| Abdomen 1 View (74018) |
$345 |
$345 |
3.8× |
| Abdomen 2 views (74019) |
$410 |
$410 |
3.8× |
| Ankle 2 views (73600) |
$250 |
$250 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$2,330 |
$2,330 |
5.6× |
| Bone Imaging Whole Body (78306) |
$1,905 |
$1,905 |
4.6× |
| Chest 1 view (71045) |
$285 |
$285 |
3.2× |
| Chest 2 views (71046) |
$370 |
$370 |
4.1× |
| Chest 3 views (71047) |
$308 |
$385 |
3.4× |
| Clavicle complete (73000) |
$305 |
$305 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,900 |
$1,900 |
17.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,565 |
$5,565 |
15.4× |
| CT abdomen and pelvis without contrast (74176) |
$4,020 |
$4,020 |
16.2× |
| CT abdomen w contrast (74160) |
$2,550 |
$2,550 |
14.0× |
| CT abdomen w wo contrast (74170) |
$3,215 |
$3,215 |
17.7× |
| CT abdomen w/o contrast (74150) |
$2,370 |
$2,370 |
21.8× |
| CT Angio Abdomen and Pelvis (74174) |
$5,965 |
$5,965 |
16.5× |
| CT Angio Chest (71275) |
$3,505 |
$3,505 |
19.2× |
| CT Angio Head (70496) |
$3,150 |
$3,150 |
17.3× |
| CT Angio Neck (70498) |
$3,100 |
$3,100 |
17.0× |
| CT cervical spine w/o contrast (72125) |
$2,510 |
$2,510 |
23.1× |
| CT chest w contrast (71260) |
$2,630 |
$2,630 |
14.4× |
| CT chest w/wo contrast (71270) |
$2,730 |
$2,730 |
15.0× |
| CT head/brain with contrast (70460) |
$1,692 |
$2,115 |
9.3× |
| CT head/brain without and with contrast (70470) |
$2,575 |
$2,575 |
14.1× |
| CT lower ext w/o (73700) |
$2,340 |
$2,340 |
21.6× |
| CT lower extremity w/contrast material (73701) |
$2,505 |
$2,505 |
13.8× |
| CT lumbar spine w contrast (72132) |
$1,704 |
$2,130 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$2,440 |
$2,440 |
22.5× |
| CT maxillofacial wo contrast (70486) |
$1,935 |
$1,935 |
17.8× |
| CT neck tissue combo (70492) |
$2,780 |
$2,780 |
15.3× |
| CT pelvis w/o contrast (72192) |
$2,370 |
$2,370 |
21.8× |
| CT scans face/jaw combo (70488) |
$2,900 |
$2,900 |
15.9× |
| CT soft tissue neck w contrast (70491) |
$2,575 |
$2,575 |
14.1× |
| CT soft tissue neck w/o contrast (70490) |
$2,100 |
$2,100 |
19.3× |
| CT thoracic spine w/o contrast (72128) |
$2,450 |
$2,450 |
22.6× |
| CT thorax w/o contrast (71250) |
$2,410 |
$2,410 |
22.2× |
| CT upper ext wo (73200) |
$2,165 |
$2,165 |
19.9× |
| CT upper extremity with contrast (73201) |
$2,300 |
$2,300 |
6.3× |
| Cta Abdomen (74175) |
$3,475 |
$3,475 |
19.1× |
| CTA pelvis (72191) |
$2,400 |
$2,400 |
13.2× |
| Dxa Bone Density Axial (77080) |
$500 |
$500 |
4.6× |
| Dxa bone density study (77085) |
$750 |
$750 |
6.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$285 |
$285 |
3.2× |
| Fluoroscopy up to 1 hr (76000) |
$618 |
$618 |
2.5× |
| Foot 2 views (73620) |
$250 |
$250 |
2.8× |
| Forearm 2 views (73090) |
$290 |
$290 |
3.2× |
| Hand 2 views (73120) |
$265 |
$265 |
2.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,960 |
$1,960 |
3.5× |
| Hepatobiliary System Imaging (78226) |
$1,695 |
$1,695 |
4.1× |
| Knee 3 Views (73562) |
$360 |
$360 |
4.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,050 |
$4,050 |
11.2× |
| MRA head w/o contrast (70544) |
$3,500 |
$3,500 |
14.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,700 |
$3,700 |
10.2× |
| MRI abdomen w/o contrast (74181) |
$3,270 |
$3,270 |
13.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,868 |
$2,335 |
2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,400 |
$3,400 |
9.4× |
| MRI cervical spine w contrast (72142) |
$2,832 |
$3,540 |
7.8× |
| MRI cervical spine w/o cont (72141) |
$3,555 |
$3,555 |
14.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,175 |
$3,175 |
8.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,350 |
$3,350 |
9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,832 |
$2,832 |
11.4× |
| MRI lumbar spine w contrast (72149) |
$3,505 |
$3,505 |
9.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,500 |
$4,500 |
12.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,600 |
$3,600 |
9.9× |
| MRI pelvis w/o & w contrast (72197) |
$4,100 |
$4,100 |
11.3× |
| MRI pelvis w/o contrast (72195) |
$3,195 |
$3,195 |
12.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,600 |
$3,600 |
14.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,855 |
$2,855 |
11.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,300 |
$3,300 |
9.1× |
| MRI, abdomen, combo (74183) |
$4,285 |
$4,285 |
11.8× |
| MRI, dorsal spine combo (72157) |
$4,330 |
$4,330 |
12.0× |
| MRI, dorsal spine contrast (72147) |
$2,804 |
$3,505 |
7.7× |
| MRI, joint upper extrem (73221) |
$2,705 |
$2,705 |
10.9× |
| MRI, joint upper extrem combo (73223) |
$3,785 |
$3,785 |
10.4× |
| MRI, lumbar spine combo (72158) |
$4,300 |
$4,300 |
11.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,390 |
$4,390 |
3.3× |
| Neck soft tissue (70360) |
$310 |
$310 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$305 |
$305 |
2.8× |
| PET image w/CT, full body (78816) |
$6,470 |
$6,470 |
4.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$6,480 |
$6,480 |
4.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$535 |
$535 |
4.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$315 |
$315 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$250 |
$250 |
2.8× |
| Radex elbow complete minimum 3 views (73080) |
$340 |
$340 |
3.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$445 |
$445 |
4.1× |
| Radex fingr minimum 2 views (73140) |
$240 |
$240 |
2.7× |
| Radex foot complete minimum 3 views (73630) |
$350 |
$350 |
3.9× |
| Radex Hand Minimum 3 Views (73130) |
$320 |
$320 |
3.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$176 |
$220 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$340 |
$340 |
3.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$315 |
$315 |
3.5× |
| Radex shoulder complete minimum 2 views (73030) |
$350 |
$350 |
3.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$280 |
$280 |
3.1× |
| Radex Spine 1 View Specify Level (72020) |
$350 |
$350 |
3.9× |
| Radex Sternum Minimum 2 Views (71120) |
$340 |
$340 |
3.8× |
| Radex Toe Minimum 2 Views (73660) |
$250 |
$250 |
2.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$210 |
$210 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$310 |
$310 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$332 |
$415 |
3.1× |
| Radiologic exam knee complete 4/more views (73564) |
$370 |
$370 |
3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$365 |
$365 |
3.4× |
| Radiologic examination femur 1 view (73551) |
$204 |
$255 |
2.3× |
| Radiologic examination femur minimum 2 views (73552) |
$350 |
$350 |
3.9× |
| Radiologic examination knee 1/2 views (73560) |
$305 |
$305 |
3.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$325 |
$325 |
3.6× |
| Ribs bilateral 3 views (71110) |
$435 |
$435 |
4.0× |
| Scapula (73010) |
$315 |
$315 |
2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$100 |
$100 |
4.3× |
| Shoulder 1 view (73020) |
$255 |
$255 |
2.8× |
| Skull less than 4 views (70250) |
$300 |
$300 |
2.8× |
| Sternoclavicular joints (71130) |
$285 |
$285 |
3.2× |
| Thoracic spine 2 views (72070) |
$370 |
$370 |
3.4× |
| Thoracic spine 3 views (72072) |
$506 |
$506 |
4.7× |
| Thoracolumbar 2 views (72080) |
$350 |
$350 |
3.9× |
| Ultrasound Breast Limited (76642) |
$465 |
$465 |
5.1× |
| Ultrasound Exam Aaa Screen (76706) |
$640 |
$640 |
5.9× |
| Ultrasound, abdomen limited (76705) |
$726 |
$726 |
6.7× |
| Us breast unilateral complete (76641) |
$575 |
$575 |
5.3× |
| Us chest (76604) |
$596 |
$596 |
5.5× |
| Us exam, pelvic, limited (76857) |
$510 |
$510 |
4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$577 |
$577 |
5.3× |
| Us ob transvaginal (76817) |
$582 |
$582 |
5.4× |
| Us pelvic non ob complete (76856) |
$840 |
$840 |
7.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$680 |
$680 |
6.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$417 |
$417 |
3.8× |
| Us retroperitoneal complete (76770) |
$844 |
$844 |
7.8× |
| Us retroperitoneal limited (76775) |
$625 |
$625 |
5.8× |
| Us scrotum and contents (76870) |
$726 |
$726 |
6.7× |
| Us spinal canal and contents (76800) |
$535 |
$535 |
4.9× |
| Us thyroid (76536) |
$633 |
$633 |
5.8× |
| Wrist 2 views (73100) |
$265 |
$265 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$300 |
$300 |
3.3× |
| X-Ray Bend Only L-S Spine (72120) |
$450 |
$450 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$275 |
$275 |
3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$465 |
$465 |
4.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$275 |
$275 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$350 |
$350 |
3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$375 |
$375 |
3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$490 |
$490 |
4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$535 |
$535 |
4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$335 |
$335 |
3.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$650 |
$650 |
6.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$345 |
$345 |
3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$416 |
$520 |
3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$370 |
$370 |
3.4× |
| X-ray humerus (73060) |
$325 |
$325 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$235 |
$235 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$440 |
$440 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$375 |
$375 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$330 |
$330 |
3.7× |
| X-ray thoracic spine 4 vw (72074) |
$348 |
$435 |
3.2× |
| Xr c-spine 4 or 5 views (72050) |
$530 |
$530 |
4.9× |
| Xr facial bones less than 3 views (70140) |
$290 |
$290 |
3.2× |