Abdomen 1 View (74018)
range across 3 matching MRF lines |
— |
$188.20–$612 |
— |
| Abdomen 2 views (74019) |
— |
$313 |
— |
| Ankle 2 views (73600) |
— |
$194 |
— |
Chest 1 view (71045)
range across 2 matching MRF lines |
— |
$177–$354 |
— |
| Chest 2 views (71046) |
— |
$240 |
— |
| Clavicle complete (73000) |
— |
$217 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$700 |
— |
CT abdomen and pelvis without and with contrast (74178)
range across 2 matching MRF lines |
— |
$2,300–$2,440 |
— |
CT abdomen and pelvis without contrast (74176)
range across 3 matching MRF lines |
— |
$1,500–$4,600 |
— |
| CT abdomen w contrast (74160) |
— |
$1,393 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,283 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$2,625 |
— |
| CT Angio Chest (71275) |
— |
$2,795 |
— |
CT Angio Head (70496)
range across 2 matching MRF lines |
— |
$2,625–$2,825 |
— |
| CT Angio Neck (70498) |
— |
$2,825 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$1,395 |
— |
CT chest w contrast (71260)
range across 3 matching MRF lines |
— |
$466.24–$1,348 |
— |
| CT chest w/wo contrast (71270) |
— |
$900 |
— |
| CT head/brain with contrast (70460) |
— |
$1,350 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$1,174 |
— |
| CT lower ext w/o (73700) |
— |
$1,155 |
— |
| CT lumbar spine w contrast (72132) |
— |
$585 |
— |
CT lumbar spine w/o contrast (72131)
range across 2 matching MRF lines |
— |
$585.57–$1,505 |
— |
| CT maxillofacial w contrast (70487) |
— |
$570.31 |
— |
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines |
— |
$570.31–$715.79 |
— |
| CT neck tissue combo (70492) |
— |
$1,208 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$1,409 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,158 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,425 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$1,190 |
— |
| 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)
range across 3 matching MRF lines |
— |
$900–$1,250 |
— |
| CT upper ext wo (73200) |
— |
$1,172 |
— |
CT upper extremity w/o & w/contrast material (73202)
range across 2 matching MRF lines |
— |
$906.26–$1,351 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$3,528 |
— |
| Cta Abdomen (74175) |
— |
$2,625 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$418 |
— |
Foot 2 views (73620)
range across 2 matching MRF lines |
— |
$180–$360 |
— |
| Forearm 2 views (73090) |
— |
$200 |
— |
Hand 2 views (73120)
range across 2 matching MRF lines |
— |
$234–$669 |
— |
| Knee 3 Views (73562) |
— |
$240 |
— |
| MRA neck w/o contrast (70547) |
— |
$900 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,600 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$1,450 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$1,376 |
— |
| 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 (72197) |
— |
$1,600 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$1,250 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$1,413 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$1,375 |
— |
| MRI, abdomen, combo (74183) |
— |
$1,740 |
— |
| MRI, joint upper extrem (73221) |
— |
$1,655 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$2,446 |
— |
| Neck soft tissue (70360) |
— |
$195 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$202 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$390 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$220 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$150 |
— |
Radex elbow complete minimum 3 views (73080)
range across 2 matching MRF lines |
— |
$190.40–$238 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$248 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$140 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$233 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$215 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$224 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$239 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$255 |
— |
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines |
— |
$140–$160.60 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$230 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$262 |
— |
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines |
— |
$174.70–$322.57 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$241 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$224 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$190 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$219 |
— |
| Scapula (73010) |
— |
$186 |
— |
| Shoulder 1 view (73020) |
— |
$144 |
— |
| Skull less than 4 views (70250) |
— |
$196 |
— |
| Thoracic spine 2 views (72070) |
— |
$234 |
— |
Ultrasound Exam Aaa Screen (76706)
range across 2 matching MRF lines |
— |
$190–$225.73 |
— |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
— |
$278.06–$439 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$418 |
— |
| Us breast unilateral complete (76641) |
— |
$418 |
— |
| Us chest (76604) |
— |
$418 |
— |
| Us exam, pelvic, limited (76857) |
— |
$418 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$418 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$418 |
— |
| Us ob transvaginal (76817) |
— |
$418 |
— |
| Us pelvic non ob complete (76856) |
— |
$495 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$418 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$418 |
— |
| Us retroperitoneal complete (76770) |
— |
$418 |
— |
| Us retroperitoneal limited (76775) |
— |
$156 |
— |
| Us scrotum and contents (76870) |
— |
$500 |
— |
Us thyroid (76536)
range across 2 matching MRF lines |
— |
$632–$716.31 |
— |
| Wrist 2 views (73100) |
— |
$196 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 2 matching MRF lines |
— |
$17.10–$193 |
— |
X-Ray Exam Hip Uni 1 View (73501)
range across 2 matching MRF lines |
— |
$177–$211.59 |
— |
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 4 matching MRF lines |
— |
$193–$1,018 |
— |
X-Ray Exam Hip Uni 4/> Views (73503)
range across 2 matching MRF lines |
— |
$265–$317.37 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$248 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$633 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$348 |
— |
| X-ray humerus (73060) |
— |
$199 |
— |
| 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 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 Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$287 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$267.21 |
— |