| Abdomen 2 views (74019) |
$216.22 |
$432.43 |
2.3× |
| Ankle 2 views (73600) |
$77.93 |
$155.86 |
1.0× |
| Bone age studies (77072) |
$101.54 |
$203.09 |
1.1× |
| Bone survey complete (77075) |
$567 |
$1,134 |
6.0× |
| Cervical spine 2 or 3 views (72040) |
$186.79 |
$373.58 |
2.4× |
| Chest 1 view (71045) |
$110.01 |
$220.02 |
1.4× |
| Chest 3 views (71047) |
$124.18 |
$248.36 |
1.6× |
| Clavicle complete (73000) |
$70.85 |
$141.70 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,684.40 |
$5,368.80 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,979.70 |
$3,959.39 |
9.2× |
| CT abdomen w contrast (74160) |
$1,373.59 |
$2,747.18 |
8.6× |
| CT abdomen w wo contrast (74170) |
$1,463.45 |
$2,926.90 |
9.2× |
| CT abdomen w/o contrast (74150) |
$942.64 |
$1,885.28 |
10.0× |
| CT c-spine w/o contrast (72125) |
$1,224.76 |
$2,449.51 |
12.9× |
| CT chest w/wo contrast (71270) |
$1,577.77 |
$3,155.54 |
9.9× |
| CT chest with contrast (71260) |
$1,446.14 |
$2,892.28 |
9.1× |
| CT head/brain with contrast (70460) |
$1,207.19 |
$2,414.38 |
7.6× |
| CT head/brain without and with contrast (70470) |
$1,463.25 |
$2,926.50 |
9.2× |
| CT lower ext w/o (73700) |
$1,135.66 |
$2,271.31 |
12.0× |
| CT lower extremity w wo contrast (73702) |
$1,577.77 |
$3,155.54 |
9.9× |
| CT lower extremity with contrast (73701) |
$1,446.14 |
$2,892.28 |
9.1× |
| CT lumbar spine w/o contrast (72131) |
$1,404.25 |
$2,808.50 |
14.8× |
| CT lumbar spine with contrast (72132) |
$944.62 |
$1,889.25 |
3.0× |
| CT maxillofacial w contrast (70487) |
$1,207.19 |
$2,414.38 |
7.6× |
| CT maxillofacial w/o contrast (70486) |
$1,096.34 |
$2,192.68 |
11.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,721.88 |
$3,443.75 |
10.8× |
| CT neck soft tissue w contrast (70491) |
$1,577.77 |
$3,155.54 |
9.9× |
| CT orbits w/o contrast (70480) |
$1,004.34 |
$2,008.68 |
10.6× |
| CT pelvis w & w/o contrast (72194) |
$708.46 |
$1,416.93 |
4.5× |
| CT pelvis w/o contrast (72192) |
$1,102.14 |
$2,204.29 |
11.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,773.53 |
$3,547.06 |
11.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,374.86 |
$2,749.72 |
14.5× |
| CT thoracic spine w/contrast (72129) |
$917.11 |
$1,834.22 |
5.8× |
| CT thoracic spine w/o contrast (72128) |
$1,229.06 |
$2,458.13 |
13.0× |
| CT thorax w/o contrast (71250) |
$1,342.92 |
$2,685.84 |
14.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,577.77 |
$3,155.54 |
9.9× |
| CT upper extremity w/o contrast rt (73200) |
$977.43 |
$1,954.86 |
10.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,845.40 |
$3,690.81 |
11.6× |
| Cta Abdomen (74175) |
$1,845.40 |
$3,690.81 |
11.6× |
| CTA abdomen pelvis (74174) |
$1,845.40 |
$3,690.81 |
5.8× |
| CTA chest (71275) |
$1,845.40 |
$3,690.81 |
11.6× |
| Cta Head (70496) |
$1,845.40 |
$3,690.81 |
11.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,400 |
$4,800 |
7.6× |
| Cta Neck (70498) |
$1,845.40 |
$3,690.81 |
11.6× |
| Cta Pelvis (72191) |
$1,845.40 |
$3,690.81 |
11.6× |
| Echoencephalography real time imaging (76506) |
$250.92 |
$501.84 |
2.7× |
| Esophagus (74220) |
$300.41 |
$600.82 |
1.9× |
| Foot 2 views (73620) |
$77.93 |
$155.86 |
1.0× |
| Forearm 2 views (73090) |
$163.77 |
$327.54 |
2.1× |
| Hand 2 views (73120) |
$70.85 |
$141.70 |
0.7× |
| Hand 3 views (73130) |
$166.88 |
$333.76 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$180.16 |
$360.32 |
2.3× |
| Knee 3 views (73562) |
$191 |
$382 |
2.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,336.20 |
$2,672.39 |
6.2× |
| MRI pelvis w contrast (72196) |
$758.66 |
$1,517.32 |
2.4× |
| Neck soft tissue (70360) |
$125.52 |
$251.03 |
1.6× |
| Osseous survey infant (77076) |
$65.54 |
$131.07 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$169.48 |
$338.97 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$178.30 |
$356.59 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$155.31 |
$310.62 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$77.93 |
$155.86 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$105.39 |
$210.78 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$110.01 |
$220.02 |
1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$327.49 |
$654.98 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$115.91 |
$231.82 |
1.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$174.92 |
$349.83 |
2.2× |
| Scapula complete (73010) |
$295.38 |
$590.75 |
3.1× |
| Screening digital breast tomosynthesis (77063) |
$47.50 |
$95 |
2.0× |
| Sella turcica (70240) |
$51.06 |
$102.13 |
0.6× |
| Spine thoracic 3 views (72072) |
$221.42 |
$442.83 |
2.3× |
| Thoracolumbar 2 views (72080) |
$184.12 |
$368.24 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$402.90 |
$805.80 |
4.3× |
| Upper Extremity Infant (73092) |
$131.06 |
$262.13 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$393.56 |
$787.12 |
2.5× |
| Us breast unilateral complete (76641) |
$266.96 |
$533.91 |
2.8× |
| Us chest (76604) |
$391.16 |
$782.33 |
4.1× |
| Us compl joint r-t w/image documentation (76881) |
$349.68 |
$699.36 |
3.7× |
| Us ob transvaginal (76817) |
$218.40 |
$436.81 |
2.3× |
| Us pelvic non ob complete (76856) |
$417.61 |
$835.22 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$282.04 |
$564.09 |
3.0× |
| Us retroperitoneal complete (76770) |
$414.35 |
$828.70 |
4.4× |
| Us retroperitoneal limited (76775) |
$432.49 |
$864.98 |
4.6× |
| Us scrotum and contents (76870) |
$453.98 |
$907.95 |
4.8× |
| Us soft tissue head/neck (76536) |
$352.38 |
$704.77 |
3.7× |
| Us transrectal (76872) |
$325.94 |
$651.88 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$189.49 |
$378.98 |
2.0× |
| Wrist 2 views (73100) |
$104.08 |
$208.17 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$287.86 |
$575.72 |
3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$150 |
$300 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$174.58 |
$349.15 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$168.72 |
$337.43 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$196.31 |
$392.62 |
2.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$178.30 |
$356.59 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$177.44 |
$354.88 |
2.3× |
| X-ray exam hip uni 4/> views (73503) |
$200 |
$400 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$188.92 |
$377.85 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$286.05 |
$572.10 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$289.23 |
$578.46 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$192.50 |
$385 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$191.92 |
$383.84 |
2.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$124.57 |
$249.14 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$131.06 |
$262.13 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$221.42 |
$442.83 |
2.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$369 |
$737.99 |
3.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$221.42 |
$442.83 |
2.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$62.58 |
$125.16 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$289.23 |
$578.46 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$116.90 |
$233.80 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$185.57 |
$371.14 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$244.02 |
$488.05 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$294.64 |
$589.27 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$230.54 |
$461.09 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$230.54 |
$461.09 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$191.50 |
$382.99 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$173.70 |
$347.41 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$125 |
$250 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$140.80 |
$281.61 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$98.88 |
$197.75 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$150 |
$300 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$93.88 |
$187.75 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$184.12 |
$368.24 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$195.63 |
$391.26 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$166.05 |
$332.10 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$369 |
$737.99 |
3.9× |
| Xr chest 4+ views (71048) |
$147.73 |
$295.46 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$142.83 |
$285.66 |
1.8× |
| Xr shoulder 1 view (73020) |
$176.16 |
$352.31 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$329.34 |
$658.69 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$179.15 |
$358.30 |
2.3× |
| Xr tmj bilateral (70330) |
$101.54 |
$203.09 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$167.32 |
$334.64 |
2.1× |