| Abdomen 2 views (74019) |
$82.80 |
$207 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$310.40 |
$776 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$1,551.60 |
$3,879 |
4.4× |
| Cervical spine 2 or 3 views (72040) |
$231.20 |
$578 |
3.0× |
| Chest 1 view (71045) |
$30 |
$75 |
0.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$115.20 |
$288 |
0.7× |
| Clavicle complete (73000) |
$229.40 |
$573.50 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$200.40 |
$501 |
2.2× |
| CT abdomen w wo contrast (74170) |
$1,557.60 |
$3,894 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,026.80 |
$2,567 |
11.2× |
| CT c-spine w/o contrast (72125) |
$458 |
$1,145 |
5.0× |
| CT chest w/wo contrast (71270) |
$381.20 |
$953 |
2.5× |
| CT chest with contrast (71260) |
$266.80 |
$667 |
1.7× |
| CT head/brain without and with contrast (70470) |
$1,625.40 |
$4,063.50 |
10.6× |
| CT lower ext w/o (73700) |
$710.80 |
$1,777 |
7.8× |
| CT maxillofacial w contrast (70487) |
$934.40 |
$2,336 |
6.1× |
| CT maxillofacial w/o contrast (70486) |
$376.80 |
$942 |
4.1× |
| CT orbits w/o contrast (70480) |
$489.20 |
$1,223 |
5.3× |
| CT soft tissue neck w/o contrast (70490) |
$568 |
$1,420 |
6.2× |
| CT thorax w/o contrast (71250) |
$200.40 |
$501 |
2.2× |
| CT upper extremity w/o contrast rt (73200) |
$766.80 |
$1,917 |
8.4× |
| Cta Head (70496) |
$891.60 |
$2,229 |
5.8× |
| Cta Neck (70498) |
$891.60 |
$2,229 |
5.8× |
| Fluoroscopy up to 1 hr (76000) |
$475.20 |
$1,188 |
2.3× |
| Foot 2 views (73620) |
$73.20 |
$183 |
1.0× |
| Forearm 2 views (73090) |
$175.20 |
$438 |
2.3× |
| Hand 2 views (73120) |
$114.80 |
$287 |
1.3× |
| Hand 3 views (73130) |
$186 |
$465 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$171.20 |
$428 |
2.2× |
| Knee 3 views (73562) |
$201.60 |
$504 |
2.6× |
| MRA head w/o contrast (70544) |
$1,012.40 |
$2,531 |
4.8× |
| MRI abdomen w/o contrast (74181) |
$496.80 |
$1,242 |
2.4× |
| MRI cervical spine w/o contrast (72141) |
$871.20 |
$2,178 |
4.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$755.60 |
$1,889 |
2.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,053.20 |
$2,633 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$746.80 |
$1,867 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$908.40 |
$2,271 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,330.80 |
$3,327 |
4.4× |
| Neck soft tissue (70360) |
$178.80 |
$447 |
2.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$236.80 |
$592 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$254.40 |
$636 |
2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$290 |
$725 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297.80 |
$744.50 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$62.40 |
$156 |
0.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$42.80 |
$107 |
0.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$227.60 |
$569 |
3.0× |
| Scapula complete (73010) |
$36 |
$90 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$347.60 |
$869 |
3.8× |
| Us abdl aorta screen aaa (76706) |
$116.80 |
$292 |
1.3× |
| Us breast unilateral complete (76641) |
$389.60 |
$974 |
4.3× |
| Us breast unilateral limited (76642) |
$106 |
$265 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$544.80 |
$1,362 |
5.9× |
| Us pelvic non ob complete (76856) |
$434 |
$1,085 |
4.7× |
| Us retroperitoneal complete (76770) |
$255.20 |
$638 |
2.8× |
| Us retroperitoneal limited (76775) |
$244.40 |
$611 |
2.7× |
| Us scrotum and contents (76870) |
$96 |
$240 |
1.0× |
| Us soft tissue head/neck (76536) |
$387.60 |
$969 |
4.2× |
| Us xtr non-vasc lmtd (76882) |
$399.60 |
$999 |
4.4× |
| Wrist 2 views (73100) |
$134.80 |
$337 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$105.60 |
$264 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$286.40 |
$716 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$195.40 |
$488.50 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$108.40 |
$271 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$265.60 |
$664 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$167.80 |
$419.50 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$106.80 |
$267 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$80.80 |
$202 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$138 |
$345 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$240.80 |
$602 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$352 |
$880 |
3.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$108.40 |
$271 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$246.80 |
$617 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$116.40 |
$291 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$189.20 |
$473 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$85.60 |
$214 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$88.80 |
$222 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$237.20 |
$593 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$82.80 |
$207 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$276.80 |
$692 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$158 |
$395 |
2.1× |
| Xr shoulder 1 view (73020) |
$194.40 |
$486 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$90.80 |
$227 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$270.80 |
$677 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$155.20 |
$388 |
2.0× |