| Abdomen 1 View (74018) |
$140 |
$140 |
1.6× |
| Abdomen 2 views (74019) |
$174 |
$174 |
1.6× |
| Ankle 2 views (73600) |
$163 |
$163 |
1.8× |
| Bone age studies (77072) |
$113 |
$113 |
1.1× |
| Chest 1 view (71045) |
$113 |
$113 |
1.3× |
| Chest 2 views (71046) |
$154 |
$154 |
1.7× |
| Chest 3 views (71047) |
$196 |
$196 |
2.2× |
| Clavicle complete (73000) |
$161 |
$161 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,100 |
$1,100 |
10.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,679 |
$2,679 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,091 |
$1,091 |
4.5× |
| CT Angio Abdomen and Pelvis (74174) |
$2,957 |
$2,957 |
8.3× |
| CT Angio Chest (71275) |
$2,082 |
$2,082 |
11.6× |
| CT cervical spine w/o contrast (72125) |
$1,226 |
$1,226 |
11.5× |
| CT cervical spine w/wo cont (72127) |
$1,935 |
$1,935 |
10.8× |
| CT chest w contrast (71260) |
$1,385 |
$1,385 |
7.7× |
| CT chest w/wo contrast (71270) |
$1,706 |
$1,706 |
9.5× |
| CT head/brain with contrast (70460) |
$1,024 |
$1,024 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,233 |
$1,233 |
6.9× |
| CT l-spine w&w/o contrast (72133) |
$2,002 |
$2,002 |
11.2× |
| CT lower ext w/o (73700) |
$1,215 |
$1,215 |
11.4× |
| CT lower extremity w/contrast material (73701) |
$1,573 |
$1,573 |
8.8× |
| CT lumbar spine w contrast (72132) |
$1,564 |
$1,564 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$1,215 |
$1,215 |
11.4× |
| CT maxillofacial w contrast (70487) |
$1,071 |
$1,071 |
6.0× |
| CT maxillofacial wo contrast (70486) |
$938 |
$938 |
8.8× |
| CT neck tissue combo (70492) |
$1,700 |
$1,700 |
9.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,139 |
$2,139 |
11.9× |
| CT orbits w/o contrast (70480) |
$1,584 |
$1,584 |
14.8× |
| CT pelvis w/o contrast (72192) |
$882 |
$882 |
8.3× |
| CT scans face/jaw combo (70488) |
$1,362 |
$1,362 |
7.6× |
| CT soft tissue neck w contrast (70491) |
$1,376 |
$1,376 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,067 |
$1,067 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$1,222 |
$1,222 |
11.4× |
| CT thorax w/o contrast (71250) |
$1,073 |
$1,073 |
10.0× |
| CT upper ext wo (73200) |
$1,256 |
$1,256 |
11.8× |
| CT upper extremity with contrast (73201) |
$1,605 |
$1,605 |
4.5× |
| Cta Abdomen (74175) |
$2,341 |
$2,341 |
13.1× |
| Dxa Bone Density Axial (77080) |
$200 |
$200 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$51 |
$51 |
0.2× |
| Foot 2 views (73620) |
$140 |
$140 |
1.6× |
| Forearm 2 views (73090) |
$141 |
$141 |
1.6× |
| Hand 2 views (73120) |
$154 |
$154 |
1.4× |
| Knee 3 Views (73562) |
$209 |
$209 |
2.4× |
| MRA neck w contrast (70548) |
$2,929 |
$2,929 |
8.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,317 |
$3,317 |
9.3× |
| MRI cervical spine w/o cont (72141) |
$1,373 |
$1,373 |
5.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,273 |
$3,273 |
9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,463 |
$2,463 |
10.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,433 |
$2,433 |
6.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,721 |
$2,721 |
7.6× |
| MRI pelvis w/o & w contrast (72197) |
$3,252 |
$3,252 |
9.1× |
| MRI pelvis w/o contrast (72195) |
$2,505 |
$2,505 |
10.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,376 |
$1,376 |
5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,742 |
$2,742 |
11.2× |
| MRI, abdomen, combo (74183) |
$2,824 |
$2,824 |
7.9× |
| MRI, dorsal spine combo (72157) |
$2,444 |
$2,444 |
6.9× |
| MRI, joint upper extrem (73221) |
$1,550 |
$1,550 |
6.4× |
| MRI, lumbar spine combo (72158) |
$2,427 |
$2,427 |
6.8× |
| Neck soft tissue (70360) |
$152 |
$152 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$155 |
$155 |
1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$230 |
$230 |
2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$189 |
$189 |
2.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$140 |
$140 |
1.6× |
| Radex elbow complete minimum 3 views (73080) |
$160 |
$160 |
1.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$232 |
$232 |
2.2× |
| Radex fingr minimum 2 views (73140) |
$205 |
$205 |
2.3× |
| Radex foot complete minimum 3 views (73630) |
$176 |
$176 |
2.0× |
| Radex Hand Minimum 3 Views (73130) |
$186 |
$186 |
2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$175 |
$175 |
2.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$174 |
$174 |
2.0× |
| Radex shoulder complete minimum 2 views (73030) |
$167 |
$167 |
1.9× |
| Radex Sternum Minimum 2 Views (71120) |
$161 |
$161 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$152 |
$152 |
1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$214 |
$214 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$210 |
$210 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$206 |
$206 |
1.9× |
| Radiologic exam knee complete 4/more views (73564) |
$235 |
$235 |
2.2× |
| Radiologic examination femur minimum 2 views (73552) |
$177 |
$177 |
2.0× |
| Radiologic examination knee 1/2 views (73560) |
$176 |
$176 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$160 |
$160 |
1.8× |
| Ribs bilateral 3 views (71110) |
$201 |
$201 |
1.9× |
| Scapula (73010) |
$147 |
$147 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$167 |
$167 |
7.1× |
| Shoulder 1 view (73020) |
$101 |
$101 |
1.1× |
| Thoracic spine 2 views (72070) |
$152 |
$152 |
1.4× |
| Thoracic spine 3 views (72072) |
$189 |
$189 |
1.8× |
| Thoracolumbar 2 views (72080) |
$163 |
$163 |
1.8× |
| Ultrasound Breast Limited (76642) |
$354 |
$354 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$405 |
$405 |
3.8× |
| Us complete joint (76881) |
$526 |
$526 |
4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$215 |
$215 |
2.0× |
| Us pelvic non ob complete (76856) |
$496 |
$496 |
4.6× |
| Us retroperitoneal complete (76770) |
$500 |
$500 |
4.7× |
| Us retroperitoneal limited (76775) |
$197 |
$197 |
1.8× |
| Us scrotum and contents (76870) |
$481 |
$481 |
4.5× |
| Us thyroid (76536) |
$577 |
$577 |
5.4× |
| Wrist 2 views (73100) |
$174 |
$174 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$171 |
$171 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$140 |
$140 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$239 |
$239 |
2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$202 |
$202 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$262 |
$262 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$311 |
$311 |
2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$191 |
$191 |
2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$196 |
$196 |
1.8× |
| X-ray humerus (73060) |
$161 |
$161 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$216 |
$216 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$193 |
$193 |
1.8× |
| X-ray nose-rectum child f.b. (76010) |
$115 |
$115 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$248 |
$248 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$160 |
$160 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$182 |
$182 |
2.0× |
| Xr c-spine 4 or 5 views (72050) |
$263 |
$263 |
2.5× |