| Abdomen 2 views (74019) |
$190 |
$190 |
2.0× |
| Ankle 2 views (73600) |
$128 |
$128 |
1.6× |
| Bone age studies (77072) |
$166 |
$166 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$144 |
$144 |
1.8× |
| Chest 1 view (71045) |
$162 |
$162 |
2.1× |
| 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 c-spine w/o contrast (72125) |
$1,123 |
$1,123 |
11.9× |
| CT chest w/wo contrast (71270) |
$1,618 |
$1,618 |
10.2× |
| CT chest with contrast (71260) |
$1,348 |
$1,348 |
8.5× |
| 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) |
$961 |
$961 |
10.2× |
| CT lower extremity with contrast (73701) |
$1,128 |
$1,128 |
7.1× |
| CT lumbar spine w/o contrast (72131) |
$1,128 |
$1,128 |
11.9× |
| CT lumbar spine with contrast (72132) |
$1,364 |
$1,364 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,187 |
$1,187 |
7.5× |
| CT maxillofacial w/o contrast (70486) |
$1,128 |
$1,128 |
11.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,474 |
$1,474 |
9.3× |
| CT neck soft tissue w contrast (70491) |
$1,213 |
$1,213 |
7.6× |
| 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 soft tissue neck w/o & w/contrast material (70492) |
$1,491 |
$1,491 |
9.4× |
| 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 extremity w/o & w/contrast material (73202) |
$1,416 |
$1,416 |
8.9× |
| CT upper extremity w/o contrast rt (73200) |
$961 |
$961 |
10.2× |
| 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× |
| CTA abdomen pelvis (74174) |
$1,898 |
$1,898 |
6.0× |
| CTA chest (71275) |
$1,816.50 |
$1,816.50 |
11.4× |
| Cta Head (70496) |
$2,533 |
$2,533 |
15.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,639 |
$1,639 |
10.3× |
| Cta Neck (70498) |
$1,900 |
$1,900 |
12.0× |
| Dxa bone density study 1/> sites axial skel (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× |
| Hand 3 views (73130) |
$144 |
$144 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$128 |
$128 |
1.6× |
| Knee 3 views (73562) |
$169 |
$169 |
2.1× |
| MRA head w/o contrast (70544) |
$2,368 |
$2,368 |
11.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,388 |
$3,388 |
10.7× |
| MRI abdomen w/o contrast (74181) |
$2,448 |
$2,448 |
11.3× |
| MRI c-spine with contrast (72142) |
$2,897 |
$2,897 |
9.2× |
| MRI cervical spine w/o contrast (72141) |
$2,397 |
$2,397 |
11.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,388 |
$3,388 |
10.7× |
| MRI pelvis w/o contrast (72195) |
$2,448 |
$2,448 |
11.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,237 |
$3,237 |
10.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,507 |
$3,507 |
11.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,414 |
$3,414 |
10.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,388 |
$3,388 |
10.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,448 |
$2,448 |
11.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,161.50 |
$2,161.50 |
10.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,363 |
$2,363 |
10.9× |
| Neck soft tissue (70360) |
$165 |
$165 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$132 |
$132 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$144 |
$144 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$204 |
$204 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$160 |
$160 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$193 |
$193 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$135 |
$135 |
1.7× |
| Ribs bilateral 3 views (71110) |
$212 |
$212 |
2.2× |
| Scapula complete (73010) |
$135 |
$135 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$283 |
$283 |
12.1× |
| Thoracolumbar 2 views (72080) |
$160 |
$160 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$317 |
$317 |
3.3× |
| Us abdl aorta screen aaa (76706) |
$339 |
$339 |
3.6× |
| Us breast unilateral complete (76641) |
$339 |
$339 |
3.6× |
| Us breast unilateral limited (76642) |
$285 |
$285 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$339 |
$339 |
3.6× |
| Us infant hips limited static (76886) |
$162 |
$162 |
2.1× |
| Us ob transvaginal (76817) |
$570 |
$570 |
6.0× |
| Us pelvic non ob complete (76856) |
$339 |
$339 |
3.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$380 |
$380 |
4.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$380 |
$380 |
4.0× |
| Us retroperitoneal complete (76770) |
$339 |
$339 |
3.6× |
| Us scrotum and contents (76870) |
$339 |
$339 |
3.6× |
| Us soft tissue head/neck (76536) |
$339 |
$339 |
3.6× |
| Us xtr non-vasc lmtd (76882) |
$339 |
$339 |
3.6× |
| Wrist 2 views (73100) |
$132 |
$132 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$254 |
$254 |
2.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$150 |
$150 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$168 |
$168 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$177 |
$177 |
2.2× |
| 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 Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$190 |
$190 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$135 |
$135 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$165 |
$165 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$135 |
$135 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$128 |
$128 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$186 |
$186 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$165 |
$165 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$144 |
$144 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$162 |
$162 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$321 |
$321 |
3.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$220 |
$220 |
2.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$141 |
$141 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$212 |
$212 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$187 |
$187 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$153 |
$153 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$212 |
$212 |
2.2× |
| 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 Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$165 |
$165 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$199 |
$199 |
2.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$128 |
$128 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$209 |
$209 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$180 |
$180 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$153 |
$153 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$153 |
$153 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$160 |
$160 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$165 |
$165 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$165 |
$165 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$317 |
$317 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$165 |
$165 |
2.1× |
| Xr shoulder 1 view (73020) |
$135 |
$135 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$267 |
$267 |
2.8× |
| Xr tibia/fibula 2 views (73590) |
$153 |
$153 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$144 |
$144 |
1.8× |