| Cervical spine 2 or 3 views (72040) |
$163.20 |
$272 |
1.9× |
| Chest 1 view (71045) |
$135 |
$225 |
1.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,283.40 |
$2,139 |
5.4× |
| CT c-spine w/o contrast (72125) |
$930 |
$1,550 |
8.9× |
| CT chest with contrast (71260) |
$1,110 |
$1,850 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$960 |
$1,600 |
9.1× |
| CT maxillofacial w/o contrast (70486) |
$900 |
$1,500 |
8.6× |
| CT neck soft tissue w contrast (70491) |
$930 |
$1,550 |
5.3× |
| CT orbits w/o contrast (70480) |
$706.80 |
$1,178 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$900 |
$1,500 |
8.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,320 |
$2,200 |
7.5× |
| CT upper extremity with contrast (73201) |
$979.80 |
$1,633 |
2.8× |
| CTA abdomen pelvis (74174) |
$1,980 |
$3,300 |
5.6× |
| CTA chest (71275) |
$1,200 |
$2,000 |
6.8× |
| Cta Head (70496) |
$915 |
$1,525 |
5.2× |
| Cta Neck (70498) |
$1,470 |
$2,450 |
8.3× |
| Forearm 2 views (73090) |
$164.40 |
$274 |
1.9× |
| Hand 2 views (73120) |
$108 |
$180 |
1.0× |
| Hand 3 views (73130) |
$180 |
$300 |
2.1× |
| Knee 3 views (73562) |
$195 |
$325 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$180 |
$300 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$180 |
$300 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$165 |
$275 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$126.60 |
$211 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$390 |
$650 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$382.20 |
$637 |
3.6× |
| Us retroperitoneal complete (76770) |
$475.80 |
$793 |
4.5× |
| Us soft tissue head/neck (76536) |
$420 |
$700 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$187.80 |
$313 |
1.8× |
| Wrist 2 views (73100) |
$108 |
$180 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$195 |
$325 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$136.20 |
$227 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$153 |
$255 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$165 |
$275 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$180 |
$300 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$210 |
$350 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$232.20 |
$387 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$167.40 |
$279 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$283.20 |
$472 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$180 |
$300 |
2.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$140.40 |
$234 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$145.20 |
$242 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$180 |
$300 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$199.80 |
$333 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$136.20 |
$227 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$204 |
$340 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$171.60 |
$286 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$132.60 |
$221 |
1.5× |