| Abdomen 2 views (74019) |
$281.25 |
$375 |
2.7× |
| Ankle 2 views (73600) |
$209.63 |
$279.50 |
2.4× |
| Bone survey complete (77075) |
$733.13 |
$977.50 |
7.0× |
| Cervical spine 2 or 3 views (72040) |
$281.25 |
$375 |
3.2× |
| Chest 1 view (71045) |
$209.63 |
$279.50 |
2.4× |
| Clavicle complete (73000) |
$245.44 |
$327.25 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,591.75 |
$4,789 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,907.75 |
$3,877 |
12.1× |
| CT abdomen w contrast (74160) |
$2,029.50 |
$2,706 |
11.5× |
| CT abdomen w wo contrast (74170) |
$2,439.38 |
$3,252.50 |
13.8× |
| CT abdomen w/o contrast (74150) |
$1,620.75 |
$2,161 |
15.4× |
| CT c-spine w/o contrast (72125) |
$1,498.13 |
$1,997.50 |
14.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,316.75 |
$3,089 |
13.1× |
| CT cervical spine with contrast (72126) |
$1,907.25 |
$2,543 |
5.4× |
| CT chest w/wo contrast (71270) |
$3,203.06 |
$4,270.75 |
18.2× |
| CT chest with contrast (71260) |
$2,875.88 |
$3,834.50 |
16.3× |
| CT head/brain with contrast (70460) |
$1,719.38 |
$2,292.50 |
9.8× |
| CT head/brain without and with contrast (70470) |
$2,128.50 |
$2,838 |
12.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$60.38 |
$80.50 |
0.7× |
| CT iac w contrast (70481) |
$1,741.13 |
$2,321.50 |
9.9× |
| CT lower ext w/o (73700) |
$1,268.63 |
$1,691.50 |
12.1× |
| CT lower extremity w wo contrast (73702) |
$2,055.38 |
$2,740.50 |
11.7× |
| CT lower extremity with contrast (73701) |
$1,581.38 |
$2,108.50 |
9.0× |
| CT lumbar spine w & w/o contrast (72133) |
$2,324.63 |
$3,099.50 |
13.2× |
| CT lumbar spine w/o contrast (72131) |
$1,506.38 |
$2,008.50 |
14.3× |
| CT lumbar spine with contrast (72132) |
$1,915.50 |
$2,554 |
5.5× |
| CT maxillofacial w contrast (70487) |
$1,621.88 |
$2,162.50 |
9.2× |
| CT maxillofacial w/o contrast (70486) |
$1,309.13 |
$1,745.50 |
12.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,955.06 |
$2,606.75 |
11.1× |
| CT neck soft tissue w contrast (70491) |
$1,907.25 |
$2,543 |
10.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,261.25 |
$3,015 |
12.8× |
| CT orbits w/o contrast (70480) |
$1,309.13 |
$1,745.50 |
12.5× |
| CT pelvis w & w/o contrast (72194) |
$2,250.75 |
$3,001 |
12.8× |
| CT pelvis w/o contrast (72192) |
$1,432.88 |
$1,910.50 |
13.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,456.88 |
$1,942.50 |
13.9× |
| CT thoracic spine w/contrast (72129) |
$2,055.38 |
$2,740.50 |
11.7× |
| CT thoracic spine w/o contrast (72128) |
$1,506.38 |
$2,008.50 |
14.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,324.63 |
$3,099.50 |
13.2× |
| CT thorax w/o contrast (71250) |
$2,534.06 |
$3,378.75 |
24.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,055.38 |
$2,740.50 |
11.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,268.63 |
$1,691.50 |
12.1× |
| CT upper extremity with contrast (73201) |
$1,581.38 |
$2,108.50 |
4.5× |
| CTA abdomen pelvis (74174) |
$3,787.13 |
$5,049.50 |
10.8× |
| CTA chest (71275) |
$2,647.13 |
$3,529.50 |
15.0× |
| Cta Head (70496) |
$2,520.75 |
$3,361 |
14.3× |
| Cta Neck (70498) |
$2,520.75 |
$3,361 |
14.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$836.63 |
$1,115.50 |
8.0× |
| Foot 2 views (73620) |
$209.63 |
$279.50 |
2.4× |
| Forearm 2 views (73090) |
$209.63 |
$279.50 |
2.4× |
| Hand 2 views (73120) |
$209.63 |
$279.50 |
2.0× |
| Hand 3 views (73130) |
$281.25 |
$375 |
3.2× |
| Humerus Min 2 Views Left (73060) |
$209.63 |
$279.50 |
2.4× |
| Neck soft tissue (70360) |
$209.63 |
$279.50 |
2.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$443.25 |
$591 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$209.63 |
$279.50 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$353.25 |
$471 |
3.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$321.75 |
$429 |
3.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$259.88 |
$346.50 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$281.25 |
$375 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$209.63 |
$279.50 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$353.25 |
$471 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$281.25 |
$375 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$281.25 |
$375 |
3.2× |
| Sacroiliac Joints < 3 Views (72200) |
$209.63 |
$279.50 |
2.0× |
| Scapula complete (73010) |
$281.25 |
$375 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$322.88 |
$430.50 |
3.1× |
| Upper Extremity Infant (73092) |
$281.25 |
$375 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$866.63 |
$1,155.50 |
4.9× |
| Us chest (76604) |
$322.88 |
$430.50 |
3.1× |
| Us compl joint r-t w/image documentation (76881) |
$242.63 |
$323.50 |
2.3× |
| Us infant hips dynamic (76885) |
$487.13 |
$649.50 |
5.6× |
| Us ob transvaginal (76817) |
$803.25 |
$1,071 |
7.6× |
| Us pelvic non ob complete (76856) |
$542.63 |
$723.50 |
5.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$466.88 |
$622.50 |
4.4× |
| Us pregnancy ltd (76815) |
$448.88 |
$598.50 |
4.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$803.25 |
$1,071 |
7.6× |
| Us retroperitoneal complete (76770) |
$616.13 |
$821.50 |
5.9× |
| Us scrotum and contents (76870) |
$242.63 |
$323.50 |
2.3× |
| Us soft tissue head/neck (76536) |
$242.63 |
$323.50 |
2.3× |
| Wrist 2 views (73100) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$281.25 |
$375 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$209.63 |
$279.50 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$294 |
$392 |
3.4× |
| X-ray exam hip uni 4/> views (73503) |
$337.50 |
$450 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$353.25 |
$471 |
3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$357 |
$476 |
3.4× |
| X-ray exam of femur 1 (73551) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$353.25 |
$471 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$270.56 |
$360.75 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$281.25 |
$375 |
3.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$321.75 |
$429 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$281.25 |
$375 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$234.94 |
$313.25 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$494.63 |
$659.50 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$281.25 |
$375 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$254.25 |
$339 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$321.75 |
$429 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$487.88 |
$650.50 |
4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$281.25 |
$375 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$319.12 |
$425.50 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$317.25 |
$423 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$353.25 |
$471 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$245.44 |
$327.25 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$209.63 |
$279.50 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$281.25 |
$375 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$281.25 |
$375 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$321.75 |
$429 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$163.88 |
$218.50 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$321.75 |
$429 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$353.25 |
$471 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$147.38 |
$196.50 |
1.7× |
| Xr shoulder 1 view (73020) |
$209.63 |
$279.50 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$353.25 |
$471 |
3.4× |
| Xr tibia/fibula 2 views (73590) |
$281.25 |
$375 |
3.2× |
| Xray knee 1 or 2 views rt (73560) |
$209.63 |
$279.50 |
2.4× |