| Abdomen 1 View (74018) |
$160 |
$160 |
2.0× |
| Abdomen 2 views (74019) |
$190 |
$190 |
2.0× |
| Ankle 2 views (73600) |
$128 |
$128 |
1.6× |
| Bone age studies (77072) |
$166 |
$166 |
1.8× |
| Chest 1 view (71045) |
$162 |
$162 |
2.1× |
| Chest 2 views (71046) |
$193 |
$193 |
2.4× |
| Clavicle complete (73000) |
$134 |
$134 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,618 |
$1,618 |
17.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,454 |
$3,454 |
10.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,187 |
$2,187 |
10.1× |
| CT abdomen w contrast (74160) |
$1,339 |
$1,339 |
8.4× |
| CT abdomen w wo contrast (74170) |
$1,937 |
$1,937 |
12.2× |
| CT abdomen w/o contrast (74150) |
$1,313 |
$1,313 |
13.9× |
| CT Angio Abdomen and Pelvis (74174) |
$1,898 |
$1,898 |
6.0× |
CT Angio Chest (71275) range across 2 matching MRF lines |
$1,690–$1,943 |
$1,690–$1,943 |
varies |
| CT Angio Head (70496) |
$2,533 |
$2,533 |
15.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,639 |
$1,639 |
10.3× |
| CT Angio Neck (70498) |
$1,900 |
$1,900 |
12.0× |
| CT cervical spine w/o contrast (72125) |
$1,123 |
$1,123 |
11.9× |
| CT chest w contrast (71260) |
$1,348 |
$1,348 |
8.5× |
| CT chest w/wo contrast (71270) |
$1,618 |
$1,618 |
10.2× |
| CT head/brain with contrast (70460) |
$1,322 |
$1,322 |
8.3× |
| CT head/brain without and with contrast (70470) |
$1,432 |
$1,432 |
9.0× |
CT lower ext w/o (73700) range across 13 matching MRF lines |
$961–$1,130 |
$961–$1,130 |
varies |
| CT lower extremity w/contrast material (73701) |
$1,128 |
$1,128 |
7.1× |
| CT lumbar spine w contrast (72132) |
$1,364 |
$1,364 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$1,128 |
$1,128 |
11.9× |
| CT maxillofacial w contrast (70487) |
$1,187 |
$1,187 |
7.5× |
| CT maxillofacial wo contrast (70486) |
$1,128 |
$1,128 |
11.9× |
| CT neck tissue combo (70492) |
$1,491 |
$1,491 |
9.4× |
| CT orbits w/o contrast (70480) |
$1,010 |
$1,010 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,095 |
$1,095 |
11.6× |
| CT scans face/jaw combo (70488) |
$1,474 |
$1,474 |
9.3× |
| CT soft tissue neck w contrast (70491) |
$1,213 |
$1,213 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,010 |
$1,010 |
10.7× |
| CT thoracic spine w/o contrast (72128) |
$1,123 |
$1,123 |
11.9× |
| CT thorax w/o contrast (71250) |
$1,128 |
$1,128 |
11.9× |
| CT upper ext wo (73200) |
$961 |
$961 |
10.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,416 |
$1,416 |
8.9× |
| CT upper extremity with contrast (73201) |
$1,128 |
$1,128 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,533 |
$2,533 |
15.9× |
| Dxa Bone Density Axial (77080) |
$422 |
$422 |
4.5× |
| Foot 2 views (73620) |
$150 |
$150 |
1.9× |
| Forearm 2 views (73090) |
$127 |
$127 |
1.6× |
| Hand 2 views (73120) |
$145 |
$145 |
1.5× |
| Infant hip ultrasound, limited static exam (76886) |
$162 |
$162 |
2.1× |
| Knee 3 Views (73562) |
$169 |
$169 |
2.1× |
| MRA head w/o contrast (70544) |
$2,368 |
$2,368 |
11.0× |
| MRI abdomen w/o contrast (74181) |
$2,448 |
$2,448 |
11.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,237 |
$3,237 |
10.2× |
| MRI cervical spine w contrast (72142) |
$2,897 |
$2,897 |
9.2× |
| MRI cervical spine w/o cont (72141) |
$2,397 |
$2,397 |
11.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,507 |
$3,507 |
11.1× |
| MRI pelvis w/o & w contrast (72197) |
$3,388 |
$3,388 |
10.7× |
| MRI pelvis w/o contrast (72195) |
$2,448 |
$2,448 |
11.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,448 |
$2,448 |
11.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,363 |
$2,363 |
10.9× |
| MRI, abdomen, combo (74183) |
$3,388 |
$3,388 |
10.7× |
| MRI, dorsal spine combo (72157) |
$3,388 |
$3,388 |
10.7× |
MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$2,011–$2,312 |
$2,011–$2,312 |
varies |
| MRI, lumbar spine combo (72158) |
$3,414 |
$3,414 |
10.8× |
| Neck soft tissue (70360) |
$165 |
$165 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$132 |
$132 |
1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$254 |
$254 |
2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$150 |
$150 |
1.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$135 |
$135 |
1.7× |
| Radex elbow complete minimum 3 views (73080) |
$177 |
$177 |
2.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$190 |
$190 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$165 |
$165 |
2.1× |
| Radex foot complete minimum 3 views (73630) |
$165 |
$165 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$144 |
$144 |
1.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$144 |
$144 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$141 |
$141 |
1.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$153 |
$153 |
1.9× |
| Radex shoulder complete minimum 2 views (73030) |
$165 |
$165 |
2.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$128 |
$128 |
1.6× |
| Radex Sternum Minimum 2 Views (71120) |
$153 |
$153 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$165 |
$165 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$165 |
$165 |
2.1× |
| Radiologic exam knee complete 4/more views (73564) |
$186 |
$186 |
2.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$187 |
$187 |
2.0× |
| Radiologic examination femur minimum 2 views (73552) |
$135 |
$135 |
1.7× |
| Radiologic examination knee 1/2 views (73560) |
$144 |
$144 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$153 |
$153 |
1.9× |
| Ribs bilateral 3 views (71110) |
$212 |
$212 |
2.2× |
| Scapula (73010) |
$135 |
$135 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$283 |
$283 |
12.1× |
| Shoulder 1 view (73020) |
$135 |
$135 |
1.7× |
| Skull less than 4 views (70250) |
$180 |
$180 |
1.9× |
| Sternoclavicular joints (71130) |
$153 |
$153 |
1.9× |
| Thoracic spine 2 views (72070) |
$160 |
$160 |
1.7× |
| Thoracolumbar 2 views (72080) |
$160 |
$160 |
2.0× |
Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$285–$570 |
$285–$570 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$339 |
$339 |
3.6× |
Ultrasound, abdomen limited (76705) range across 7 matching MRF lines |
$317–$339 |
$317–$339 |
varies |
| Us breast unilateral complete (76641) |
$339 |
$339 |
3.6× |
| Us complete joint (76881) |
$339 |
$339 |
3.6× |
| Us exam, pelvic, limited (76857) |
$380 |
$380 |
4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$339 |
$339 |
3.6× |
| Us ob transvaginal (76817) |
$570 |
$570 |
6.0× |
| Us pelvic non ob complete (76856) |
$339 |
$339 |
3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$380 |
$380 |
4.0× |
| Us retroperitoneal complete (76770) |
$339 |
$339 |
3.6× |
| Us scrotum and contents (76870) |
$339 |
$339 |
3.6× |
| Us thyroid (76536) |
$339 |
$339 |
3.6× |
| Wrist 2 views (73100) |
$132 |
$132 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$220 |
$220 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$168 |
$168 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$144 |
$144 |
1.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$165 |
$165 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$144 |
$144 |
1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$204 |
$204 |
2.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$321 |
$321 |
3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$144 |
$144 |
1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$317 |
$317 |
3.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$212 |
$212 |
2.2× |
| X-ray humerus (73060) |
$128 |
$128 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$128 |
$128 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$165 |
$165 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$162 |
$162 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$237 |
$237 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$179 |
$179 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$179 |
$179 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$199 |
$199 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$209 |
$209 |
2.2× |
| Xr c-spine 4 or 5 views (72050) |
$267 |
$267 |
2.8× |
| Xr facial bones less than 3 views (70140) |
$135 |
$135 |
1.7× |
| Xr orbits complete 4 views (70200) |
$212 |
$212 |
2.2× |