| Abdomen 1 View (74018) |
$374 |
$374 |
4.2× |
| Abdomen 2 views (74019) |
$447 |
$447 |
4.2× |
| Ankle 2 views (73600) |
$268 |
$268 |
3.0× |
| Bone age studies (77072) |
$257 |
$257 |
2.4× |
| Bone survey infant (77076) |
$350 |
$350 |
3.3× |
| Cat Scan Follow-Up Study (76380) |
$1,076 |
$1,076 |
12.1× |
| Chest 1 view (71045) |
$313 |
$313 |
3.5× |
| Chest 2 views (71046) |
$402 |
$402 |
4.5× |
| Chest 3 views (71047) |
$368 |
$368 |
4.1× |
| Chest 4 or more views (71048) |
$368 |
$368 |
3.4× |
| Clavicle complete (73000) |
$323 |
$323 |
3.6× |
| Contrast X-Ray Bladder (74430) |
$334 |
$334 |
0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$223 |
$223 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,437 |
$6,437 |
18.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,375 |
$4,375 |
17.9× |
| CT abdomen w contrast (74160) |
$3,641 |
$3,641 |
20.3× |
| CT abdomen w wo contrast (74170) |
$4,056 |
$4,056 |
22.6× |
| CT abdomen w/o contrast (74150) |
$2,517 |
$2,517 |
23.6× |
| CT Angio Abdomen and Pelvis (74174) |
$6,702 |
$6,702 |
18.8× |
| CT Angio Chest (71275) |
$4,173 |
$4,173 |
23.3× |
| CT Angio Head (70496) |
$3,808 |
$3,808 |
21.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,891 |
$2,891 |
16.1× |
| CT Angio Neck (70498) |
$3,584 |
$3,584 |
20.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,891 |
$2,891 |
16.1× |
| CT cervical spine w/ contrast (72126) |
$3,473 |
$3,473 |
9.7× |
| CT cervical spine w/o contrast (72125) |
$2,702 |
$2,702 |
25.3× |
| CT chest w contrast (71260) |
$3,366 |
$3,366 |
18.8× |
| CT chest w/wo contrast (71270) |
$3,647 |
$3,647 |
20.4× |
| CT head/brain with contrast (70460) |
$3,214 |
$3,214 |
17.9× |
| CT head/brain without and with contrast (70470) |
$3,260 |
$3,260 |
18.2× |
| CT iac w contrast (70481) |
$3,264 |
$3,264 |
18.2× |
| CT lower ext w/o (73700) |
$2,614 |
$2,614 |
24.5× |
| CT lower extremity w/contrast material (73701) |
$3,193 |
$3,193 |
17.8× |
| CT lumbar spine w contrast (72132) |
$3,115 |
$3,115 |
8.7× |
| CT lumbar spine w/o contrast (72131) |
$2,598 |
$2,598 |
24.3× |
| CT maxillofacial w contrast (70487) |
$3,163 |
$3,163 |
17.7× |
| CT maxillofacial wo contrast (70486) |
$2,099 |
$2,099 |
19.7× |
| CT neck tissue combo (70492) |
$3,740 |
$3,740 |
20.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,520 |
$3,520 |
19.6× |
| CT orbits w/o contrast (70480) |
$2,432 |
$2,432 |
22.8× |
| CT pelvis w&w/o contrast (72194) |
$3,582 |
$3,582 |
20.0× |
| CT pelvis w/o contrast (72192) |
$2,574 |
$2,574 |
24.1× |
| CT scan of leg combo (73702) |
$3,551 |
$3,551 |
19.8× |
| CT scans face/jaw combo (70488) |
$3,373 |
$3,373 |
18.8× |
| CT soft tissue neck w contrast (70491) |
$3,145 |
$3,145 |
17.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,318 |
$2,318 |
21.7× |
| CT thoracic spine w contrast (72129) |
$2,031 |
$2,031 |
11.3× |
| CT thoracic spine w/o contrast (72128) |
$2,584 |
$2,584 |
24.2× |
| CT thorax w/o contrast (71250) |
$2,628 |
$2,628 |
24.6× |
| CT upper ext wo (73200) |
$2,361 |
$2,361 |
22.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,056 |
$3,056 |
17.1× |
| CT upper extremity with contrast (73201) |
$3,298 |
$3,298 |
9.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,048 |
$5,048 |
28.2× |
| Cta Abdomen (74175) |
$4,261 |
$4,261 |
23.8× |
| CTA pelvis (72191) |
$3,888 |
$3,888 |
21.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$390 |
$390 |
3.7× |
| Dxa Bone Density Axial (77080) |
$548 |
$548 |
5.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$283 |
$283 |
3.2× |
| Esophagram (74220) |
$708 |
$708 |
4.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$602 |
$602 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$713 |
$713 |
2.9× |
| Foot 2 views (73620) |
$278 |
$278 |
3.1× |
| Forearm 2 views (73090) |
$355 |
$355 |
4.0× |
| Hand 2 views (73120) |
$277 |
$277 |
2.6× |
| Infant hip ultrasound, limited static exam (76886) |
$389 |
$389 |
4.4× |
| Joint Survey Single View (77077) |
$190 |
$190 |
1.8× |
| Knee 3 Views (73562) |
$391 |
$391 |
4.4× |
| Neck soft tissue (70360) |
$335 |
$335 |
3.8× |
| Optic foramina (70190) |
$168 |
$168 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$328 |
$328 |
3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$592 |
$592 |
5.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$352 |
$352 |
4.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$264 |
$264 |
3.0× |
| Radex elbow complete minimum 3 views (73080) |
$366 |
$366 |
4.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$486 |
$486 |
4.6× |
| Radex fingr minimum 2 views (73140) |
$249 |
$249 |
2.8× |
| Radex foot complete minimum 3 views (73630) |
$361 |
$361 |
4.1× |
| Radex Hand Minimum 3 Views (73130) |
$354 |
$354 |
4.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$239 |
$239 |
2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$370 |
$370 |
4.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$347 |
$347 |
3.9× |
| Radex shoulder complete minimum 2 views (73030) |
$386 |
$386 |
4.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$283 |
$283 |
3.2× |
| Radex Spine 1 View Specify Level (72020) |
$295 |
$295 |
3.3× |
| Radex Sternum Minimum 2 Views (71120) |
$352 |
$352 |
4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$260 |
$260 |
2.9× |
| Radex Toe Minimum 2 Views (73660) |
$262 |
$262 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$268 |
$268 |
2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$356 |
$356 |
4.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$334 |
$334 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$459 |
$459 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$428 |
$428 |
4.0× |
| Radiologic exam colon double contrast study (74280) |
$1,242 |
$1,242 |
6.9× |
| Radiologic exam colon single contrast study (74270) |
$865 |
$865 |
4.8× |
| Radiologic exam knee complete 4/more views (73564) |
$391 |
$391 |
3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$449 |
$449 |
4.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$863 |
$863 |
4.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$366 |
$366 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$301 |
$301 |
3.4× |
| Radiologic examination femur minimum 2 views (73552) |
$373 |
$373 |
4.2× |
| Radiologic examination knee 1/2 views (73560) |
$334 |
$334 |
3.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$894 |
$894 |
8.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$380 |
$380 |
4.3× |
| Ribs bilateral 3 views (71110) |
$478 |
$478 |
4.5× |
| Scapula (73010) |
$349 |
$349 |
3.3× |
| Sella turcica (70240) |
$260 |
$260 |
2.9× |
| Shoulder 1 view (73020) |
$257 |
$257 |
2.9× |
| Skull less than 4 views (70250) |
$297 |
$297 |
2.8× |
| Sternoclavicular joints (71130) |
$384 |
$384 |
4.3× |
| Thoracic spine 2 views (72070) |
$411 |
$411 |
3.8× |
| Thoracic spine 3 views (72072) |
$511 |
$511 |
4.8× |
| Thoracolumbar 2 views (72080) |
$370 |
$370 |
4.2× |
| Ultrasound Exam Aaa Screen (76706) |
$1,387 |
$1,387 |
13.0× |
| Ultrasound, abdomen limited (76705) |
$853 |
$853 |
8.0× |
| Umbilical-artery Doppler (OB) (76820) |
$388 |
$388 |
3.6× |
| Upper gi w/o kub (74240) |
$720 |
$720 |
4.0× |
| Urethrocystogram voiding (74455) |
$744 |
$744 |
3.1× |
| Urethrocystography retrograde (74450) |
$283 |
$283 |
1.2× |
| Us chest (76604) |
$963 |
$963 |
9.0× |
| Us complete joint (76881) |
$667 |
$667 |
6.2× |
| Us exam, pelvic, limited (76857) |
$488 |
$488 |
4.6× |
| Us kidney transplant (76776) |
$1,271 |
$1,271 |
11.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$629 |
$629 |
5.9× |
| Us ob detailed single fetus (76811) |
$830 |
$830 |
3.4× |
| Us ob limited 1 or more fetuses (76815) |
$498 |
$498 |
4.7× |
| Us ob transvaginal (76817) |
$596 |
$596 |
5.6× |
| Us pelvic non ob complete (76856) |
$963 |
$963 |
9.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$593 |
$593 |
5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$445 |
$445 |
4.2× |
| Us retroperitoneal complete (76770) |
$920 |
$920 |
8.6× |
| Us retroperitoneal limited (76775) |
$788 |
$788 |
7.4× |
| Us scrotum and contents (76870) |
$791 |
$791 |
7.4× |
| Us spinal canal and contents (76800) |
$487 |
$487 |
4.6× |
| Us thyroid (76536) |
$755 |
$755 |
7.1× |
| Venography extremity bilateral rs&i (75822) |
$453 |
$453 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$411 |
$411 |
0.3× |
| Wrist 2 views (73100) |
$279 |
$279 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$329 |
$329 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$301 |
$301 |
3.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$324 |
$324 |
3.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$289 |
$289 |
2.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$345 |
$345 |
3.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$374 |
$374 |
4.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$417 |
$417 |
3.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$537 |
$537 |
5.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$606 |
$606 |
5.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$532 |
$532 |
5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$370 |
$370 |
4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$573 |
$573 |
5.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$514 |
$514 |
4.8× |
| X-ray humerus (73060) |
$334 |
$334 |
3.8× |
| X-ray IV pyelogram (ivp) (74400) |
$615 |
$615 |
3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$300 |
$300 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$270 |
$270 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$477 |
$477 |
4.5× |
| X-ray nose-rectum child f.b. (76010) |
$337 |
$337 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$605 |
$605 |
5.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$410 |
$410 |
3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$411 |
$411 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$357 |
$357 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$411 |
$411 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$476 |
$476 |
4.5× |
| X-ray thoracic spine 4 vw (72074) |
$334 |
$334 |
3.1× |
| X-Ray Tmj Unilat (70328) |
$223 |
$223 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$239 |
$239 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$1,784 |
$1,784 |
16.7× |
| Xr c-spine 4 or 5 views (72050) |
$548 |
$548 |
5.1× |
| Xr facial bones less than 3 views (70140) |
$319 |
$319 |
3.6× |
| Xr orbits complete 4 views (70200) |
$467 |
$467 |
4.4× |