| Abdomen 2 views (74019) |
$208.50 |
$278 |
2.1× |
| Ankle 2 views (73600) |
$54.94 |
$73.25 |
0.7× |
| Bone survey complete (77075) |
$107.25 |
$143 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$99 |
$132 |
1.2× |
| Chest 1 view (71045) |
$108.56 |
$144.75 |
1.3× |
| Chest 3 views (71047) |
$231.38 |
$308.50 |
2.8× |
| Clavicle complete (73000) |
$94.12 |
$125.50 |
1.2× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$201.38 |
$268.50 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,329.19 |
$1,772.25 |
4.1× |
| CT abdomen and pelvis without contrast (74176) |
$728.44 |
$971.25 |
3.3× |
| CT abdomen w contrast (74160) |
$786.94 |
$1,049.25 |
4.8× |
| CT abdomen w wo contrast (74170) |
$853.50 |
$1,138 |
5.2× |
| CT abdomen w/o contrast (74150) |
$688.50 |
$918 |
7.0× |
| CT angiography upper extremity lt (73206) |
$663.38 |
$884.50 |
4.0× |
| CT c-spine w/o contrast (72125) |
$580.69 |
$774.25 |
5.9× |
| CT cervical spine w&w/o contrast (72127) |
$786.38 |
$1,048.50 |
4.8× |
| CT cervical spine with contrast (72126) |
$704.06 |
$938.75 |
2.2× |
| CT chest w/wo contrast (71270) |
$732 |
$976 |
4.4× |
| CT chest with contrast (71260) |
$770.25 |
$1,027 |
4.7× |
| CT head/brain with contrast (70460) |
$697.50 |
$930 |
4.2× |
| CT head/brain without and with contrast (70470) |
$782.82 |
$1,043.75 |
4.8× |
| CT iac w contrast (70481) |
$601.32 |
$801.75 |
3.7× |
| CT lower ext w/o (73700) |
$444.19 |
$592.25 |
4.5× |
| CT lower extremity w wo contrast (73702) |
$702 |
$936 |
4.3× |
| CT lower extremity with contrast (73701) |
$531.75 |
$709 |
3.2× |
| CT lumbar spine w & w/o contrast (72133) |
$720.94 |
$961.25 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$727.69 |
$970.25 |
7.4× |
| CT lumbar spine with contrast (72132) |
$718.50 |
$958 |
2.2× |
| CT maxillofacial w contrast (70487) |
$696.19 |
$928.25 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$573.56 |
$764.75 |
5.8× |
| CT maxillofacial w/wo contrast (70488) |
$693.56 |
$924.75 |
4.2× |
| CT neck soft tissue w contrast (70491) |
$561.94 |
$749.25 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$729.56 |
$972.75 |
4.4× |
| CT orbits w/o contrast (70480) |
$440.44 |
$587.25 |
4.5× |
| CT pelvis w & w/o contrast (72194) |
$874.50 |
$1,166 |
5.3× |
| CT pelvis w/o contrast (72192) |
$709.88 |
$946.50 |
7.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$144 |
$192 |
0.9× |
| CT soft tissue neck w/o contrast (70490) |
$514.32 |
$685.75 |
5.2× |
| CT thoracic spine w/contrast (72129) |
$721.69 |
$962.25 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$117.38 |
$156.50 |
1.2× |
| CT thoracic spine w/wo contrast (72130) |
$720.56 |
$960.75 |
4.4× |
| CT thorax w/o contrast (71250) |
$687.94 |
$917.25 |
7.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$732.94 |
$977.25 |
4.5× |
| CT upper extremity w/o contrast rt (73200) |
$456.94 |
$609.25 |
4.7× |
| CT upper extremity with contrast (73201) |
$614.44 |
$819.25 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$606 |
$808 |
3.7× |
| Cta Abdomen (74175) |
$663.38 |
$884.50 |
4.0× |
| CTA chest (71275) |
$868.13 |
$1,157.50 |
5.3× |
| Cta Head (70496) |
$663.38 |
$884.50 |
4.0× |
| CTA lwr ext w&w/o contrast (73706) |
$663.38 |
$884.50 |
4.0× |
| Cta Neck (70498) |
$193.88 |
$258.50 |
1.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$122.06 |
$162.75 |
1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$98.82 |
$131.75 |
1.2× |
| Esophagus (74220) |
$167.25 |
$223 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$109.12 |
$145.50 |
0.5× |
| Foot 2 views (73620) |
$54.76 |
$73 |
0.7× |
| Forearm 2 views (73090) |
$84.38 |
$112.50 |
1.0× |
| Hand 2 views (73120) |
$63.56 |
$84.75 |
0.6× |
| Hand 3 views (73130) |
$113.62 |
$151.50 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$112.88 |
$150.50 |
1.4× |
| Knee 3 views (73562) |
$113.62 |
$151.50 |
1.4× |
| Neck soft tissue (70360) |
$96.38 |
$128.50 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$119.62 |
$159.50 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$131.62 |
$175.50 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$142.50 |
$190 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$29.25 |
$39 |
0.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$129.75 |
$173 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$188.82 |
$251.75 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$447 |
$596 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$210 |
$280 |
2.6× |
| Ribs bilateral 3 views (71110) |
$29.25 |
$39 |
0.3× |
| Sacroiliac Joints < 3 Views (72200) |
$84 |
$112 |
0.9× |
| Scapula complete (73010) |
$56.82 |
$75.75 |
0.6× |
| Small bowel series (74250) |
$171.75 |
$229 |
1.0× |
| Spine thoracic 3 views (72072) |
$175.69 |
$234.25 |
1.8× |
| Tmj unilateral (70328) |
$30 |
$40 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$198.38 |
$264.50 |
2.0× |
| Upper Extremity Infant (73092) |
$107.62 |
$143.50 |
1.1× |
| Us abdl aorta screen aaa (76706) |
$162.56 |
$216.75 |
1.7× |
| Us breast unilateral complete (76641) |
$307.50 |
$410 |
3.1× |
| Us chest (76604) |
$231.75 |
$309 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$310.69 |
$414.25 |
3.2× |
| Us pelvic non ob complete (76856) |
$322.88 |
$430.50 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$240.75 |
$321 |
2.5× |
| Us pregnancy ltd (76815) |
$325.13 |
$433.50 |
3.3× |
| Us retroperitoneal limited (76775) |
$324.38 |
$432.50 |
3.3× |
| Us scrotum and contents (76870) |
$313.12 |
$417.50 |
3.2× |
| Us soft tissue head/neck (76536) |
$310.69 |
$414.25 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$184.50 |
$246 |
1.9× |
| Vertebral fracture assessment via dxa (77086) |
$71.44 |
$95.25 |
0.9× |
| Wrist 2 views (73100) |
$63.56 |
$84.75 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$36 |
$48 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$79.12 |
$105.50 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$119.62 |
$159.50 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$269.06 |
$358.75 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$30.38 |
$40.50 |
0.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$113.62 |
$151.50 |
1.4× |
| X-ray exam hip uni 1 view (73501) |
$71.25 |
$95 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$108 |
$144 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$190.69 |
$254.25 |
1.9× |
| X-ray exam of femur 1 (73551) |
$29.25 |
$39 |
0.4× |
| X-ray eye for foreign body (70030) |
$24.75 |
$33 |
0.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$159.94 |
$213.25 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$130.32 |
$173.75 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$96.38 |
$128.50 |
1.2× |
| X-ray IV pyelogram+drip infusn (74410) |
$167.25 |
$223 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$180 |
$240 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$99.38 |
$132.50 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$113.62 |
$151.50 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$107.62 |
$143.50 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$133.69 |
$178.25 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$118.12 |
$157.50 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$29.25 |
$39 |
0.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$143.25 |
$191 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$270 |
$360 |
3.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$124.88 |
$166.50 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$114.75 |
$153 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$109.32 |
$145.75 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$112.88 |
$150.50 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$142.12 |
$189.50 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$145.88 |
$194.50 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$62.44 |
$83.25 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$96.75 |
$129 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$140.44 |
$187.25 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$105.38 |
$140.50 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$177 |
$236 |
2.2× |
| Xr c-spine 6 or more views (72052) |
$141.19 |
$188.25 |
1.4× |
| Xr chest 4+ views (71048) |
$187.50 |
$250 |
1.9× |
| Xr Cholecystography Oral Contrast (74290) |
$243.38 |
$324.50 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$90.56 |
$120.75 |
1.1× |
| Xr shoulder 1 view (73020) |
$50.25 |
$67 |
0.6× |
| Xr tibia/fibula 2 views (73590) |
$108 |
$144 |
1.3× |
| Xr tmj bilateral (70330) |
$172.69 |
$230.25 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$69.75 |
$93 |
0.9× |