| Abdomen 2 views (74019) |
$234 |
$234 |
2.2× |
| Ankle 2 views (73600) |
$259.74 |
$259.74 |
3.0× |
| Cervical spine 2 or 3 views (72040) |
$313 |
$313 |
3.6× |
| Chest 1 view (71045) |
$259.74 |
$259.74 |
3.0× |
| Clavicle complete (73000) |
$259.74 |
$259.74 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,545 |
$1,545 |
4.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,030 |
$1,030 |
4.3× |
| CT abdomen w contrast (74160) |
$1,236 |
$1,236 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,648 |
$1,648 |
9.4× |
| CT abdomen w/o contrast (74150) |
$1,030 |
$1,030 |
9.8× |
| CT c-spine w/o contrast (72125) |
$1,030 |
$1,030 |
9.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,100 |
$1,100 |
6.2× |
| CT cervical spine with contrast (72126) |
$1,129 |
$1,129 |
3.2× |
| CT chest w/wo contrast (71270) |
$1,785 |
$1,785 |
10.1× |
| CT chest with contrast (71260) |
$1,300 |
$1,300 |
7.4× |
| CT head/brain with contrast (70460) |
$1,300 |
$1,300 |
7.4× |
| CT head/brain without and with contrast (70470) |
$1,288 |
$1,288 |
7.3× |
| CT lower ext w/o (73700) |
$1,030 |
$1,030 |
9.8× |
| CT lower extremity w wo contrast (73702) |
$1,053 |
$1,053 |
6.0× |
| CT lower extremity with contrast (73701) |
$989 |
$989 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$1,030 |
$1,030 |
9.8× |
| CT lumbar spine with contrast (72132) |
$1,129 |
$1,129 |
3.2× |
| CT maxillofacial w contrast (70487) |
$1,300 |
$1,300 |
7.4× |
| CT maxillofacial w/o contrast (70486) |
$1,030 |
$1,030 |
9.8× |
| CT neck soft tissue w contrast (70491) |
$1,300 |
$1,300 |
7.4× |
| CT orbits w/o contrast (70480) |
$515 |
$515 |
4.9× |
| CT pelvis w & w/o contrast (72194) |
$1,442 |
$1,442 |
8.2× |
| CT pelvis w/o contrast (72192) |
$1,030 |
$1,030 |
9.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,054 |
$1,054 |
6.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,100 |
$1,100 |
10.5× |
| CT thoracic spine w/o contrast (72128) |
$1,030 |
$1,030 |
9.8× |
| CT thorax w/o contrast (71250) |
$1,030 |
$1,030 |
9.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,030 |
$1,030 |
9.8× |
| CT upper extremity with contrast (73201) |
$1,129 |
$1,129 |
3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,030 |
$1,030 |
5.8× |
| CTA chest (71275) |
$1,236 |
$1,236 |
7.0× |
| Cta Head (70496) |
$989 |
$989 |
5.6× |
| Cta Neck (70498) |
$1,030 |
$1,030 |
5.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$259.74 |
$259.74 |
3.0× |
| Foot 2 views (73620) |
$259.74 |
$259.74 |
3.0× |
| Forearm 2 views (73090) |
$259.74 |
$259.74 |
3.0× |
| Hand 2 views (73120) |
$313 |
$313 |
3.0× |
| Hand 3 views (73130) |
$259.74 |
$259.74 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$259.74 |
$259.74 |
3.0× |
| Knee 3 views (73562) |
$259.74 |
$259.74 |
3.0× |
| MRA head w/o contrast (70544) |
$700.41 |
$700.41 |
2.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,288.64 |
$2,288.64 |
2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,288.64 |
$2,288.64 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$872 |
$872 |
3.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$872 |
$872 |
3.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,415 |
$1,415 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,415 |
$1,415 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$872 |
$872 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$872 |
$872 |
3.6× |
| Neck soft tissue (70360) |
$259.74 |
$259.74 |
3.0× |
| Osseous survey infant (77076) |
$334 |
$334 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$313 |
$313 |
3.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$259.74 |
$259.74 |
3.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$309 |
$309 |
2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297.50 |
$297.50 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$259.74 |
$259.74 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$259.74 |
$259.74 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$259.74 |
$259.74 |
3.0× |
| Ribs bilateral 3 views (71110) |
$323.50 |
$323.50 |
3.1× |
| Scapula complete (73010) |
$314.25 |
$314.25 |
3.0× |
| Thoracolumbar 2 views (72080) |
$259.74 |
$259.74 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$475 |
$475 |
4.5× |
| Us breast unilateral complete (76641) |
$284 |
$284 |
2.7× |
| Us breast unilateral limited (76642) |
$392 |
$392 |
4.5× |
| Us compl joint r-t w/image documentation (76881) |
$475 |
$475 |
4.5× |
| Us ob detailed single fetus (76811) |
$591 |
$591 |
2.5× |
| Us ob transvaginal (76817) |
$475 |
$475 |
4.5× |
| Us pelvic non ob complete (76856) |
$500 |
$500 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$284 |
$284 |
2.7× |
| Us retroperitoneal complete (76770) |
$475 |
$475 |
4.5× |
| Us retroperitoneal limited (76775) |
$473 |
$473 |
4.5× |
| Us scrotum and contents (76870) |
$500 |
$500 |
4.8× |
| Us soft tissue head/neck (76536) |
$475 |
$475 |
4.5× |
| Us xtr non-vasc lmtd (76882) |
$299 |
$299 |
2.8× |
| Vertebral fracture assessment via dxa (77086) |
$259.74 |
$259.74 |
3.0× |
| Wrist 2 views (73100) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$313 |
$313 |
3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$314.25 |
$314.25 |
3.0× |
| X-ray eye for foreign body (70030) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$313 |
$313 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$313 |
$313 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$313 |
$313 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$279.50 |
$279.50 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$334 |
$334 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$313 |
$313 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$334 |
$334 |
3.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$313 |
$313 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$259.74 |
$259.74 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$259.74 |
$259.74 |
3.0× |
| Xr c-spine 6 or more views (72052) |
$313 |
$313 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$259.74 |
$259.74 |
3.0× |
| Xr shoulder 1 view (73020) |
$259.74 |
$259.74 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$259.74 |
$259.74 |
3.0× |
| Xr tmj bilateral (70330) |
$259.74 |
$259.74 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$259.74 |
$259.74 |
3.0× |