| Abdomen 2 views (74019) |
$185.67 |
$529 |
1.8× |
| Ankle 2 views (73600) |
$131.22 |
$266.50 |
1.6× |
| Bone age studies (77072) |
$119.69 |
$341 |
1.2× |
| Bone survey complete (77075) |
$890.13 |
$2,536 |
8.9× |
| Cervical spine 2 or 3 views (72040) |
$144.96 |
$413 |
1.7× |
| Chest 1 view (71045) |
$131.27 |
$374 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$245.34 |
$699 |
1.5× |
| Clavicle complete (73000) |
$330.32 |
$596.50 |
3.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,621.44 |
$4,619.50 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,554.04 |
$4,427.50 |
6.8× |
| CT abdomen w contrast (74160) |
$1,232.01 |
$3,510 |
7.3× |
| CT abdomen w wo contrast (74170) |
$1,274.13 |
$3,630 |
7.6× |
| CT abdomen w/o contrast (74150) |
$1,031.94 |
$2,940 |
10.3× |
| CT angio hrt w/3d image (75574) |
$1,272.37 |
$3,625 |
3.8× |
| CT angiography upper extremity lt (73206) |
$1,572.12 |
$4,479 |
9.3× |
| CT c-spine w/o contrast (72125) |
$1,067.74 |
$3,042 |
10.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,318 |
$3,755 |
7.8× |
| CT cervical spine with contrast (72126) |
$1,285.71 |
$3,663 |
3.8× |
| CT chest w/wo contrast (71270) |
$1,424 |
$4,057 |
8.4× |
| CT chest with contrast (71260) |
$1,251.66 |
$3,566 |
7.4× |
| CT head/brain with contrast (70460) |
$1,203.93 |
$3,430 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,289.92 |
$3,675 |
7.6× |
| CT iac w contrast (70481) |
$1,256.22 |
$3,579 |
7.4× |
| CT limited/localized follow up study (76380) |
$485.43 |
$1,383 |
5.8× |
| CT lower ext w/o (73700) |
$809.05 |
$2,305 |
8.0× |
| CT lower extremity w wo contrast (73702) |
$1,318.70 |
$3,757 |
7.8× |
| CT lower extremity with contrast (73701) |
$1,054.40 |
$3,004 |
6.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,422.25 |
$4,052 |
8.4× |
| CT lumbar spine w/o contrast (72131) |
$1,040.01 |
$2,963 |
10.3× |
| CT lumbar spine with contrast (72132) |
$1,286.76 |
$3,666 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,162.86 |
$3,313 |
6.9× |
| CT maxillofacial w/o contrast (70486) |
$848.01 |
$2,416 |
8.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,424.35 |
$4,058 |
8.4× |
| CT neck soft tissue w contrast (70491) |
$1,111.61 |
$3,167 |
6.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,424 |
$4,057 |
8.4× |
| CT orbits w/o contrast (70480) |
$1,010.52 |
$2,879 |
10.0× |
| CT pelvis w & w/o contrast (72194) |
$1,160.40 |
$3,306 |
6.9× |
| CT pelvis w/o contrast (72192) |
$1,015.44 |
$2,893 |
10.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,320.81 |
$3,763 |
7.8× |
| CT soft tissue neck w/o contrast (70490) |
$865.21 |
$2,465 |
8.6× |
| CT thoracic spine w/contrast (72129) |
$1,191.29 |
$3,394 |
7.1× |
| CT thoracic spine w/o contrast (72128) |
$1,040.01 |
$2,963 |
10.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,315.19 |
$3,747 |
7.8× |
| CT thorax w/o contrast (71250) |
$1,004.56 |
$2,862 |
10.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,316.95 |
$3,752 |
7.8× |
| CT upper extremity w/o contrast rt (73200) |
$809.05 |
$2,305 |
8.0× |
| CT upper extremity with contrast (73201) |
$1,054.75 |
$3,005 |
3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,465.07 |
$4,174 |
8.7× |
| Cta Abdomen (74175) |
$1,573.88 |
$4,484 |
9.3× |
| CTA abdomen pelvis (74174) |
$1,465.07 |
$4,174 |
4.4× |
| CTA chest (71275) |
$1,712.17 |
$4,878 |
10.1× |
| Cta Head (70496) |
$1,571.77 |
$4,478 |
9.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,573.88 |
$4,484 |
9.3× |
| Cta Neck (70498) |
$1,571.77 |
$4,478 |
9.3× |
| Cta Pelvis (72191) |
$1,572.12 |
$4,479 |
9.3× |
| Cystography minimum 3 views rs&i (74430) |
$281.50 |
$802 |
0.8× |
| Echoencephalography real time imaging (76506) |
$200.77 |
$572 |
2.0× |
| Esophagus (74220) |
$288.87 |
$823 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$325.02 |
$926 |
3.2× |
| Fluoroscopy up to 1 hr (76000) |
$426.11 |
$1,214 |
1.9× |
| Foot 2 views (73620) |
$131.22 |
$266.50 |
1.6× |
| Forearm 2 views (73090) |
$308.66 |
$562.50 |
3.7× |
| Hand 2 views (73120) |
$128.93 |
$260 |
1.3× |
| Hand 3 views (73130) |
$308.66 |
$562.50 |
3.7× |
| Humerus Min 2 Views Left (73060) |
$222.36 |
$633.50 |
2.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$82.13 |
$234 |
0.8× |
| Knee 3 views (73562) |
$351.59 |
$640.50 |
4.2× |
| Neck soft tissue (70360) |
$136.89 |
$390 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$157.59 |
$449 |
1.6× |
| Osseous survey infant (77076) |
$164.97 |
$470 |
1.6× |
| Osseous survey limited (77074) |
$108.81 |
$310 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$143.20 |
$408 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$324.32 |
$924 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$186.03 |
$530 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$196.91 |
$561 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$129.51 |
$369 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$149.70 |
$426.50 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$366.79 |
$1,045 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$333.45 |
$950 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$388.20 |
$1,106 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$356.02 |
$648 |
4.3× |
| Radiological examination surgical specimen (76098) |
$189.89 |
$541 |
0.4× |
| Scanogram (77073) |
$139.69 |
$398 |
1.4× |
| Scapula complete (73010) |
$350.76 |
$639 |
3.5× |
| Sella turcica (70240) |
$155.14 |
$442 |
1.9× |
| Small bowel series (74250) |
$273.07 |
$778 |
1.6× |
| Spine thoracic 3 views (72072) |
$188.48 |
$537 |
1.9× |
| Tbs Technical Calculation Only (77091) |
$56.16 |
$160 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$457.70 |
$1,304 |
4.6× |
| Umbilical-artery Doppler (OB) (76820) |
$69.50 |
$198 |
0.7× |
| Unlisted Ultrasound Procedure (76999) |
$233.76 |
$666 |
2.8× |
| Urethrocystography retrograde rs&i (74450) |
$147.77 |
$421 |
0.6× |
| Us abdl aorta screen aaa (76706) |
$215.16 |
$613 |
2.1× |
| Us breast unilateral complete (76641) |
$300.66 |
$569.50 |
3.0× |
| Us breast unilateral limited (76642) |
$237.92 |
$470 |
2.8× |
| Us chest (76604) |
$323.27 |
$921 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$233.76 |
$666 |
2.3× |
| Us ob transvaginal (76817) |
$206.91 |
$589.50 |
2.1× |
| Us pelvic non ob complete (76856) |
$353.80 |
$1,008 |
3.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$198.66 |
$566 |
2.0× |
| Us pregnancy ltd (76815) |
$157.59 |
$449 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$229.55 |
$654 |
2.3× |
| Us retroperitoneal complete (76770) |
$382.23 |
$1,089 |
3.8× |
| Us scrotum and contents (76870) |
$236.57 |
$674 |
2.4× |
| Us soft tissue head/neck (76536) |
$219.72 |
$626 |
2.2× |
| Us spinal canal and contents (76800) |
$148.12 |
$422 |
1.5× |
| Wrist 2 views (73100) |
$123.08 |
$251 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$145.31 |
$414 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$311.46 |
$567.50 |
3.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$473.49 |
$1,349 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$94.06 |
$268 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$350.76 |
$639 |
4.2× |
| X-ray exam hip uni 1 view (73501) |
$94.06 |
$268 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$154.44 |
$440 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$300.10 |
$855 |
3.0× |
| X-ray eye for foreign body (70030) |
$170.58 |
$486 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$189.18 |
$539 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$203.93 |
$581 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$323.40 |
$601.50 |
3.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$311.46 |
$567.50 |
3.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$335.55 |
$956 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$137.24 |
$391 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$425.71 |
$775 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$95.12 |
$271 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$183.22 |
$522 |
1.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$203.58 |
$580 |
2.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$140.04 |
$399 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$211.65 |
$603 |
2.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$301.50 |
$859 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$188.83 |
$538 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$210.60 |
$600 |
2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$170.58 |
$486 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$142.15 |
$405 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$351.59 |
$640.50 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$186.73 |
$532 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$108.81 |
$310 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$230.60 |
$657 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$172.34 |
$491 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$88.45 |
$252 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$134.78 |
$384 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$137.24 |
$391 |
1.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$292.42 |
$549 |
3.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$328.15 |
$598 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$281.36 |
$517.50 |
3.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$188.13 |
$536 |
1.9× |
| Xr optic foramina (70190) |
$194.80 |
$555 |
2.3× |
| Xr shoulder 1 view (73020) |
$94.06 |
$268 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$239.03 |
$681 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$308.66 |
$562.50 |
3.7× |
| Xr tmj bilateral (70330) |
$204.98 |
$584 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$335.56 |
$611 |
4.0× |