| Abdomen 2 views (74019) |
$451 |
$451 |
4.8× |
| Ankle 2 views (73600) |
$312 |
$312 |
4.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$837 |
$837 |
2.6× |
| Arthrogram elbow (73085) |
$805 |
$805 |
2.5× |
| Arthrogram hip (73525) |
$978 |
$978 |
3.1× |
| Arthrogram shoulder (73040) |
$426 |
$426 |
1.3× |
| Arthrogram wrist (73115) |
$1,140 |
$1,140 |
3.6× |
| Arthrography knee lt (73580) |
$1,300 |
$1,300 |
4.1× |
| Bone &/joint imaging whole body (78306) |
$2,363 |
$2,363 |
6.5× |
| Bone age studies (77072) |
$381 |
$381 |
4.0× |
| Bone survey complete (77075) |
$350 |
$350 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$438 |
$438 |
5.6× |
| Chest 1 view (71045) |
$327.50 |
$327.50 |
4.2× |
| Chest 3 views (71047) |
$412 |
$412 |
5.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$887 |
$887 |
5.6× |
| Clavicle complete (73000) |
$417 |
$417 |
5.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,666 |
$6,666 |
21.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,680 |
$4,680 |
21.7× |
| CT abdomen w contrast (74160) |
$2,309 |
$2,309 |
14.5× |
| CT abdomen w wo contrast (74170) |
$2,893 |
$2,893 |
18.2× |
| CT abdomen w/o contrast (74150) |
$2,057 |
$2,057 |
21.7× |
| CT c-spine w/o contrast (72125) |
$2,237.50 |
$2,237.50 |
23.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,674 |
$2,674 |
16.8× |
| CT cervical spine with contrast (72126) |
$2,393 |
$2,393 |
7.6× |
| CT chest w/wo contrast (71270) |
$2,666 |
$2,666 |
16.8× |
| CT chest with contrast (71260) |
$2,288 |
$2,288 |
14.4× |
| CT head/brain with contrast (70460) |
$1,999 |
$1,999 |
12.6× |
| CT head/brain without and with contrast (70470) |
$2,331 |
$2,331 |
14.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$748 |
$748 |
9.5× |
| CT iac w contrast (70481) |
$2,109 |
$2,109 |
13.3× |
| CT lower ext w/o (73700) |
$1,874 |
$1,874 |
19.8× |
| CT lower extremity w wo contrast (73702) |
$2,464 |
$2,464 |
15.5× |
| CT lower extremity with contrast (73701) |
$2,125 |
$2,125 |
13.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,634 |
$2,634 |
16.6× |
| CT lumbar spine w/o contrast (72131) |
$2,281.50 |
$2,281.50 |
24.1× |
| CT lumbar spine with contrast (72132) |
$2,406 |
$2,406 |
7.6× |
| CT maxillofacial w contrast (70487) |
$2,046 |
$2,046 |
12.9× |
| CT maxillofacial w/o contrast (70486) |
$1,377 |
$1,377 |
14.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,431 |
$2,431 |
15.3× |
| CT neck soft tissue w contrast (70491) |
$2,147 |
$2,147 |
13.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,216 |
$2,216 |
14.0× |
| CT orbits w/o contrast (70480) |
$1,987 |
$1,987 |
21.0× |
| CT pelvis w & w/o contrast (72194) |
$2,663 |
$2,663 |
16.8× |
| CT pelvis w/o contrast (72192) |
$1,958 |
$1,958 |
20.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$655 |
$655 |
8.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,600 |
$2,600 |
16.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,983 |
$1,983 |
20.9× |
| CT thoracic spine w/contrast (72129) |
$2,435 |
$2,435 |
15.3× |
| CT thoracic spine w/o contrast (72128) |
$2,255 |
$2,255 |
23.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,716 |
$2,716 |
17.1× |
| CT thorax w/o contrast (71250) |
$1,986 |
$1,986 |
21.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,435 |
$2,435 |
15.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,843 |
$1,843 |
19.5× |
| CT upper extremity with contrast (73201) |
$2,095 |
$2,095 |
6.6× |
| CTA abdomen pelvis (74174) |
$2,884 |
$2,884 |
9.1× |
| Cystography minimum 3 views rs&i (74430) |
$678.50 |
$678.50 |
2.1× |
| Diskogram cervical (72285) |
$2,943 |
$2,943 |
1.7× |
| Diskography lumbar (72295) |
$2,104.50 |
$2,104.50 |
1.2× |
| Esophagus (74220) |
$593 |
$593 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$627.50 |
$627.50 |
2.9× |
| Foot 2 views (73620) |
$307 |
$307 |
3.9× |
| Forearm 2 views (73090) |
$348 |
$348 |
4.4× |
| Hand 2 views (73120) |
$325 |
$325 |
3.4× |
| Hand 3 views (73130) |
$381 |
$381 |
4.8× |
| Humerus Min 2 Views Left (73060) |
$365 |
$365 |
4.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$703 |
$703 |
7.4× |
| Knee 3 views (73562) |
$417 |
$417 |
5.3× |
| MRA head w/o contrast (70544) |
$1,736 |
$1,736 |
8.0× |
| MRA head with contrast (70545) |
$1,775 |
$1,775 |
5.6× |
| MRA neck w contrast (70548) |
$2,102 |
$2,102 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,518 |
$2,518 |
8.0× |
| MRA neck w/o contrast (70547) |
$1,748 |
$1,748 |
8.1× |
| MRI abdomen w contrast (74182) |
$1,995 |
$1,995 |
6.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,692 |
$2,692 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$1,867 |
$1,867 |
8.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,948 |
$1,948 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,746 |
$1,746 |
2.5× |
| MRI c-spine with contrast (72142) |
$1,893 |
$1,893 |
6.0× |
| MRI cervical spine w/o contrast (72141) |
$1,867 |
$1,867 |
8.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,982 |
$2,982 |
9.4× |
| MRI chest w/o contrast (71550) |
$2,170 |
$2,170 |
10.0× |
| MRI chest with contrast (71551) |
$2,375 |
$2,375 |
3.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,210 |
$2,210 |
7.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,980 |
$1,980 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,789 |
$1,789 |
8.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,836 |
$1,836 |
8.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,564 |
$2,564 |
8.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,594 |
$2,594 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$1,708 |
$1,708 |
7.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,355 |
$2,355 |
7.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,169 |
$2,169 |
6.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,618 |
$2,618 |
8.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,336 |
$2,336 |
7.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,701 |
$2,701 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,855 |
$1,855 |
8.6× |
| MRI tmj (70336) |
$1,906 |
$1,906 |
8.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,725.50 |
$1,725.50 |
8.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,342 |
$2,342 |
7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,733 |
$1,733 |
8.0× |
| Myelogram Lumbar (72265) |
$1,630.50 |
$1,630.50 |
2.3× |
| Neck soft tissue (70360) |
$250 |
$250 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$342.50 |
$342.50 |
3.6× |
| Pr gi endoscopic ultrasound (76975) |
$1,052 |
$1,052 |
4.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,310 |
$2,310 |
7.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$671 |
$671 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$433 |
$433 |
5.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$436 |
$436 |
4.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$529 |
$529 |
5.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$681.50 |
$681.50 |
7.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$671 |
$671 |
7.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$328 |
$328 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$473 |
$473 |
5.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$369 |
$369 |
4.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$835 |
$835 |
5.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,023 |
$1,023 |
6.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$391 |
$391 |
5.0× |
| Ribs bilateral 3 views (71110) |
$518 |
$518 |
5.5× |
| Sacroiliac Joints < 3 Views (72200) |
$399 |
$399 |
4.2× |
| Scapula complete (73010) |
$417 |
$417 |
4.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$588 |
$588 |
6.2× |
| Small bowel series (74250) |
$758 |
$758 |
4.8× |
| Spine thoracic 3 views (72072) |
$683 |
$683 |
7.2× |
| Thoracolumbar 2 views (72080) |
$422 |
$422 |
5.4× |
| Ultrasound scan to determine eye length and lens power (76519) |
$123 |
$123 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$979 |
$979 |
10.3× |
| Urethrocystography retrograde rs&i (74450) |
$741 |
$741 |
3.4× |
| Urethrocystography voiding (74455) |
$1,048 |
$1,048 |
4.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,011 |
$1,011 |
6.4× |
| Us breast unilateral complete (76641) |
$367 |
$367 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$711 |
$711 |
7.5× |
| Us pelvic non ob complete (76856) |
$869 |
$869 |
9.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$711 |
$711 |
7.5× |
| Us retroperitoneal complete (76770) |
$1,097 |
$1,097 |
11.6× |
| Us scrotum and contents (76870) |
$770 |
$770 |
8.1× |
| Us soft tissue head/neck (76536) |
$657 |
$657 |
6.9× |
| Us spinal canal and contents (76800) |
$804 |
$804 |
8.5× |
| Wrist 2 views (73100) |
$305 |
$305 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$366 |
$366 |
4.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$383 |
$383 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$315 |
$315 |
4.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$394 |
$394 |
5.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$473.50 |
$473.50 |
5.0× |
| X-ray exam hip uni 1 view (73501) |
$594 |
$594 |
7.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$372 |
$372 |
4.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$608 |
$608 |
6.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$350 |
$350 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$433 |
$433 |
5.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$371.50 |
$371.50 |
4.7× |
| X-ray head for orthodontia (70350) |
$228 |
$228 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$310 |
$310 |
3.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$503 |
$503 |
5.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$299 |
$299 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$488 |
$488 |
5.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$681.50 |
$681.50 |
7.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$533 |
$533 |
5.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$408 |
$408 |
5.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$654 |
$654 |
6.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$351 |
$351 |
3.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$896.50 |
$896.50 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$407 |
$407 |
5.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$417 |
$417 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$506 |
$506 |
5.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$395 |
$395 |
5.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$417 |
$417 |
5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$501 |
$501 |
6.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$612 |
$612 |
7.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$588 |
$588 |
6.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$374 |
$374 |
4.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$329.50 |
$329.50 |
4.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$490 |
$490 |
6.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$555.50 |
$555.50 |
5.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$692 |
$692 |
7.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$282 |
$282 |
3.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$381 |
$381 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$672.50 |
$672.50 |
7.1× |
| Xr chest 4+ views (71048) |
$338 |
$338 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$279 |
$279 |
3.5× |
| Xr shoulder 1 view (73020) |
$324 |
$324 |
4.1× |
| Xr spine cervical 4 or 5 views (72050) |
$599.50 |
$599.50 |
6.3× |
| Xr tibia/fibula 2 views (73590) |
$369 |
$369 |
4.7× |
| Xr tmj bilateral (70330) |
$498 |
$498 |
6.3× |
| Xray knee 1 or 2 views rt (73560) |
$336 |
$336 |
4.3× |