| Abdomen 2 views (74019) |
$224 |
$263 |
2.1× |
| Ankle 2 views (73600) |
$147 |
$173 |
1.7× |
| Bone age studies (77072) |
$161 |
$189 |
1.5× |
| Bone survey complete (77075) |
$451 |
$531 |
4.3× |
| Cervical spine 2 or 3 views (72040) |
$208 |
$245 |
2.4× |
| Chest 1 view (71045) |
$149 |
$175 |
1.7× |
| Chest 3 views (71047) |
$275 |
$323 |
3.1× |
| Clavicle complete (73000) |
$169 |
$199 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$404 |
$475 |
3.8× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$295 |
$347 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,730 |
$4,388 |
10.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,965 |
$3,488 |
12.4× |
| CT abdomen w contrast (74160) |
$2,004 |
$2,358 |
11.4× |
| CT abdomen w wo contrast (74170) |
$2,404 |
$2,828 |
13.6× |
| CT abdomen w/o contrast (74150) |
$1,742 |
$2,049 |
16.6× |
| CT angiography upper extremity lt (73206) |
$2,635 |
$3,100 |
15.0× |
| CT c-spine w/o contrast (72125) |
$1,351 |
$1,589 |
12.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,865 |
$2,194 |
10.6× |
| CT cervical spine with contrast (72126) |
$1,568 |
$1,845 |
4.5× |
| CT chest w/wo contrast (71270) |
$2,100 |
$2,471 |
11.9× |
| CT chest with contrast (71260) |
$1,614 |
$1,899 |
9.2× |
| CT head/brain with contrast (70460) |
$1,208 |
$1,421 |
6.9× |
| CT head/brain without and with contrast (70470) |
$1,448 |
$1,704 |
8.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$340 |
$400 |
3.9× |
| CT iac w contrast (70481) |
$1,216 |
$1,430 |
6.9× |
| CT lower ext w/o (73700) |
$912 |
$1,073 |
8.7× |
| CT lower extremity w wo contrast (73702) |
$1,094 |
$1,287 |
6.2× |
| CT lower extremity with contrast (73701) |
$912 |
$1,073 |
5.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,681 |
$1,978 |
9.5× |
| CT lumbar spine w/o contrast (72131) |
$1,351 |
$1,589 |
12.9× |
| CT lumbar spine with contrast (72132) |
$1,568 |
$1,845 |
4.5× |
| CT maxillofacial w contrast (70487) |
$1,403 |
$1,650.50 |
8.0× |
| CT maxillofacial w/o contrast (70486) |
$1,218.50 |
$1,433.50 |
11.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,972 |
$2,320 |
11.2× |
| CT neck soft tissue w contrast (70491) |
$1,422 |
$1,673 |
8.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,965 |
$2,312 |
11.2× |
| CT orbits w/o contrast (70480) |
$1,403 |
$1,650 |
13.4× |
| CT pelvis w & w/o contrast (72194) |
$1,561 |
$1,836 |
8.9× |
| CT pelvis w/o contrast (72192) |
$1,223 |
$1,439 |
11.6× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$383 |
$450 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,705 |
$2,006 |
9.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,235 |
$1,453 |
11.8× |
| CT thoracic spine w/contrast (72129) |
$1,568 |
$1,845 |
8.9× |
| CT thoracic spine w/o contrast (72128) |
$1,351 |
$1,589 |
12.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,865 |
$2,194 |
10.6× |
| CT thorax w/o contrast (71250) |
$1,522 |
$1,790 |
14.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,094 |
$1,287 |
6.2× |
| CT upper extremity w/o contrast rt (73200) |
$912 |
$1,073 |
8.7× |
| CT upper extremity with contrast (73201) |
$912 |
$1,073 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,550 |
$3,000 |
14.5× |
| Cta Abdomen (74175) |
$2,635 |
$3,100 |
15.0× |
| CTA abdomen pelvis (74174) |
$2,032 |
$2,390 |
5.8× |
| CTA chest (71275) |
$1,618 |
$1,904 |
9.2× |
| Cta Head (70496) |
$2,125 |
$2,500 |
12.1× |
| CTA lwr ext w&w/o contrast (73706) |
$3,060 |
$3,600 |
17.4× |
| Cta Neck (70498) |
$3,230 |
$3,800 |
18.3× |
| Cta Pelvis (72191) |
$2,380 |
$2,800 |
13.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$297 |
$349 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$297 |
$349 |
3.4× |
| Esophagus (74220) |
$284 |
$334 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$187 |
$220 |
0.8× |
| Foot 2 views (73620) |
$153 |
$180 |
1.8× |
| Forearm 2 views (73090) |
$136 |
$160 |
1.6× |
| Hand 2 views (73120) |
$128 |
$151 |
1.2× |
| Hand 3 views (73130) |
$142 |
$167 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$158 |
$186 |
1.8× |
| Knee 3 views (73562) |
$177 |
$208 |
2.0× |
| Neck soft tissue (70360) |
$190 |
$223 |
2.2× |
| Nm whole blood volume (78122) |
$8 |
$9 |
0.0× |
| Pelvis 1 or 2 views (72170) |
$139 |
$163 |
1.3× |
| Pr red cell survival study (78130) |
$20 |
$23 |
0.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$247 |
$291 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$366 |
$431 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$218 |
$256 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$210 |
$247 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$231 |
$272 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$162 |
$190 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$255 |
$300 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$187 |
$220 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$483 |
$568 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$162 |
$191 |
1.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$4 |
$5 |
0.0× |
| Sacroiliac Joints < 3 Views (72200) |
$135 |
$159 |
1.3× |
| Scapula complete (73010) |
$177 |
$208 |
1.7× |
| Sella turcica (70240) |
$167 |
$197 |
1.9× |
| Small bowel series (74250) |
$343 |
$403 |
1.9× |
| Spine thoracic 3 views (72072) |
$216 |
$254 |
2.1× |
| Thoracolumbar 2 views (72080) |
$209 |
$246 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$316 |
$372 |
3.0× |
| Upper Extremity Infant (73092) |
$162 |
$191 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$428 |
$503 |
2.4× |
| Us abdl aorta screen aaa (76706) |
$492 |
$579 |
4.7× |
| Us breast unilateral complete (76641) |
$314 |
$369 |
3.0× |
| Us breast unilateral limited (76642) |
$157 |
$185 |
1.8× |
| Us chest (76604) |
$314 |
$369 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$292 |
$343 |
2.8× |
| Us ob transvaginal (76817) |
$422 |
$497 |
4.0× |
| Us pelvic non ob complete (76856) |
$369 |
$434 |
3.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$327 |
$385 |
3.1× |
| Us pregnancy ltd (76815) |
$253 |
$298 |
2.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$345 |
$406 |
3.3× |
| Us retroperitoneal complete (76770) |
$371 |
$437 |
3.5× |
| Us retroperitoneal limited (76775) |
$240 |
$282 |
2.3× |
| Us scrotum and contents (76870) |
$316 |
$372 |
3.0× |
| Us soft tissue head/neck (76536) |
$335 |
$394 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$240 |
$282 |
2.3× |
| Wrist 2 views (73100) |
$125 |
$147 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$309 |
$364 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$169 |
$199 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$158 |
$186 |
1.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$632 |
$743 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$142 |
$167 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$146 |
$172 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$126 |
$148 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$168 |
$198 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$235 |
$276 |
2.2× |
| X-ray exam of femur 1 (73551) |
$145 |
$171 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$243 |
$286 |
2.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$158 |
$186 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$136 |
$160 |
1.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$456 |
$537 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$198 |
$233 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$150 |
$176 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$162 |
$191 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$190 |
$223 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$349 |
$411 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$88 |
$103 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$153 |
$180 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$228 |
$268 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$175 |
$206 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$213 |
$250 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$134 |
$157.50 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$306 |
$360 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$148 |
$174 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$190 |
$224 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$275 |
$323 |
3.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$167 |
$197 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$275 |
$323 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$197 |
$232 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$146 |
$172 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$225 |
$265 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$187 |
$220 |
2.1× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$13 |
$15 |
0.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$201 |
$237 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$247 |
$291 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$120 |
$141 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$142 |
$167 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$314 |
$369 |
3.0× |
| Xr chest 4+ views (71048) |
$306 |
$360 |
2.9× |
| Xr Cholecystography Oral Contrast (74290) |
$247 |
$291 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$107 |
$126 |
1.2× |
| Xr optic foramina (70190) |
$195 |
$229 |
2.2× |
| Xr shoulder 1 view (73020) |
$150 |
$176 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$264 |
$311 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$162 |
$191 |
1.9× |
| Xr tmj bilateral (70330) |
$365 |
$429 |
4.2× |
| Xray knee 1 or 2 views rt (73560) |
$150 |
$176 |
1.7× |