| Abdomen 2 views (74019) |
$314 |
$314 |
3.0× |
| Ankle 2 views (73600) |
$224 |
$224 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,484 |
$1,484 |
3.7× |
| Bone survey complete (77075) |
$800 |
$800 |
7.6× |
| Cervical spine 2 or 3 views (72040) |
$254 |
$254 |
2.9× |
| Chest 1 view (71045) |
$224 |
$224 |
2.6× |
| Clavicle complete (73000) |
$224 |
$224 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$500 |
$500 |
4.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,189 |
$2,189 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,435 |
$1,435 |
6.0× |
| CT abdomen w contrast (74160) |
$1,189.50 |
$1,189.50 |
6.8× |
| CT abdomen w wo contrast (74170) |
$1,662 |
$1,662 |
9.4× |
| CT abdomen w/o contrast (74150) |
$958 |
$958 |
9.1× |
| CT angiography upper extremity lt (73206) |
$1,250 |
$1,250 |
7.1× |
| CT c-spine w/o contrast (72125) |
$958 |
$958 |
9.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,095 |
$1,095 |
6.2× |
| CT cervical spine with contrast (72126) |
$1,146 |
$1,146 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,139 |
$1,139 |
6.5× |
| CT chest with contrast (71260) |
$1,103 |
$1,103 |
6.3× |
| CT head/brain with contrast (70460) |
$1,004 |
$1,004 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,170 |
$1,170 |
6.6× |
| CT iac w contrast (70481) |
$997 |
$997 |
5.7× |
| CT lower ext w/o (73700) |
$749 |
$749 |
7.1× |
| CT lower extremity w wo contrast (73702) |
$1,216.50 |
$1,216.50 |
6.9× |
| CT lower extremity with contrast (73701) |
$959 |
$959 |
5.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,206 |
$1,206 |
6.8× |
| CT lumbar spine w/o contrast (72131) |
$1,010 |
$1,010 |
9.6× |
| CT lumbar spine with contrast (72132) |
$1,146 |
$1,146 |
3.3× |
| CT maxillofacial w contrast (70487) |
$1,044 |
$1,044 |
5.9× |
| CT maxillofacial w/o contrast (70486) |
$958 |
$958 |
9.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,216 |
$1,216 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$1,202 |
$1,202 |
6.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$991 |
$991 |
5.6× |
| CT orbits w/o contrast (70480) |
$997 |
$997 |
9.5× |
| CT pelvis w & w/o contrast (72194) |
$980 |
$980 |
5.6× |
| CT pelvis w/o contrast (72192) |
$938 |
$938 |
8.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$473 |
$473 |
5.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$958 |
$958 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$958 |
$958 |
9.1× |
| CT thoracic spine w/contrast (72129) |
$974 |
$974 |
5.5× |
| CT thoracic spine w/o contrast (72128) |
$913 |
$913 |
8.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,034 |
$1,034 |
5.9× |
| CT thorax w/o contrast (71250) |
$1,047 |
$1,047 |
10.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,246 |
$1,246 |
7.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,055 |
$1,055 |
10.0× |
| CT upper extremity with contrast (73201) |
$1,150 |
$1,150 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,750 |
$1,750 |
9.9× |
| Cta Abdomen (74175) |
$1,650 |
$1,650 |
9.4× |
| CTA chest (71275) |
$1,565.50 |
$1,565.50 |
8.9× |
| Cta Head (70496) |
$1,156 |
$1,156 |
6.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,450 |
$1,450 |
8.2× |
| Cta Neck (70498) |
$1,150 |
$1,150 |
6.5× |
| Cta Pelvis (72191) |
$980 |
$980 |
5.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$522 |
$522 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$696 |
$696 |
8.0× |
| Foot 2 views (73620) |
$224 |
$224 |
2.6× |
| Forearm 2 views (73090) |
$224 |
$224 |
2.6× |
| Hand 2 views (73120) |
$314 |
$314 |
3.0× |
| Hand 3 views (73130) |
$224 |
$224 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$224 |
$224 |
2.6× |
| Knee 3 views (73562) |
$224 |
$224 |
2.6× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$34 |
$34 |
0.1× |
| MRA head w & w/o contrast (70546) |
$1,886 |
$1,886 |
5.4× |
| MRA head w/o contrast (70544) |
$1,641 |
$1,641 |
6.8× |
| MRA head with contrast (70545) |
$1,764 |
$1,764 |
5.0× |
| MRA neck w contrast (70548) |
$1,724 |
$1,724 |
4.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,230 |
$2,230 |
6.4× |
| MRA neck w/o contrast (70547) |
$1,414 |
$1,414 |
5.9× |
| MRI abdomen w contrast (74182) |
$2,078 |
$2,078 |
5.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,272 |
$2,272 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,886 |
$1,886 |
7.9× |
| MRI c-spine with contrast (72142) |
$1,845 |
$1,845 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$1,795 |
$1,795 |
7.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,270 |
$2,270 |
6.5× |
| MRI chest w/o contrast (71550) |
$1,949 |
$1,949 |
8.1× |
| MRI chest with contrast (71551) |
$2,183 |
$2,183 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,345 |
$1,345 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,671 |
$1,671 |
7.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,861 |
$1,861 |
5.3× |
| MRI pelvis w contrast (72196) |
$1,754 |
$1,754 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,161 |
$2,161 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$1,997 |
$1,997 |
8.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,015 |
$2,015 |
5.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,015 |
$2,015 |
5.7× |
| MRI spectroscopy (76390) |
$1,345 |
$1,345 |
15.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,387 |
$2,387 |
6.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,892 |
$1,892 |
5.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,358 |
$2,358 |
6.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,776 |
$1,776 |
5.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,297 |
$2,297 |
6.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,817 |
$1,817 |
7.6× |
| MRI tmj (70336) |
$1,345 |
$1,345 |
5.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,776 |
$1,776 |
7.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,764 |
$1,764 |
5.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,746 |
$1,746 |
7.3× |
| Neck soft tissue (70360) |
$224 |
$224 |
2.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$314 |
$314 |
3.0× |
| Pelvis 1 or 2 views (72170) |
$314 |
$314 |
3.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,940 |
$1,940 |
5.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$224 |
$224 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$314 |
$314 |
3.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$314 |
$314 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$224 |
$224 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$314 |
$314 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$224 |
$224 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$314 |
$314 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$224 |
$224 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$224 |
$224 |
2.6× |
| Scapula complete (73010) |
$314 |
$314 |
3.0× |
| Small bowel series (74250) |
$511 |
$511 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$399 |
$399 |
3.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$483 |
$483 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$375 |
$375 |
3.6× |
| Us breast unilateral complete (76641) |
$314 |
$314 |
3.0× |
| Us chest (76604) |
$376 |
$376 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$375 |
$375 |
3.6× |
| Us ob transvaginal (76817) |
$457 |
$457 |
4.4× |
| Us pelvic non ob complete (76856) |
$424 |
$424 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$314 |
$314 |
3.0× |
| Us pregnancy ltd (76815) |
$314 |
$314 |
3.0× |
| Us retroperitoneal complete (76770) |
$421 |
$421 |
4.0× |
| Us retroperitoneal limited (76775) |
$424 |
$424 |
4.0× |
| Us scrotum and contents (76870) |
$399 |
$399 |
3.8× |
| Us soft tissue head/neck (76536) |
$380 |
$380 |
3.6× |
| Us xtr non-vasc lmtd (76882) |
$314 |
$314 |
3.0× |
| Wrist 2 views (73100) |
$224 |
$224 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$224 |
$224 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$224 |
$224 |
2.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$180 |
$180 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$224 |
$224 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$224 |
$224 |
2.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$314 |
$314 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$224 |
$224 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$224 |
$224 |
2.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$224 |
$224 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$224 |
$224 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$314 |
$314 |
3.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$314 |
$314 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$224 |
$224 |
2.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$314 |
$314 |
3.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$314 |
$314 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$224 |
$224 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$314 |
$314 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$224 |
$224 |
2.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$224 |
$224 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$235 |
$235 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$314 |
$314 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$314 |
$314 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$224 |
$224 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$224 |
$224 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$314 |
$314 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$224 |
$224 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$224 |
$224 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$409 |
$409 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$224 |
$224 |
2.6× |
| Xr optic foramina (70190) |
$224 |
$224 |
2.6× |
| Xr shoulder 1 view (73020) |
$224 |
$224 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$314 |
$314 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$224 |
$224 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$224 |
$224 |
2.6× |