| Abdomen 2 views (74019) |
$77.70 |
$518 |
0.7× |
| Ankle 2 views (73600) |
$74.78 |
$498.50 |
0.8× |
| Bone age studies (77072) |
$64.65 |
$431 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$77.70 |
$518 |
0.9× |
| Chest 1 view (71045) |
$44.70 |
$298 |
0.5× |
| Clavicle complete (73000) |
$77.70 |
$518 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$32.85 |
$219 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$255 |
$1,700 |
0.7× |
| CT abdomen and pelvis without contrast (74176) |
$255 |
$1,700 |
1.0× |
| CT abdomen w contrast (74160) |
$230.85 |
$1,539 |
1.3× |
| CT abdomen w wo contrast (74170) |
$230.85 |
$1,539 |
1.3× |
| CT abdomen w/o contrast (74150) |
$230.85 |
$1,539 |
2.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$230.85 |
$1,539 |
1.3× |
| CT c-spine w/o contrast (72125) |
$230.85 |
$1,539 |
2.1× |
| CT chest w contrast (71260) |
$230.85 |
$1,539 |
1.3× |
| CT chest w/wo contrast (71270) |
$230.85 |
$1,539 |
1.3× |
| CT head/brain with contrast (70460) |
$230.85 |
$1,539 |
1.3× |
| CT head/brain without and with contrast (70470) |
$230.85 |
$1,539 |
1.3× |
| CT iac w contrast (70481) |
$226.35 |
$1,509 |
1.2× |
| CT limited/localized follow up study (76380) |
$78.45 |
$523 |
0.9× |
| CT lower ext w/o (73700) |
$230.85 |
$1,539 |
2.1× |
| CT lower extremity w wo contrast (73702) |
$230.85 |
$1,539 |
1.3× |
| CT lower extremity w/contrast material (73701) |
$230.85 |
$1,539 |
1.3× |
| CT lumbar spine w/contrast (72132) |
$230.85 |
$1,539 |
0.6× |
| CT lumbar spine w/o contrast (72131) |
$230.85 |
$1,539 |
2.1× |
| CT maxillofacial w contrast (70487) |
$230.85 |
$1,539 |
1.3× |
| CT maxillofacial w/wo contrast (70488) |
$226.35 |
$1,509 |
1.2× |
| CT maxillofacial wo contrast (70486) |
$230.85 |
$1,539 |
2.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$230.85 |
$1,539 |
1.3× |
| CT orbits w/o contrast (70480) |
$230.85 |
$1,539 |
2.1× |
| CT pelvis w/o contrast (72192) |
$230.85 |
$1,539 |
2.1× |
| CT pelvis w/wo contrast (72194) |
$230.85 |
$1,539 |
1.3× |
| CT soft tissue neck w contrast (70491) |
$230.85 |
$1,539 |
1.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$230.85 |
$1,539 |
1.3× |
| CT soft tissue neck w/o contrast (70490) |
$230.85 |
$1,539 |
2.1× |
| CT thoracic spine w/contrast (72129) |
$230.85 |
$1,539 |
1.3× |
| CT thoracic spine w/o contrast (72128) |
$230.85 |
$1,539 |
2.1× |
| CT thorax w/o contrast (71250) |
$230.85 |
$1,539 |
2.1× |
| CT upper ext wo (73200) |
$230.85 |
$1,539 |
2.1× |
| CT upper extremity with contrast (73201) |
$230.85 |
$1,539 |
0.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$230.85 |
$1,539 |
1.3× |
| Cta Abdomen (74175) |
$230.85 |
$1,539 |
1.3× |
| CTA abdomen pelvis (74174) |
$230.85 |
$1,539 |
0.6× |
| CTA chest (71275) |
$230.85 |
$1,539 |
1.3× |
| Cta Head (70496) |
$230.85 |
$1,539 |
1.3× |
| Cta Neck (70498) |
$230.85 |
$1,539 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$65.55 |
$437 |
0.6× |
| Facial bones min 3 views (70150) |
$77.70 |
$518 |
0.7× |
| Foot 2 views (73620) |
$77.70 |
$518 |
0.9× |
| Forearm 2 views (73090) |
$77.70 |
$518 |
0.9× |
| Hand 2 views (73120) |
$77.70 |
$518 |
0.7× |
| Knee 3 views (73562) |
$76.72 |
$511.50 |
0.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$319.65 |
$2,131 |
0.9× |
| MRA head w/o contrast (70544) |
$319.65 |
$2,131 |
1.3× |
| MRA neck w/o contrast (70547) |
$319.65 |
$2,131 |
1.3× |
| MRI abdomen w/o contrast (74181) |
$319.65 |
$2,131 |
1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$319.65 |
$2,131 |
0.9× |
| MRI cervical spine w/o contrast (72141) |
$319.65 |
$2,131 |
1.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$319.65 |
$2,131 |
0.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$319.65 |
$2,131 |
1.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$319.65 |
$2,131 |
0.9× |
| MRI pelvis w/o contrast (72195) |
$319.65 |
$2,131 |
1.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$319.65 |
$2,131 |
0.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$319.65 |
$2,131 |
0.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$319.65 |
$2,131 |
0.9× |
| MRI thoracic spine w/o contrast (72146) |
$319.65 |
$2,131 |
1.3× |
| MRI up ext w/o contrast (73218) |
$476.32 |
$3,175.50 |
1.9× |
| MRI upper ext joint w/o contrast (73221) |
$319.65 |
$2,131 |
1.3× |
| MRI, joint upper extrem combo (73223) |
$319.65 |
$2,131 |
0.9× |
| Neck soft tissue (70360) |
$77.70 |
$518 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$77.70 |
$518 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$77.70 |
$518 |
0.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$77.70 |
$518 |
0.9× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$77.70 |
$518 |
0.9× |
| Radex fingr minimum 2 views (73140) |
$77.70 |
$518 |
0.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$77.70 |
$518 |
0.9× |
| Radex Hand Minimum 3 Views (73130) |
$77.70 |
$518 |
0.9× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$77.70 |
$518 |
0.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$37.50 |
$250 |
0.3× |
| Radex Humerus Minimum 2 Views (73060) |
$77.70 |
$518 |
0.9× |
| Radex Kne 1/2 Views (73560) |
$77.70 |
$518 |
0.9× |
| Radex Kne Compl 4/More Views (73564) |
$77.70 |
$518 |
0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$77.70 |
$518 |
0.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$77.70 |
$518 |
0.7× |
| Radex Sho Compl Minimum 2 Views (73030) |
$77.70 |
$518 |
0.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$55.50 |
$370 |
0.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$77.70 |
$518 |
0.7× |
| Radex Toe Minimum 2 Views (73660) |
$77.70 |
$518 |
0.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$77.70 |
$518 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$74.40 |
$496 |
0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$77.70 |
$518 |
0.7× |
| Radiologic exam chest 2 views (71046) |
$57.15 |
$381 |
0.6× |
| Radiologic examination femur 1 view (73551) |
$77.70 |
$518 |
0.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$77.70 |
$518 |
0.9× |
| Ribs bilateral 3 views (71110) |
$77.70 |
$518 |
0.7× |
| Scapula (73010) |
$63 |
$420 |
0.6× |
| Shoulder 1 view (73020) |
$77.70 |
$518 |
0.9× |
| Spine thoracic 3 views (72072) |
$77.70 |
$518 |
0.7× |
| Thoracolumbar 2 views (72080) |
$77.70 |
$518 |
0.9× |
| Ultrasound Exam Aaa Screen (76706) |
$74.70 |
$498 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$105 |
$700 |
1.0× |
| Us chest (76604) |
$105 |
$700 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$105 |
$700 |
1.0× |
| Us ob limited (76815) |
$105 |
$700 |
1.0× |
| Us ob transvaginal (76817) |
$46.05 |
$307 |
0.4× |
| Us pelvic non ob complete (76856) |
$105 |
$700 |
1.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$105 |
$700 |
1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$105 |
$700 |
1.0× |
| Us retroperitoneal complete (76770) |
$105 |
$700 |
1.0× |
| Us retroperitoneal limited (76775) |
$105 |
$700 |
1.0× |
| Us scrotum and contents (76870) |
$105 |
$700 |
1.0× |
| Us soft tissue head/neck (76536) |
$105 |
$700 |
1.0× |
| Wrist 2 views (73100) |
$71.85 |
$479 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$77.70 |
$518 |
0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$77.70 |
$518 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$77.70 |
$518 |
0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$77.70 |
$518 |
0.7× |
| X-ray exam of femur 2/> (73552) |
$77.70 |
$518 |
0.9× |
| X-ray eye for foreign body (70030) |
$76.20 |
$508 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$46.65 |
$311 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$59.70 |
$398 |
0.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$77.70 |
$518 |
0.7× |
| X-ray nose-rectum child f.b. (76010) |
$43.95 |
$293 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$77.70 |
$518 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$77.70 |
$518 |
0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$77.70 |
$518 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$71.70 |
$478 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$77.70 |
$518 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$77.70 |
$518 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$77.70 |
$518 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$77.70 |
$518 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$77.70 |
$518 |
0.7× |
| Xr c-spine 4 or 5 views (72050) |
$77.70 |
$518 |
0.7× |
| Xr c-spine 6 or more views (72052) |
$77.70 |
$518 |
0.7× |
| Xr chest 4+ views (71048) |
$57.15 |
$381 |
0.5× |