.8× |
| Cta Pelvis (72191) |
$2,156.25 |
$2,875 |
12.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$400.20 |
$533.60 |
3.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$363.15 |
$484.20 |
4.1× |
| Dxa bone density study axial skeleton (77085) |
$419.18 |
$558.90 |
3.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$273.45 |
$364.60 |
2.6× |
| Foot 2 views (73620) |
$160.42 |
$213.90 |
1.8× |
| Forearm 2 views (73090) |
$201 |
$268 |
2.3× |
| Hand 2 views (73120) |
$166.50 |
$222 |
1.6× |
| Hand 3 views (73130) |
$179.40 |
$239.20 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$201 |
$268 |
2.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$172.50 |
$230 |
1.6× |
| Knee 3 views (73562) |
$239.78 |
$319.70 |
2.7× |
| MRA head w & w/o contrast (70546) |
$2,975.62 |
$3,967.50 |
8.3× |
| MRA head w/o contrast (70544) |
$2,203.72 |
$2,938.30 |
9.0× |
| MRA neck w contrast (70548) |
$2,495.25 |
$3,327 |
7.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,735.02 |
$3,646.70 |
7.7× |
| MRA neck w/o contrast (70547) |
$1,914.75 |
$2,553 |
7.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,207.18 |
$2,942.90 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$1,743.98 |
$2,325.30 |
7.2× |
| MRI cervical spine w/o contrast (72141) |
$2,220.08 |
$2,960.10 |
9.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,610.82 |
$3,481.10 |
7.3× |
| MRI chest w/o contrast (71550) |
$1,843.20 |
$2,457.60 |
7.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,778.48 |
$2,371.30 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,072.62 |
$2,763.50 |
8.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,543.55 |
$3,391.40 |
7.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,015.70 |
$2,687.60 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,743.98 |
$2,325.30 |
7.2× |
| MRI scan of arm joint before and after contrast (73223) |
$2,351.18 |
$3,134.90 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,214.90 |
$2,953.20 |
6.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,588.40 |
$3,451.20 |
7.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,760 |
$3,680 |
7.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,105 |
$4,140 |
8.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,712.60 |
$3,616.80 |
11.1× |
| MRI tmj (70336) |
$1,754.32 |
$2,339.10 |
7.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,753.50 |
$2,338 |
7.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,303.78 |
$3,071.70 |
6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,727.62 |
$2,303.50 |
7.1× |
| Neck soft tissue (70360) |
$232.05 |
$309.40 |
2.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$220.80 |
$294.40 |
2.1× |
| Osseous survey infant (77076) |
$410.55 |
$547.40 |
3.8× |
| Osseous survey limited (77074) |
$566.70 |
$755.60 |
5.3× |
| Pelvis 1 or 2 views (72170) |
$225.98 |
$301.30 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,258.02 |
$3,010.70 |
6.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$414 |
$552 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$382.95 |
$510.60 |
3.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$278.62 |
$371.50 |
2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297.60 |
$396.80 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$197.55 |
$263.40 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$293.25 |
$391 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$196.65 |
$262.20 |
2.2× |
| Ribs bilateral 3 views (71110) |
$259.65 |
$346.20 |
2.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$378.68 |
$504.90 |
1.6× |
| Scanogram (77073) |
$239.78 |
$319.70 |
2.2× |
| Scapula complete (73010) |
$187.20 |
$249.60 |
1.8× |
| Sella turcica (70240) |
$197.55 |
$263.40 |
2.2× |
| Spine thoracic 3 views (72072) |
$264.82 |
$353.10 |
2.5× |
| Thoracolumbar 2 views (72080) |
$235.50 |
$314 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$720.22 |
$960.30 |
6.7× |
| Unlisted Ultrasound Procedure (76999) |
$464.92 |
$619.90 |
5.2× |
| Us abdl aorta screen aaa (76706) |
$432.15 |
$576.20 |
4.0× |
| Us chest (76604) |
$368.32 |
$491.10 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$345 |
$460 |
3.2× |
| Us ob detailed single fetus (76811) |
$643.42 |
$857.90 |
2.6× |
| Us ob transvaginal (76817) |
$403.65 |
$538.20 |
3.8× |
| Us pelvic non ob complete (76856) |
$476.10 |
$634.80 |
4.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$343.28 |
$457.70 |
3.2× |
| Us pregnancy ltd (76815) |
$282.90 |
$377.20 |
2.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$401.10 |
$534.80 |
3.8× |
| Us retroperitoneal complete (76770) |
$637.42 |
$849.90 |
6.0× |
| Us retroperitoneal limited (76775) |
$389.85 |
$519.80 |
3.6× |
| Us scrotum and contents (76870) |
$383.85 |
$511.80 |
3.6× |
| Us soft tissue head/neck (76536) |
$563.25 |
$751 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$307.05 |
$409.40 |
2.9× |
| Wrist 2 views (73100) |
$163.05 |
$217.40 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$385.58 |
$514.10 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$211.35 |
$281.80 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$250.12 |
$333.50 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$186.30 |
$248.40 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$229.42 |
$305.90 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$171.68 |
$228.90 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$221.70 |
$295.60 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$388.12 |
$517.50 |
3.6× |
| X-ray exam of femur 1 (73551) |
$163.05 |
$217.40 |
1.8× |
| X-ray eye for foreign body (70030) |
$188.02 |
$250.70 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$307.05 |
$409.40 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$263.10 |
$350.80 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$199.28 |
$265.70 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$172.50 |
$230 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$231.15 |
$308.20 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$316.58 |
$422.10 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$182.85 |
$243.80 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$172.50 |
$230 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$377.78 |
$503.70 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$312.22 |
$416.30 |
2.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$286.35 |
$381.80 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$263.92 |
$351.90 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$240.68 |
$320.90 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$297.60 |
$396.80 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$265.65 |
$354.20 |
2.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$182.85 |
$243.80 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$248.40 |
$331.20 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$381.22 |
$508.30 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$268.28 |
$357.70 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$163.05 |
$217.40 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$278.62 |
$371.50 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$282.90 |
$377.20 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$187.20 |
$249.60 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$297.60 |
$396.80 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$224.25 |
$299 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$148.35 |
$197.80 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$220.80 |
$294.40 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$231.15 |
$308.20 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$235.50 |
$314 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$160.42 |
$213.90 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$201 |
$268 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$280.35 |
$373.80 |
2.6× |
| Xr chest 4+ views (71048) |
$429.52 |
$572.70 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$160.42 |
$213.90 |
1.8× |
| Xr optic foramina (70190) |
$197.55 |
$263.40 |
2.2× |
| Xr shoulder 1 view (73020) |
$228.60 |
$304.80 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$263.10 |
$350.80 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$201 |
$268 |
2.3× |
| Xr tmj bilateral (70330) |
$297.60 |
$396.80 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$201 |
$268 |
2.3× |