| Abdomen 2 views (74019) |
— |
$313 |
— |
| Ankle 2 views (73600) |
— |
$194 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$248 |
— |
| Chest 1 view (71045) |
— |
$265.50 |
— |
| Clavicle complete (73000) |
— |
$217 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$700 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$2,370 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$2,300 |
— |
| CT abdomen w contrast (74160) |
— |
$1,393 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,283 |
— |
| CT c-spine w/o contrast (72125) |
— |
$1,395 |
— |
| CT chest w/wo contrast (71270) |
— |
$900 |
— |
| CT chest with contrast (71260) |
— |
$900 |
— |
| CT head/brain with contrast (70460) |
— |
$1,350 |
— |
| CT lower ext w/o (73700) |
— |
$1,155 |
— |
| CT lumbar spine w & w/o contrast (72133) |
— |
$1,174 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,045.28 |
— |
| CT lumbar spine with contrast (72132) |
— |
$585 |
— |
| CT maxillofacial w contrast (70487) |
— |
$570.31 |
— |
| CT maxillofacial w/o contrast (70486) |
— |
$643.05 |
— |
| CT neck soft tissue w contrast (70491) |
— |
$1,190 |
— |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
— |
$1,409 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,158 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,425 |
— |
| CT soft tissue neck w/o & w/contrast material (70492) |
— |
$1,208 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,178 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$1,505 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,000 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$1,128.63 |
— |
| CT upper extremity w/o contrast rt (73200) |
— |
$1,172 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$3,528 |
— |
| Cta Abdomen (74175) |
— |
$2,625 |
— |
| CTA abdomen pelvis (74174) |
— |
$2,625 |
— |
| CTA chest (71275) |
— |
$2,795 |
— |
| Cta Head (70496) |
— |
$2,725 |
— |
| Cta Neck (70498) |
— |
$2,825 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$418 |
— |
| Foot 2 views (73620) |
— |
$270 |
— |
| Forearm 2 views (73090) |
— |
$200 |
— |
| Hand 2 views (73120) |
— |
$451.50 |
— |
| Hand 3 views (73130) |
— |
$215 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$199 |
— |
| Knee 3 views (73562) |
— |
$240 |
— |
| MRA neck w/o contrast (70547) |
— |
$900 |
— |
| MRI abdomen w/o & w/contrast material (74183) |
— |
$1,740 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,600 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$1,376 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$1,375 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$1,300 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$1,300 |
— |
| MRI orbit/face/neck w/contrast (70542) |
— |
$1,375 |
— |
| MRI pelvis w contrast (72196) |
— |
$1,375 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$1,600 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$1,250 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$1,450 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$1,413 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$1,655 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$2,446 |
— |
| Neck soft tissue (70360) |
— |
$195 |
— |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
— |
$418 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$202 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$262 |
— |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$204 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$240 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$224 |
— |
| Scapula complete (73010) |
— |
$186 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$358.53 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$418 |
— |
| Us abdl aorta screen aaa (76706) |
— |
$207.86 |
— |
| Us breast unilateral complete (76641) |
— |
$418 |
— |
| Us chest (76604) |
— |
$418 |
— |
| Us ob transvaginal (76817) |
— |
$418 |
— |
| Us pelvic non ob complete (76856) |
— |
$495 |
— |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
— |
$418 |
— |
| Us pregnancy ltd (76815) |
— |
$418 |
— |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
— |
$418 |
— |
| Us retroperitoneal complete (76770) |
— |
$418 |
— |
| Us retroperitoneal limited (76775) |
— |
$156 |
— |
| Us scrotum and contents (76870) |
— |
$500 |
— |
| Us soft tissue head/neck (76536) |
— |
$674.16 |
— |
| Us xtr non-vasc lmtd (76882) |
— |
$418 |
— |
| Wrist 2 views (73100) |
— |
$196 |
— |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
— |
$390 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$220 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$105.05 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$214.20 |
— |
| X-ray exam hip uni 1 view (73501) |
— |
$194.30 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$387.20 |
— |
| X-ray exam hip uni 4/> views (73503) |
— |
$291.18 |
— |
| X-ray exam of femur 1 (73551) |
— |
$241 |
— |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
— |
$248 |
— |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
— |
$267.21 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$233 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$150 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$280 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$161 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$262 |
— |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
— |
$224 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$239 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$348 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$372 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$207 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$255 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$287 |
— |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
— |
$196 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$234 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$150.30 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$230 |
— |
| Xr c-spine 6 or more views (72052) |
— |
$633 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$140 |
— |
| Xr shoulder 1 view (73020) |
— |
$144 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$219 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$190 |
— |