| Abdomen 2 views (74019) |
$128.50 |
$257 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$116.50 |
$233 |
1.3× |
| Chest 1 view (71045) |
$113 |
$226 |
1.3× |
| Clavicle complete (73000) |
$116.50 |
$233 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,443.50 |
$4,887 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,821 |
$3,642 |
7.6× |
| CT abdomen w contrast (74160) |
$991.50 |
$1,983 |
5.6× |
| CT c-spine w/o contrast (72125) |
$961 |
$1,922 |
9.2× |
| CT chest w/wo contrast (71270) |
$1,377 |
$2,754 |
7.8× |
| CT chest with contrast (71260) |
$1,100.50 |
$2,201 |
6.2× |
| CT head/brain with contrast (70460) |
$888 |
$1,776 |
5.0× |
| CT head/brain without and with contrast (70470) |
$1,146 |
$2,292 |
6.5× |
| CT lower ext w/o (73700) |
$1,113 |
$2,226 |
10.6× |
| CT lower extremity w wo contrast (73702) |
$1,206.50 |
$2,413 |
6.8× |
| CT lower extremity with contrast (73701) |
$906.50 |
$1,813 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$1,016 |
$2,032 |
9.7× |
| CT maxillofacial w/o contrast (70486) |
$694.75 |
$1,389.50 |
6.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,247 |
$2,494 |
7.1× |
| CT neck soft tissue w contrast (70491) |
$1,018.50 |
$2,037 |
5.8× |
| CT pelvis w/o contrast (72192) |
$894.50 |
$1,789 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$954.50 |
$1,909 |
9.1× |
| CT thoracic spine w/o contrast (72128) |
$1,055 |
$2,110 |
10.0× |
| CT thorax w/o contrast (71250) |
$1,024 |
$2,048 |
9.8× |
| CT upper extremity w/o contrast rt (73200) |
$833.50 |
$1,667 |
7.9× |
| CT upper extremity with contrast (73201) |
$897 |
$1,794 |
2.6× |
| Cta Abdomen (74175) |
$1,079 |
$2,158 |
6.1× |
| CTA abdomen pelvis (74174) |
$1,079 |
$2,158 |
3.1× |
| CTA chest (71275) |
$1,055 |
$2,110 |
6.0× |
| Cta Head (70496) |
$888 |
$1,776 |
5.0× |
| Cta Neck (70498) |
$830.50 |
$1,661 |
4.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$270.50 |
$541 |
2.6× |
| Forearm 2 views (73090) |
$116.50 |
$233 |
1.3× |
| Hand 3 views (73130) |
$116.50 |
$233 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$116.50 |
$233 |
1.3× |
| Knee 3 views (73562) |
$116.50 |
$233 |
1.3× |
| MRA head w/o contrast (70544) |
$1,072 |
$2,144 |
4.5× |
| MRA neck w/o contrast (70547) |
$1,118 |
$2,236 |
4.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,662 |
$3,324 |
4.7× |
| MRI cervical spine w/o contrast (72141) |
$1,120.50 |
$2,241 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,054 |
$2,108 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,598 |
$3,196 |
4.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,676 |
$3,352 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,190 |
$2,380 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$952.50 |
$1,905 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$116.50 |
$233 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$116.50 |
$233 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$125 |
$250 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$116.50 |
$233 |
1.3× |
| Ribs bilateral 3 views (71110) |
$195 |
$390 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$116.50 |
$233 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$265 |
$530 |
11.3× |
| Spine thoracic 3 views (72072) |
$159 |
$318 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$258 |
$516 |
2.5× |
| Us breast unilateral complete (76641) |
$213 |
$426 |
2.0× |
| Us breast unilateral limited (76642) |
$188.50 |
$377 |
2.2× |
| Us pelvic non ob complete (76856) |
$269.50 |
$539 |
2.6× |
| Us retroperitoneal complete (76770) |
$264 |
$528 |
2.5× |
| Us scrotum and contents (76870) |
$267 |
$534 |
2.5× |
| Us soft tissue head/neck (76536) |
$238 |
$476 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$116.50 |
$233 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$116.50 |
$233 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$169 |
$338 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$116.50 |
$233 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$116.50 |
$233 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$122.50 |
$245 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$125 |
$250 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$128.50 |
$257 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$137.50 |
$275 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$185.50 |
$371 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$128.50 |
$257 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$119 |
$238 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$116.50 |
$233 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$116.50 |
$233 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$116.50 |
$233 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$197.50 |
$395 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$161.50 |
$323 |
1.8× |