| Abdomen 2 views (74019) |
$535.50 |
$630 |
4.6× |
| Ankle 2 views (73600) |
$389.30 |
$458 |
4.0× |
| Bone age studies (77072) |
$283.05 |
$333 |
2.4× |
| Bone survey complete (77075) |
$833 |
$980 |
7.2× |
| Cervical spine 2 or 3 views (72040) |
$428.40 |
$504 |
4.4× |
| Chest 1 view (71045) |
$427.12 |
$502.50 |
4.4× |
| Chest xray 3 views (71047) |
$652.80 |
$768 |
6.7× |
| Clavicle complete (73000) |
$386.75 |
$455 |
4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,000.05 |
$2,353 |
17.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,035.85 |
$7,101 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,571.70 |
$4,202 |
13.4× |
| CT abdomen w contrast (74160) |
$2,416.55 |
$2,843 |
12.4× |
| CT abdomen w wo contrast (74170) |
$2,832.20 |
$3,332 |
14.5× |
| CT abdomen w/o contrast (74150) |
$1,660.90 |
$1,954 |
14.3× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,245.30 |
$3,818 |
16.6× |
| CT angiography upper extremity lt (73206) |
$1,745.05 |
$2,053 |
8.9× |
| CT c-spine w/contrast (72126) |
$3,009.85 |
$3,541 |
7.7× |
| CT c-spine w/o contrast (72125) |
$2,504.10 |
$2,946 |
21.5× |
| CT cervical spine w&w/o contrast (72127) |
$3,912.55 |
$4,603 |
20.0× |
| CT chest w contrast (71260) |
$2,629.05 |
$3,093 |
13.5× |
| CT chest w/wo contrast (71270) |
$3,286.10 |
$3,866 |
16.8× |
| CT head/brain with contrast (70460) |
$2,310.30 |
$2,718 |
11.8× |
| CT head/brain without and with contrast (70470) |
$3,014.10 |
$3,546 |
15.4× |
| CT iac w contrast (70481) |
$2,439.50 |
$2,870 |
12.5× |
| CT limited/localized follow up study (76380) |
$808.35 |
$951 |
8.3× |
| CT lower ext w/o (73700) |
$1,904.85 |
$2,241 |
16.4× |
| CT lower extremity w wo contrast (73702) |
$2,975.85 |
$3,501 |
15.2× |
| CT lower extremity w/contrast material (73701) |
$2,289.90 |
$2,694 |
11.7× |
| CT lumbar spine w & w/o contrast (72133) |
$3,278.45 |
$3,857 |
16.8× |
| CT lumbar spine w/contrast (72132) |
$2,521.95 |
$2,967 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$2,097.80 |
$2,468 |
18.0× |
| CT maxillofacial w contrast (70487) |
$2,400.40 |
$2,824 |
12.3× |
| CT maxillofacial w/wo contrast (70488) |
$3,119.50 |
$3,670 |
16.0× |
| CT maxillofacial wo contrast (70486) |
$1,996.65 |
$2,349 |
17.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,109.30 |
$3,658 |
15.9× |
| CT orbits w/o contrast (70480) |
$1,840.25 |
$2,165 |
15.8× |
| CT pelvis w/o contrast (72192) |
$1,937.15 |
$2,279 |
16.6× |
| CT pelvis w/wo contrast (72194) |
$2,561.90 |
$3,014 |
13.1× |
| CT scan of arm combo (73202) |
$3,322.65 |
$3,909 |
17.0× |
| CT soft tissue neck w contrast (70491) |
$2,719.15 |
$3,199 |
13.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,267.40 |
$3,844 |
16.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,091.85 |
$2,461 |
18.0× |
| CT thoracic spine w/contrast (72129) |
$2,626.50 |
$3,090 |
13.4× |
| CT thoracic spine w/o contrast (72128) |
$2,185.35 |
$2,571 |
18.8× |
| CT thoracic spine w/wo contrast (72130) |
$3,413.60 |
$4,016 |
17.5× |
| CT thorax w/o contrast (71250) |
$2,022.15 |
$2,379 |
17.4× |
| CT upper ext wo (73200) |
$2,126.70 |
$2,502 |
18.3× |
| CT upper extremity with contrast (73201) |
$2,555.95 |
$3,007 |
6.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,592.10 |
$4,226 |
18.4× |
| Cta Abdomen (74175) |
$3,660.95 |
$4,307 |
18.7× |
| CTA abdomen pelvis (74174) |
$6,375.85 |
$7,501 |
16.4× |
| CTA chest (71275) |
$3,972.90 |
$4,674 |
20.3× |
| Cta Head (70496) |
$3,429.75 |
$4,035 |
17.5× |
| Cta Neck (70498) |
$3,549.60 |
$4,176 |
18.2× |
| Cta Pelvis (72191) |
$3,115.25 |
$3,665 |
15.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$634.95 |
$747 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$255.85 |
$301 |
2.6× |
| Facial bones min 3 views (70150) |
$554.20 |
$652 |
4.8× |
| Foot 2 views (73620) |
$305.15 |
$359 |
3.1× |
| Forearm 2 views (73090) |
$380.80 |
$448 |
3.9× |
| Hand 2 views (73120) |
$282.20 |
$332 |
2.4× |
| Knee 3 views (73562) |
$459 |
$540 |
4.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,643.95 |
$4,287 |
9.4× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$195.50 |
$230 |
2.0× |
| MRA head w & w/o contrast (70546) |
$4,373.25 |
$5,145 |
11.2× |
| MRA head w/o contrast (70544) |
$3,031.95 |
$3,567 |
11.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,230.45 |
$4,977 |
10.9× |
| MRA neck w/o contrast (70547) |
$2,712.35 |
$3,191 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,578.10 |
$5,386 |
11.8× |
| MRI abdomen w/o contrast (74181) |
$2,833.90 |
$3,334 |
10.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,707.70 |
$4,362 |
9.5× |
| MRI c-spine with contrast (72142) |
$4,172.65 |
$4,909 |
10.7× |
| MRI cervical spine w/o contrast (72141) |
$3,415.30 |
$4,018 |
12.8× |
| MRI chest w/o & w/contrast material (71552) |
$4,282.30 |
$5,038 |
11.0× |
| MRI chest w/o contrast (71550) |
$2,855.15 |
$3,359 |
10.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,323.95 |
$5,087 |
11.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,070.20 |
$3,612 |
11.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,147.10 |
$2,526 |
8.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,796.10 |
$4,466 |
9.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,306.10 |
$5,066 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$2,901.05 |
$3,413 |
10.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,391.10 |
$5,166 |
11.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,330.30 |
$3,918 |
8.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,848 |
$6,880 |
15.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,551.75 |
$5,355 |
11.7× |
| MRI temporomandibular joint (70336) |
$2,550 |
$3,000 |
9.6× |
| MRI thoracic spine w/o contrast (72146) |
$3,221.50 |
$3,790 |
12.1× |
| MRI up ext w/o contrast (73218) |
$2,887.45 |
$3,397 |
10.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,196.85 |
$3,761 |
12.0× |
| MRI, joint upper extrem combo (73223) |
$3,882.80 |
$4,568 |
10.0× |
| Neck soft tissue (70360) |
$318.75 |
$375 |
3.3× |
| Osseous survey limited (77074) |
$305.15 |
$359 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$362.10 |
$426 |
3.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$431.80 |
$508 |
4.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$296.65 |
$349 |
3.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$408.85 |
$481 |
4.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$195.92 |
$230.50 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$374.85 |
$441 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$281.35 |
$331 |
2.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$417.35 |
$491 |
4.3× |
| Radex Hand Minimum 3 Views (73130) |
$463.25 |
$545 |
4.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$363.80 |
$428 |
3.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$450.50 |
$530 |
3.9× |
| Radex Humerus Minimum 2 Views (73060) |
$371.45 |
$437 |
3.8× |
| Radex Kne 1/2 Views (73560) |
$346.80 |
$408 |
3.6× |
| Radex Kne Compl 4/More Views (73564) |
$508.72 |
$598.50 |
4.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$598.40 |
$704 |
5.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$421.60 |
$496 |
4.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$572.90 |
$674 |
4.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$443.70 |
$522 |
4.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$234.60 |
$276 |
2.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$484.50 |
$570 |
4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$372.30 |
$438 |
3.8× |
| Radex Toe Minimum 2 Views (73660) |
$281.35 |
$331 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$238.85 |
$281 |
2.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$425.85 |
$501 |
4.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$402.90 |
$474 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$630.70 |
$742 |
5.4× |
| Radiologic exam chest 2 views (71046) |
$507.45 |
$597 |
5.2× |
| Radiologic examination femur 1 view (73551) |
$239.70 |
$282 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$364.65 |
$429 |
3.8× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$374.85 |
$441 |
3.2× |
| Ribs bilateral 3 views (71110) |
$471.75 |
$555 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$368.90 |
$434 |
3.2× |
| Scapula (73010) |
$284.75 |
$335 |
2.4× |
| Shoulder 1 view (73020) |
$286.45 |
$337 |
3.0× |
| Spine thoracic 3 views (72072) |
$504.90 |
$594 |
4.3× |
| Thoracolumbar 2 views (72080) |
$634.10 |
$746 |
6.5× |
| Ultrasound Exam Aaa Screen (76706) |
$650.25 |
$765 |
5.6× |
| Ultrasound, abdomen limited (76705) |
$736.95 |
$867 |
6.3× |
| Us chest (76604) |
$548.25 |
$645 |
4.7× |
| Us compl joint r-t w/image documentation (76881) |
$528.70 |
$622 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$317.90 |
$374 |
2.7× |
| Us ob limited (76815) |
$555.05 |
$653 |
4.8× |
| Us ob transvaginal (76817) |
$640.90 |
$754 |
5.5× |
| Us pelvic non ob complete (76856) |
$902.70 |
$1,062 |
7.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$892.50 |
$1,050 |
7.7× |
| Us retroperitoneal complete (76770) |
$1,003.85 |
$1,181 |
8.6× |
| Us retroperitoneal limited (76775) |
$965.60 |
$1,136 |
8.3× |
| Us scrotum and contents (76870) |
$792.20 |
$932 |
6.8× |
| Us soft tissue head/neck (76536) |
$908.65 |
$1,069 |
7.8× |
| Wrist 2 views (73100) |
$366.35 |
$431 |
3.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$681.70 |
$802 |
5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$357.85 |
$421 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$375.70 |
$442 |
3.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$504.90 |
$594 |
5.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$554.20 |
$652 |
4.8× |
| X-ray exam of femur 2/> (73552) |
$311.10 |
$366 |
3.2× |
| X-ray eye for foreign body (70030) |
$238.85 |
$281 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$458.15 |
$539 |
4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$274.55 |
$323 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$346.80 |
$408 |
3.6× |
| X-ray leg, infant (73592) |
$335.75 |
$395 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$347.65 |
$409 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$775.20 |
$912 |
6.7× |
| X-ray nose-rectum child f.b. (76010) |
$289.85 |
$341 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$348.50 |
$410 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$415.65 |
$489 |
4.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$514.25 |
$605 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$559.30 |
$658 |
4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$374.85 |
$441 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$476.85 |
$561 |
4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$296.65 |
$349 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$360.40 |
$424 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$299.20 |
$352 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$362.95 |
$427 |
3.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$425.85 |
$501 |
4.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$442.85 |
$521 |
3.8× |
| Xr bone length studies (77073) |
$538.05 |
$633 |
4.6× |
| Xr c-spine 4 or 5 views (72050) |
$684.25 |
$805 |
5.9× |
| Xr c-spine 6 or more views (72052) |
$857.65 |
$1,009 |
7.4× |