| Abdomen 2 views (74019) |
$492.80 |
$704 |
4.7× |
| Ankle 2 views (73600) |
$452.90 |
$647 |
5.2× |
| Arthrogram shoulder (73040) |
$853.30 |
$1,219 |
2.4× |
| Bone age studies (77072) |
$253.40 |
$362 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$442.40 |
$632 |
5.1× |
| Chest 1 view (71045) |
$280.70 |
$401 |
3.2× |
| Clavicle complete (73000) |
$455.70 |
$651 |
5.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$8,430.10 |
$12,043 |
24.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,757.60 |
$5,368 |
15.7× |
| CT abdomen w contrast (74160) |
$4,744.60 |
$6,778 |
26.9× |
| CT abdomen w wo contrast (74170) |
$5,457.20 |
$7,796 |
31.0× |
| CT abdomen w/o contrast (74150) |
$2,582.30 |
$3,689 |
24.6× |
| CT angiography upper extremity lt (73206) |
$2,240 |
$3,200 |
12.7× |
| CT c-spine w/o contrast (72125) |
$2,406.60 |
$3,438 |
22.9× |
| CT cervical spine w&w/o contrast (72127) |
$3,377.50 |
$4,825 |
19.2× |
| CT chest w/wo contrast (71270) |
$5,527.90 |
$7,897 |
31.4× |
| CT chest with contrast (71260) |
$4,136.30 |
$5,909 |
23.5× |
| CT head/brain with contrast (70460) |
$1,436.40 |
$2,052 |
8.2× |
| CT head/brain without and with contrast (70470) |
$2,066.40 |
$2,952 |
11.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$146.30 |
$209 |
1.7× |
| CT iac w contrast (70481) |
$1,819.30 |
$2,599 |
10.3× |
| CT lower ext w/o (73700) |
$2,188.20 |
$3,126 |
20.8× |
| CT lower extremity w wo contrast (73702) |
$1,887.90 |
$2,697 |
10.7× |
| CT lower extremity with contrast (73701) |
$2,160.90 |
$3,087 |
12.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,930.60 |
$2,758 |
11.0× |
| CT lumbar spine w/o contrast (72131) |
$2,870.70 |
$4,101 |
27.3× |
| CT maxillofacial w contrast (70487) |
$1,819.30 |
$2,599 |
10.3× |
| CT maxillofacial w/o contrast (70486) |
$2,146.20 |
$3,066 |
20.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,911 |
$2,730 |
10.8× |
| CT neck soft tissue w contrast (70491) |
$2,360.40 |
$3,372 |
13.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,876 |
$2,680 |
10.6× |
| CT orbits w/o contrast (70480) |
$2,188.20 |
$3,126 |
20.8× |
| CT pelvis w & w/o contrast (72194) |
$1,934.10 |
$2,763 |
11.0× |
| CT pelvis w/o contrast (72192) |
$1,750 |
$2,500 |
16.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,092.30 |
$2,989 |
11.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,750 |
$2,500 |
16.7× |
| CT thoracic spine w/o contrast (72128) |
$2,678.20 |
$3,826 |
25.5× |
| CT thoracic spine w/wo contrast (72130) |
$2,123.10 |
$3,033 |
12.0× |
| CT thorax w/o contrast (71250) |
$3,615.50 |
$5,165 |
34.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,905.40 |
$2,722 |
10.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,167.20 |
$3,096 |
20.6× |
| CT upper extremity with contrast (73201) |
$1,850.80 |
$2,644 |
5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$6,922.30 |
$9,889 |
39.3× |
| Cta Abdomen (74175) |
$2,675.40 |
$3,822 |
15.2× |
| CTA abdomen pelvis (74174) |
$6,324.50 |
$9,035 |
18.0× |
| CTA chest (71275) |
$4,526.20 |
$6,466 |
25.7× |
| Cta Head (70496) |
$2,536.80 |
$3,624 |
14.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,404.50 |
$3,435 |
13.6× |
| Cta Neck (70498) |
$2,536.80 |
$3,624 |
14.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$427.70 |
$611 |
4.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$594.30 |
$849 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$71.40 |
$102 |
0.3× |
| Foot 2 views (73620) |
$452.90 |
$647 |
5.2× |
| Forearm 2 views (73090) |
$471.80 |
$674 |
5.4× |
| Hand 2 views (73120) |
$469 |
$670 |
4.5× |
| Hand 3 views (73130) |
$473.20 |
$676 |
5.4× |
| Humerus Min 2 Views Left (73060) |
$500.50 |
$715 |
5.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$280.70 |
$401 |
2.7× |
| Knee 3 views (73562) |
$495.60 |
$708 |
5.7× |
| MRA head w & w/o contrast (70546) |
$2,889.60 |
$4,128 |
8.2× |
| MRA head w/o contrast (70544) |
$3,466.40 |
$4,952 |
14.5× |
| MRA head with contrast (70545) |
$2,889.60 |
$4,128 |
8.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,919.70 |
$4,171 |
8.3× |
| MRA neck w/o contrast (70547) |
$2,555.70 |
$3,651 |
10.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,687.20 |
$6,696 |
13.4× |
| MRI abdomen w/o contrast (74181) |
$2,080.40 |
$2,972 |
8.7× |
| MRI c-spine with contrast (72142) |
$3,007.90 |
$4,297 |
8.6× |
| MRI cervical spine w/o contrast (72141) |
$4,322.50 |
$6,175 |
18.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,340.10 |
$3,343 |
9.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,892.40 |
$4,132 |
12.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,236.10 |
$4,623 |
9.2× |
| MRI pelvis w contrast (72196) |
$2,889.60 |
$4,128 |
8.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,322.50 |
$6,175 |
12.3× |
| MRI pelvis w/o contrast (72195) |
$2,555.70 |
$3,651 |
10.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,889.60 |
$4,128 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,889.60 |
$4,128 |
8.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,040.70 |
$7,201 |
14.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,842.70 |
$4,061 |
8.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,040.70 |
$7,201 |
14.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,889.60 |
$4,128 |
8.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,040.70 |
$7,201 |
14.4× |
| MRI thoracic spine w/o contrast (72146) |
$4,322.50 |
$6,175 |
18.0× |
| MRI tmj (70336) |
$2,842.70 |
$4,061 |
11.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,810.10 |
$5,443 |
15.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,889.60 |
$4,128 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,340.10 |
$3,343 |
9.8× |
| Neck soft tissue (70360) |
$373.10 |
$533 |
4.3× |
| Osseous survey infant (77076) |
$238.70 |
$341 |
2.3× |
| Osseous survey limited (77074) |
$606.90 |
$867 |
5.8× |
| Pelvis 1 or 2 views (72170) |
$317.80 |
$454 |
3.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,889.60 |
$4,128 |
8.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$410.20 |
$586 |
3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$381.50 |
$545 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$299.60 |
$428 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$373.10 |
$533 |
4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$324.80 |
$464 |
3.7× |
| Ribs bilateral 3 views (71110) |
$357 |
$510 |
3.4× |
| Scapula complete (73010) |
$280.70 |
$401 |
2.7× |
| Spine thoracic 3 views (72072) |
$665 |
$950 |
6.3× |
| Tmj unilateral (70328) |
$306.60 |
$438 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$1,085.70 |
$1,551 |
10.3× |
| Umbilical-artery Doppler (OB) (76820) |
$233.10 |
$333 |
2.2× |
| Upper Extremity Infant (73092) |
$280.70 |
$401 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$385.70 |
$551 |
3.7× |
| Us breast unilateral complete (76641) |
$680.40 |
$972 |
6.5× |
| Us chest (76604) |
$289.10 |
$413 |
2.8× |
| Us ob transvaginal (76817) |
$379.40 |
$542 |
3.6× |
| Us pelvic non ob complete (76856) |
$1,349.60 |
$1,928 |
12.9× |
| Us pregnancy ltd (76815) |
$350.70 |
$501 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$379.40 |
$542 |
3.6× |
| Us retroperitoneal complete (76770) |
$800.10 |
$1,143 |
7.6× |
| Us scrotum and contents (76870) |
$1,071 |
$1,530 |
10.2× |
| Us soft tissue head/neck (76536) |
$1,257.20 |
$1,796 |
12.0× |
| Wrist 2 views (73100) |
$402.50 |
$575 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$494.20 |
$706 |
4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$238.70 |
$341 |
2.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$434 |
$620 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$455.70 |
$651 |
5.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$460.60 |
$658 |
5.3× |
| X-ray exam hip uni 1 view (73501) |
$214.90 |
$307 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$357 |
$510 |
4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$467.60 |
$668 |
4.5× |
| X-ray eye for foreign body (70030) |
$238.70 |
$341 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$344.40 |
$492 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$280.70 |
$401 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$560.70 |
$801 |
6.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$280.70 |
$401 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$410.20 |
$586 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$214.90 |
$307 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$280.70 |
$401 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$680.40 |
$972 |
6.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$884.80 |
$1,264 |
8.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$310.80 |
$444 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$280.70 |
$401 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$280.70 |
$401 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$288.40 |
$412 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$455 |
$650 |
5.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$550.20 |
$786 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$280.70 |
$401 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$413.70 |
$591 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$471.80 |
$674 |
5.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$300.30 |
$429 |
3.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$253.40 |
$362 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$490 |
$700 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$291.20 |
$416 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$350.70 |
$501 |
4.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$264.60 |
$378 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$280.70 |
$401 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$529.20 |
$756 |
5.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$294.70 |
$421 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$460.60 |
$658 |
5.3× |
| Xr c-spine 6 or more views (72052) |
$410.20 |
$586 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$469 |
$670 |
5.4× |
| Xr shoulder 1 view (73020) |
$280.70 |
$401 |
3.2× |
| Xr spine cervical 4 or 5 views (72050) |
$680.40 |
$972 |
6.5× |
| Xr tibia/fibula 2 views (73590) |
$351.40 |
$502 |
4.0× |
| Xr tmj bilateral (70330) |
$608.30 |
$869 |
7.0× |
| Xray knee 1 or 2 views rt (73560) |
$574 |
$820 |
6.6× |