| Abdomen 2 views (74019) |
$336.21 |
$336.21 |
3.3× |
| Ankle 2 views (73600) |
$401.10 |
$401.10 |
4.8× |
| Bone age studies (77072) |
$336.21 |
$336.21 |
3.3× |
| Bone survey complete (77075) |
$336.21 |
$336.21 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$239.40 |
$239.40 |
2.9× |
| Chest 1 view (71045) |
$239.40 |
$239.40 |
2.9× |
| Chest 3 views (71047) |
$479.18 |
$479.18 |
5.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$546.60 |
$546.60 |
3.2× |
| Clavicle complete (73000) |
$362.25 |
$362.25 |
4.3× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$546.60 |
$546.60 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,318 |
$4,318 |
12.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,392 |
$2,392 |
10.4× |
| CT abdomen w contrast (74160) |
$1,727.25 |
$1,727.25 |
10.2× |
| CT abdomen w wo contrast (74170) |
$2,329.95 |
$2,329.95 |
13.8× |
| CT abdomen w/o contrast (74150) |
$1,570.80 |
$1,570.80 |
15.6× |
| CT angiography upper extremity lt (73206) |
$1,630.65 |
$1,630.65 |
9.7× |
| CT c-spine w/o contrast (72125) |
$1,739.85 |
$1,739.85 |
17.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,601 |
$1,601 |
9.5× |
| CT cervical spine with contrast (72126) |
$1,836.45 |
$1,836.45 |
5.5× |
| CT chest w/wo contrast (71270) |
$2,423.40 |
$2,423.40 |
14.4× |
| CT chest with contrast (71260) |
$1,834.35 |
$1,834.35 |
10.9× |
| CT head/brain with contrast (70460) |
$4,148.50 |
$4,148.50 |
24.6× |
| CT head/brain without and with contrast (70470) |
$2,411 |
$2,411 |
14.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$192 |
$192 |
2.3× |
| CT iac w contrast (70481) |
$1,298.85 |
$1,298.85 |
7.7× |
| CT lower ext w/o (73700) |
$1,365 |
$1,365 |
13.6× |
| CT lower extremity w wo contrast (73702) |
$1,559.25 |
$1,559.25 |
9.2× |
| CT lower extremity with contrast (73701) |
$1,559.25 |
$1,559.25 |
9.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,634.98 |
$2,634.98 |
15.6× |
| CT lumbar spine w/o contrast (72131) |
$1,756.65 |
$1,756.65 |
17.5× |
| CT lumbar spine with contrast (72132) |
$1,892.10 |
$1,892.10 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,426.95 |
$1,426.95 |
8.5× |
| CT maxillofacial w/o contrast (70486) |
$1,257.90 |
$1,257.90 |
12.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,027 |
$2,027 |
12.0× |
| CT neck soft tissue w contrast (70491) |
$1,593.90 |
$1,593.90 |
9.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,691.55 |
$1,691.55 |
10.0× |
| CT orbits w/o contrast (70480) |
$1,127.70 |
$1,127.70 |
11.2× |
| CT pelvis w & w/o contrast (72194) |
$2,219.70 |
$2,219.70 |
13.2× |
| CT pelvis w/o contrast (72192) |
$1,414.35 |
$1,414.35 |
14.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,774.50 |
$1,774.50 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,142.40 |
$1,142.40 |
11.4× |
| CT thoracic spine w/contrast (72129) |
$1,403.85 |
$1,403.85 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$1,275.75 |
$1,275.75 |
12.7× |
| CT thorax w/o contrast (71250) |
$1,681.05 |
$1,681.05 |
16.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,559.25 |
$1,559.25 |
9.2× |
| CT upper extremity w/o contrast rt (73200) |
$827.40 |
$827.40 |
8.2× |
| CT upper extremity with contrast (73201) |
$993.30 |
$993.30 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,963.75 |
$3,963.75 |
23.5× |
| Cta Abdomen (74175) |
$2,514.02 |
$2,514.02 |
14.9× |
| CTA abdomen pelvis (74174) |
$3,964 |
$3,964 |
11.8× |
| CTA chest (71275) |
$2,450.50 |
$2,450.50 |
14.5× |
| Cta Head (70496) |
$1,843.80 |
$1,843.80 |
10.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,630.65 |
$1,630.65 |
9.7× |
| Cta Neck (70498) |
$2,275.35 |
$2,275.35 |
13.5× |
| Cystography minimum 3 views rs&i (74430) |
$1,145.43 |
$1,145.43 |
3.4× |
| Esophagus (74220) |
$546.60 |
$546.60 |
3.2× |
| Foot 2 views (73620) |
$370.65 |
$370.65 |
4.4× |
| Forearm 2 views (73090) |
$315.79 |
$315.79 |
3.8× |
| Hand 2 views (73120) |
$328.65 |
$328.65 |
3.3× |
| Hand 3 views (73130) |
$442.05 |
$442.05 |
5.3× |
| Humerus Min 2 Views Left (73060) |
$315.79 |
$315.79 |
3.8× |
| Hysterosalpingogram (74740) |
$699.03 |
$699.03 |
3.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$336.21 |
$336.21 |
3.3× |
| Knee 3 views (73562) |
$548.10 |
$548.10 |
6.5× |
| Neck soft tissue (70360) |
$239.40 |
$239.40 |
2.9× |
| Osseous survey infant (77076) |
$336.21 |
$336.21 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$336.21 |
$336.21 |
3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,444.59 |
$1,444.59 |
2.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$535.50 |
$535.50 |
6.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$535.50 |
$535.50 |
5.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$336.21 |
$336.21 |
3.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$336.21 |
$336.21 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$336.21 |
$336.21 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$339.59 |
$339.59 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$325 |
$325 |
3.9× |
| Radiologic exam colon single contrast study (74270) |
$546.60 |
$546.60 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$546.60 |
$546.60 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$546.60 |
$546.60 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$329.18 |
$329.18 |
3.9× |
| Ribs bilateral 3 views (71110) |
$336.21 |
$336.21 |
3.3× |
| Sacroiliac Joints < 3 Views (72200) |
$393.75 |
$393.75 |
3.9× |
| Scanogram (77073) |
$336.21 |
$336.21 |
3.3× |
| Scapula complete (73010) |
$416.85 |
$416.85 |
4.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$336.21 |
$336.21 |
3.3× |
| Small bowel series (74250) |
$546.60 |
$546.60 |
3.2× |
| Spine thoracic 3 views (72072) |
$336.21 |
$336.21 |
3.3× |
| Therapeutic Enema (74283) |
$546.60 |
$546.60 |
3.2× |
| Thoracolumbar 2 views (72080) |
$239.40 |
$239.40 |
2.9× |
| Upper Extremity Infant (73092) |
$237.04 |
$237.04 |
2.4× |
| Urethrocystography retrograde rs&i (74450) |
$699.03 |
$699.03 |
3.0× |
| Urethrocystography voiding (74455) |
$699.03 |
$699.03 |
3.0× |
| Wrist 2 views (73100) |
$320.25 |
$320.25 |
3.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$522.90 |
$522.90 |
6.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$546.60 |
$546.60 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$401.10 |
$401.10 |
4.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$537.60 |
$537.60 |
6.4× |
| X-ray exam hip uni 1 view (73501) |
$240.45 |
$240.45 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$385.35 |
$385.35 |
4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$337.62 |
$337.62 |
3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$336.21 |
$336.21 |
3.3× |
| X-ray exam of femur 1 (73551) |
$226.23 |
$226.23 |
2.7× |
| X-ray eye for foreign body (70030) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$416.85 |
$416.85 |
5.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$444.15 |
$444.15 |
5.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$330.75 |
$330.75 |
4.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$546.60 |
$546.60 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$597.45 |
$597.45 |
5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$321.05 |
$321.05 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,145.43 |
$1,145.43 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$535.50 |
$535.50 |
6.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$590.10 |
$590.10 |
5.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$385.35 |
$385.35 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$551.25 |
$551.25 |
6.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$239.40 |
$239.40 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$336.21 |
$336.21 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$334.95 |
$334.95 |
4.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$430.50 |
$430.50 |
5.1× |
| Xr c-spine 6 or more views (72052) |
$336.21 |
$336.21 |
3.3× |
| Xr chest 4+ views (71048) |
$336.21 |
$336.21 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$380.10 |
$380.10 |
4.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$336.21 |
$336.21 |
3.3× |
| Xr shoulder 1 view (73020) |
$238.88 |
$238.88 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$336.21 |
$336.21 |
3.3× |
| Xr tibia/fibula 2 views (73590) |
$315.79 |
$315.79 |
3.8× |
| Xr tmj bilateral (70330) |
$239.40 |
$239.40 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$429.45 |
$429.45 |
5.1× |