| Abdomen 1 View (74018) |
$214 |
$214 |
2.0× |
| Abdomen 2 views (74019) |
$262 |
$262 |
2.0× |
| Ankle 2 views (73600) |
$233 |
$233 |
2.1× |
| Bone age studies (77072) |
$185 |
$185 |
1.4× |
| Chest 1 view (71045) |
$188 |
$188 |
1.7× |
| Chest 2 views (71046) |
$239 |
$239 |
2.2× |
| Chest 3 views (71047) |
$300 |
$300 |
2.8× |
| Chest 4 or more views (71048) |
$325 |
$325 |
2.5× |
| Clavicle complete (73000) |
$278 |
$278 |
2.6× |
| Contrast X-Ray Bladder (74430) |
$291 |
$291 |
0.7× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$688 |
$688 |
3.1× |
| CT abdomen w contrast (74160) |
$1,801 |
$1,801 |
8.2× |
| CT abdomen w/o contrast (74150) |
$1,188 |
$1,188 |
9.1× |
| CT cervical spine w/o contrast (72125) |
$1,130 |
$1,130 |
8.7× |
| CT chest w contrast (71260) |
$1,424 |
$1,424 |
6.5× |
| CT head/brain with contrast (70460) |
$1,181 |
$1,181 |
5.4× |
| CT head/brain without and with contrast (70470) |
$1,386 |
$1,386 |
6.3× |
| CT lower ext w/o (73700) |
$1,125 |
$1,125 |
8.6× |
| CT pelvis w/o contrast (72192) |
$1,051 |
$1,051 |
8.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,188 |
$1,188 |
9.1× |
| CT thorax w/o contrast (71250) |
$1,143 |
$1,143 |
8.8× |
| CT upper ext wo (73200) |
$1,301 |
$1,301 |
10.0× |
| Dxa Bone Density Axial (77080) |
$290 |
$290 |
2.2× |
| Dxa bone density study (77085) |
$388 |
$388 |
3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$237 |
$237 |
2.2× |
| Esophagram (74220) |
$701 |
$701 |
3.2× |
| Fluoroscopy up to 1 hr (76000) |
$310 |
$310 |
1.0× |
| Foot 2 views (73620) |
$204 |
$204 |
1.9× |
| Forearm 2 views (73090) |
$212 |
$212 |
2.0× |
| Hand 2 views (73120) |
$223 |
$223 |
1.7× |
| Knee 3 Views (73562) |
$288 |
$288 |
2.7× |
| MRI lumbar spine w contrast (72149) |
$2,261 |
$2,261 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,575 |
$1,575 |
5.3× |
| MRI, dorsal spine contrast (72147) |
$2,282 |
$2,282 |
5.2× |
| MRI, joint upper extrem (73221) |
$1,667 |
$1,667 |
5.6× |
| Neck soft tissue (70360) |
$225 |
$225 |
2.1× |
| Optic foramina (70190) |
$281 |
$281 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$209 |
$209 |
1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$348 |
$348 |
2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$257 |
$257 |
2.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$207 |
$207 |
1.9× |
| Radex elbow complete minimum 3 views (73080) |
$288 |
$288 |
2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$335 |
$335 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$263 |
$263 |
2.4× |
| Radex foot complete minimum 3 views (73630) |
$241 |
$241 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$257 |
$257 |
2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$437 |
$437 |
3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$267 |
$267 |
2.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$260 |
$260 |
2.4× |
| Radex shoulder complete minimum 2 views (73030) |
$243 |
$243 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$228 |
$228 |
2.1× |
| Radex Spine 1 View Specify Level (72020) |
$178 |
$178 |
1.6× |
| Radex Sternum Minimum 2 Views (71120) |
$240 |
$240 |
2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$378 |
$378 |
3.5× |
| Radex Toe Minimum 2 Views (73660) |
$208 |
$208 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$286 |
$286 |
2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$309 |
$309 |
2.4× |
| Radiologic exam knee complete 4/more views (73564) |
$320 |
$320 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$296 |
$296 |
2.3× |
| Radiologic exam swallow function contrast study (74230) |
$945 |
$945 |
4.3× |
| Radiologic examination femur minimum 2 views (73552) |
$254 |
$254 |
2.3× |
| Radiologic examination knee 1/2 views (73560) |
$246 |
$246 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$225 |
$225 |
2.1× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$409 |
$409 |
0.6× |
| Ribs bilateral 3 views (71110) |
$313 |
$313 |
2.4× |
| Scapula (73010) |
$204 |
$204 |
1.6× |
| Sella turcica (70240) |
$245 |
$245 |
2.3× |
Shoulder 1 view (73020)
range across 2 matching MRF lines |
$157–$160 |
$157–$160 |
varies |
| Skull less than 4 views (70250) |
$261 |
$261 |
2.0× |
| Sternoclavicular joints (71130) |
$292 |
$292 |
2.7× |
| Thoracic spine 2 views (72070) |
$232 |
$232 |
1.8× |
| Thoracolumbar 2 views (72080) |
$665 |
$665 |
6.1× |
| Ultrasound, abdomen limited (76705) |
$664 |
$664 |
5.1× |
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines |
$317–$334 |
$317–$334 |
varies |
| Urethrocystogram voiding (74455) |
$713 |
$713 |
2.4× |
| Us exam, pelvic, limited (76857) |
$350 |
$350 |
2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$413 |
$413 |
3.2× |
| Us pelvic non ob complete (76856) |
$797 |
$797 |
6.1× |
| Us retroperitoneal complete (76770) |
$822 |
$822 |
6.3× |
| Us retroperitoneal limited (76775) |
$426 |
$426 |
3.3× |
| Us scrotum and contents (76870) |
$544 |
$544 |
4.2× |
| Us thyroid (76536) |
$843 |
$843 |
6.5× |
| Vertebral fracture assessment via dxa (77086) |
$254 |
$254 |
2.3× |
| Wrist 2 views (73100) |
$241 |
$241 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$230 |
$230 |
2.1× |
| X-Ray Bend Only L-S Spine (72120) |
$209 |
$209 |
1.6× |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 2 matching MRF lines |
$210–$231 |
$210–$231 |
varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$496 |
$496 |
3.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$233 |
$233 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$498 |
$498 |
4.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$408 |
$408 |
3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$292 |
$292 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$378 |
$378 |
2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$250 |
$250 |
1.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$433 |
$433 |
3.3× |
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 2 matching MRF lines |
$276–$278 |
$276–$278 |
varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$433 |
$433 |
3.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$298 |
$298 |
2.3× |
| X-ray eye for foreign body (70030) |
$228 |
$228 |
2.1× |
| X-ray humerus (73060) |
$231 |
$231 |
2.1× |
| X-ray IV pyelogram (ivp) (74400) |
$936 |
$936 |
4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$269 |
$269 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$286 |
$286 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$279 |
$279 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$372 |
$372 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$278 |
$278 |
2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$278 |
$278 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$230 |
$230 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$268 |
$268 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$321 |
$321 |
2.5× |
| X-ray thoracic spine 4 vw (72074) |
$314 |
$314 |
2.4× |
| X-Ray Tmj Unilat (70328) |
$246 |
$246 |
2.3× |
| Xr c-spine 4 or 5 views (72050) |
$369 |
$369 |
2.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$269 |
$269 |
2.1× |
| Xr orbits complete 4 views (70200) |
$339 |
$339 |
2.6× |
| Xr Tomogram Single Plane (76100) |
$717 |
$717 |
5.5× |