| Abdomen 2 views (74019) |
$137.60 |
$172 |
1.3× |
| Ankle 2 views (73600) |
$105.60 |
$132 |
1.2× |
| Bone age studies (77072) |
$227.20 |
$284 |
2.2× |
| Bone survey complete (77075) |
$227.20 |
$284 |
2.2× |
| Cervical spine 2 or 3 views (72040) |
$149.60 |
$187 |
1.7× |
| Chest 1 view (71045) |
$138.40 |
$173 |
1.6× |
| Chest 3 views (71047) |
$218.40 |
$273 |
2.5× |
| Clavicle complete (73000) |
$184.80 |
$231 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$106.40 |
$133 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,852 |
$2,315 |
5.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,640 |
$2,050 |
6.9× |
| CT abdomen w contrast (74160) |
$1,161.28 |
$1,451.60 |
6.6× |
| CT abdomen w wo contrast (74170) |
$1,273.60 |
$1,592 |
7.3× |
| CT abdomen w/o contrast (74150) |
$1,047.85 |
$1,309.82 |
10.1× |
| CT c-spine w/o contrast (72125) |
$1,052.63 |
$1,315.78 |
10.1× |
| CT chest w/wo contrast (71270) |
$1,055.64 |
$1,319.55 |
6.0× |
| CT chest with contrast (71260) |
$1,083.20 |
$1,354 |
6.2× |
| CT head/brain with contrast (70460) |
$934.91 |
$1,168.64 |
5.3× |
| CT head/brain without and with contrast (70470) |
$1,135.08 |
$1,418.86 |
6.5× |
| CT iac w contrast (70481) |
$650.20 |
$812.75 |
3.7× |
| CT lower ext w/o (73700) |
$797.43 |
$996.78 |
7.6× |
| CT lower extremity w wo contrast (73702) |
$476.20 |
$595.25 |
2.7× |
| CT lower extremity with contrast (73701) |
$400.60 |
$500.75 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$1,046.60 |
$1,308.25 |
10.0× |
| CT maxillofacial w contrast (70487) |
$400.60 |
$500.75 |
2.3× |
| CT maxillofacial w/o contrast (70486) |
$792 |
$990 |
7.6× |
| CT neck soft tissue w contrast (70491) |
$800.80 |
$1,001 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$801.80 |
$1,002.25 |
4.6× |
| CT orbits w/o contrast (70480) |
$749.38 |
$936.73 |
7.2× |
| CT pelvis w & w/o contrast (72194) |
$1,161.40 |
$1,451.75 |
6.6× |
| CT pelvis w/o contrast (72192) |
$1,118.40 |
$1,398 |
10.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$951.20 |
$1,189 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$792 |
$990 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$911.40 |
$1,139.25 |
8.7× |
| CT thorax w/o contrast (71250) |
$977.24 |
$1,221.55 |
9.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$757.80 |
$947.25 |
4.3× |
| CT upper extremity w/o contrast rt (73200) |
$953.48 |
$1,191.86 |
9.1× |
| CT upper extremity with contrast (73201) |
$655.20 |
$819 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$383.20 |
$479 |
2.2× |
| Cta Abdomen (74175) |
$960 |
$1,200 |
5.5× |
| CTA chest (71275) |
$960 |
$1,200 |
5.5× |
| Cta Head (70496) |
$212 |
$265 |
1.2× |
| Cta Neck (70498) |
$212 |
$265 |
1.2× |
| Echoencephalography real time imaging (76506) |
$440 |
$550 |
4.2× |
| Fetal biophysical profile non-stress testing (76818) |
$339 |
$423.75 |
3.3× |
| Foot 2 views (73620) |
$105.60 |
$132 |
1.2× |
| Forearm 2 views (73090) |
$145.20 |
$181.50 |
1.7× |
| Hand 2 views (73120) |
$137.60 |
$172 |
1.3× |
| Hand 3 views (73130) |
$161.20 |
$201.50 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$118.80 |
$148.50 |
1.4× |
| Hysterosalpingogram (74740) |
$96 |
$120 |
0.4× |
| Knee 3 views (73562) |
$149.60 |
$187 |
1.7× |
| Neck soft tissue (70360) |
$101.20 |
$126.50 |
1.2× |
| Osseous survey limited (77074) |
$126.86 |
$158.57 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$132.80 |
$166 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$61.60 |
$77 |
0.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$197.20 |
$246.50 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$184 |
$230 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$154 |
$192.50 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$258.40 |
$323 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$178.40 |
$223 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$167.20 |
$209 |
1.9× |
| Ribs bilateral 3 views (71110) |
$227.20 |
$284 |
2.2× |
| Scapula complete (73010) |
$179.60 |
$224.50 |
1.7× |
| Spine thoracic 3 views (72072) |
$185.60 |
$232 |
1.8× |
| Tmj unilateral (70328) |
$132 |
$165 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$367.31 |
$459.14 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$223.60 |
$279.50 |
2.1× |
| Unlisted Ultrasound Procedure (76999) |
$180.40 |
$225.50 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$227.20 |
$284 |
2.2× |
| Us chest (76604) |
$213.60 |
$267 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$224 |
$280 |
2.1× |
| Us guided compression repair (76936) |
$454.80 |
$568.50 |
2.1× |
| Us infant hips dynamic (76885) |
$300 |
$375 |
3.5× |
| Us kidney transplant (76776) |
$201.60 |
$252 |
1.9× |
| Us ob transvaginal (76817) |
$420 |
$525 |
4.0× |
| Us pelvic non ob complete (76856) |
$365.23 |
$456.54 |
3.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$365.23 |
$456.54 |
3.5× |
| Us pregnancy ltd (76815) |
$227.20 |
$284 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$428.78 |
$535.98 |
4.1× |
| Us retroperitoneal complete (76770) |
$387.20 |
$484 |
3.7× |
| Us retroperitoneal limited (76775) |
$227.20 |
$284 |
2.2× |
| Us scrotum and contents (76870) |
$227.20 |
$284 |
2.2× |
| Us soft tissue head/neck (76536) |
$317.60 |
$397 |
3.0× |
| Us xtr non-vasc lmtd (76882) |
$176 |
$220 |
1.7× |
| Wrist 2 views (73100) |
$101.20 |
$126.50 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$258.87 |
$323.59 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$154 |
$192.50 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$159.27 |
$199.09 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$96.80 |
$121 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$140 |
$175 |
1.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$227.20 |
$284 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$123.20 |
$154 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$140.40 |
$175.50 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$304 |
$380 |
2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$364.80 |
$456 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$210.40 |
$263 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$132 |
$165 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$132 |
$165 |
1.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$156.23 |
$195.29 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$121 |
$151.25 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$184.80 |
$231 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$92.60 |
$115.75 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$158.40 |
$198 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$220 |
$275 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$158.40 |
$198 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$123.20 |
$154 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$132 |
$165 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$132.60 |
$165.75 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$156.78 |
$195.98 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$227.20 |
$284 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$246.40 |
$308 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$157.60 |
$197 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$123.20 |
$154 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$162.80 |
$203.50 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$185.60 |
$232 |
2.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$125.40 |
$156.75 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$233.20 |
$291.50 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$153.20 |
$191.50 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$80.80 |
$101 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$148.20 |
$185.25 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$171.60 |
$214.50 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$154.16 |
$192.70 |
1.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$161.80 |
$202.25 |
1.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$110 |
$137.50 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$149.89 |
$187.36 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$268.55 |
$335.68 |
2.6× |
| Xr chest 4+ views (71048) |
$258.40 |
$323 |
2.5× |
| Xr finger(s) 2+ views (73140) |
$140.80 |
$176 |
1.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$153.20 |
$191.50 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$236.80 |
$296 |
2.3× |
| Xr tibia/fibula 2 views (73590) |
$167.20 |
$209 |
1.9× |
| Xr tmj bilateral (70330) |
$172.40 |
$215.50 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$120.74 |
$150.93 |
1.4× |