| Abdomen 2 views (74019) |
— |
$415.86 |
— |
| Ankle 2 views (73600) |
— |
$107.98 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$162.33 |
— |
| Chest 1 view (71045) |
— |
$387.54 |
— |
| Clavicle complete (73000) |
— |
$387.54 |
— |
| CT thorax w/o contrast (71250) |
— |
$3,135.44 |
— |
| Diskogram cervical (72285) |
— |
$429.20 |
— |
| Diskography lumbar (72295) |
— |
$749.82 |
— |
| Foot 2 views (73620) |
— |
$320.86 |
— |
| Forearm 2 views (73090) |
— |
$321.38 |
— |
| Hand 2 views (73120) |
— |
$107.98 |
— |
| Hand 3 views (73130) |
— |
$387.54 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$238.64 |
— |
| Knee 3 views (73562) |
— |
$128.48 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,625.11 |
— |
| MRI any jnt lwr ext with con lt (73722) |
— |
$2,031.40 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$1,692.83 |
— |
| MRI c-spine with contrast (72142) |
— |
$1,692.83 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$1,625.11 |
— |
| MRI chest w/o & w/contrast material (71552) |
— |
$1,692.83 |
— |
| MRI chest w/o contrast (71550) |
— |
$1,625.11 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$1,692.83 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$1,692.83 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$1,625.11 |
— |
| MRI orbit/face/neck w&w/o cont (70543) |
— |
$2,031.40 |
— |
| MRI pelvis w contrast (72196) |
— |
$1,692.83 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$2,031.40 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,031.40 |
— |
| MRI scan of arm joint before and after contrast (73223) |
— |
$2,031.40 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$2,031.40 |
— |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
— |
$2,031.40 |
— |
| MRI spinal canal lumbar w/contrast material (72149) |
— |
$1,692.83 |
— |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
— |
$2,031.40 |
— |
| MRI spinal canal thoracic w/contrast matrl (72147) |
— |
$1,625.11 |
— |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
— |
$1,895.96 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$1,625.11 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$1,625.11 |
— |
| MRI upper extrem other than jt w/o & w/contras (73220) |
— |
$2,031.40 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$1,625.11 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$107.98 |
— |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
— |
$2,031.40 |
— |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$415.86 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$362.36 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$107.98 |
— |
| Ribs bilateral 3 views (71110) |
— |
$616.74 |
— |
| Scapula complete (73010) |
— |
$482.06 |
— |
| Spine thoracic 3 views (72072) |
— |
$162.33 |
— |
| Wrist 2 views (73100) |
— |
$214.42 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$508.05 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$415.86 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$107.98 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$415.86 |
— |
| X-ray exam hip uni 1 view (73501) |
— |
$238.64 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$401.71 |
— |
| X-ray exam hip uni 4/> views (73503) |
— |
$107.98 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$247.76 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$321.38 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$121.70 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$162.33 |
— |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
— |
$238.64 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$387.54 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$107.98 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$162.33 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$335.56 |
— |
| X-Ray Spine One View - Xr Spine (72020) |
— |
$295.37 |
— |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
— |
$107.98 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$362.36 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$214.68 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$214.68 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$321.38 |
— |
| Xr shoulder 1 view (73020) |
— |
$107.98 |
— |
| Xr spine cervical 4 or 5 views (72050) |
— |
$162.33 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$401.71 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$430.04 |
— |