| Abdomen 2 views (74019) |
$179.04 |
$179.04 |
1.7× |
| Ankle 2 views (73600) |
$143.07 |
$143.07 |
1.6× |
| Bone age studies (77072) |
$249.01 |
$249.01 |
2.4× |
| Bone survey complete (77075) |
$273.62 |
$273.62 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$165.10 |
$165.10 |
1.9× |
| Chest 1 view (71045) |
$151.84 |
$151.84 |
1.7× |
| Chest 3 views (71047) |
$168.42 |
$168.42 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$430.35 |
$430.35 |
2.4× |
| Clavicle complete (73000) |
$143.97 |
$143.97 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$237.94 |
$237.94 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,033.71 |
$2,033.71 |
5.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,515.76 |
$1,515.76 |
6.3× |
| CT abdomen w contrast (74160) |
$1,334.57 |
$1,334.57 |
7.6× |
| CT abdomen w wo contrast (74170) |
$1,592.62 |
$1,592.62 |
9.0× |
| CT abdomen w/o contrast (74150) |
$1,078.92 |
$1,078.92 |
10.3× |
| CT angiography upper extremity lt (73206) |
$1,869.55 |
$1,869.55 |
10.6× |
| CT c-spine w/o contrast (72125) |
$1,066.16 |
$1,066.16 |
10.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,584.10 |
$1,584.10 |
9.0× |
| CT cervical spine with contrast (72126) |
$1,330.80 |
$1,330.80 |
3.8× |
| CT chest w/wo contrast (71270) |
$266.19 |
$266.19 |
1.5× |
| CT chest with contrast (71260) |
$1,327.48 |
$1,327.48 |
7.5× |
| CT head/brain with contrast (70460) |
$1,325.12 |
$1,325.12 |
7.5× |
| CT head/brain without and with contrast (70470) |
$1,584.57 |
$1,584.57 |
9.0× |
| CT iac w contrast (70481) |
$1,325.12 |
$1,325.12 |
7.5× |
| CT lower ext w/o (73700) |
$1,066.16 |
$1,066.16 |
10.2× |
| CT lower extremity w wo contrast (73702) |
$1,580.34 |
$1,580.34 |
9.0× |
| CT lower extremity with contrast (73701) |
$1,327.02 |
$1,327.02 |
7.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,584.10 |
$1,584.10 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$1,066.16 |
$1,066.16 |
10.2× |
| CT lumbar spine with contrast (72132) |
$1,330.80 |
$1,330.80 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,325.12 |
$1,325.12 |
7.5× |
| CT maxillofacial w/o contrast (70486) |
$1,057.15 |
$1,057.15 |
10.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,584.10 |
$1,584.10 |
9.0× |
| CT neck soft tissue w contrast (70491) |
$1,341.66 |
$1,341.66 |
7.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$168.21 |
$168.21 |
1.0× |
| CT orbits w/o contrast (70480) |
$1,085.50 |
$1,085.50 |
10.3× |
| CT pelvis w & w/o contrast (72194) |
$1,580.80 |
$1,580.80 |
9.0× |
| CT pelvis w/o contrast (72192) |
$1,072.30 |
$1,072.30 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,607.26 |
$1,607.26 |
9.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,085.50 |
$1,085.50 |
10.3× |
| CT thoracic spine w/contrast (72129) |
$1,331.26 |
$1,331.26 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$1,066.16 |
$1,066.16 |
10.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,584.57 |
$1,584.57 |
9.0× |
| CT thorax w/o contrast (71250) |
$1,071.82 |
$1,071.82 |
10.2× |
| CT unlisted procedure (76497) |
$183.84 |
$183.84 |
2.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,580.34 |
$1,580.34 |
9.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,066.16 |
$1,066.16 |
10.2× |
| CT upper extremity with contrast (73201) |
$1,327.02 |
$1,327.02 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,157.84 |
$2,157.84 |
12.2× |
| Cta Abdomen (74175) |
$1,870.94 |
$1,870.94 |
10.6× |
| CTA abdomen pelvis (74174) |
$1,896.44 |
$1,896.44 |
5.4× |
| CTA chest (71275) |
$1,871.41 |
$1,871.41 |
10.6× |
| Cta Head (70496) |
$1,866.24 |
$1,866.24 |
10.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,875.68 |
$1,875.68 |
10.6× |
| Cta Neck (70498) |
$1,911.74 |
$1,911.74 |
10.8× |
| Cta Pelvis (72191) |
$1,869.55 |
$1,869.55 |
10.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$188.23 |
$188.23 |
1.8× |
| Echoencephalography real time imaging (76506) |
$220.26 |
$220.26 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$221.21 |
$221.21 |
0.9× |
| Foot 2 views (73620) |
$142.14 |
$142.14 |
1.6× |
| Forearm 2 views (73090) |
$159.22 |
$159.22 |
1.8× |
| Hand 2 views (73120) |
$160.12 |
$160.12 |
1.5× |
| Hand 3 views (73130) |
$187.04 |
$187.04 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$143.07 |
$143.07 |
1.6× |
| Knee 3 views (73562) |
$162.97 |
$162.97 |
1.9× |
| MRA head w & w/o contrast (70546) |
$1,848.28 |
$1,848.28 |
5.3× |
| MRA head w/o contrast (70544) |
$1,829.40 |
$1,829.40 |
7.6× |
| MRA head with contrast (70545) |
$1,829.40 |
$1,829.40 |
5.2× |
| MRA neck w contrast (70548) |
$1,849.69 |
$1,849.69 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,865.04 |
$1,865.04 |
5.3× |
| MRA neck w/o contrast (70547) |
$1,829.84 |
$1,829.84 |
7.6× |
| MRI abdomen w contrast (74182) |
$1,364.81 |
$1,364.81 |
3.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,646.91 |
$1,646.91 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,146.86 |
$1,146.86 |
4.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,358.18 |
$1,358.18 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,358.18 |
$1,358.18 |
1.7× |
| MRI c-spine with contrast (72142) |
$1,369.96 |
$1,369.96 |
3.9× |
| MRI cervical spine w/o contrast (72141) |
$1,098.73 |
$1,098.73 |
4.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,651.16 |
$1,651.16 |
4.7× |
| MRI chest w/o contrast (71550) |
$1,097.32 |
$1,097.32 |
4.6× |
| MRI chest with contrast (71551) |
$1,364.81 |
$1,364.81 |
1.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,357.73 |
$1,357.73 |
3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,357.73 |
$1,357.73 |
3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,089.78 |
$1,089.78 |
4.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,089.31 |
$1,089.31 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,643.60 |
$1,643.60 |
4.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,357.73 |
$1,357.73 |
3.9× |
| MRI pelvis w contrast (72196) |
$1,364.81 |
$1,364.81 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,646.91 |
$1,646.91 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$1,097.32 |
$1,097.32 |
4.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,644.06 |
$1,644.06 |
4.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,644.06 |
$1,644.06 |
4.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,653.50 |
$1,653.50 |
4.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,369.49 |
$1,369.49 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,653.50 |
$1,653.50 |
4.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,368.59 |
$1,368.59 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,653.50 |
$1,653.50 |
4.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,098.73 |
$1,098.73 |
4.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,090.22 |
$1,090.22 |
4.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,644.06 |
$1,644.06 |
4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,090.22 |
$1,090.22 |
4.5× |
| Neck soft tissue (70360) |
$133.62 |
$133.62 |
1.5× |
| Osseous survey infant (77076) |
$283.46 |
$283.46 |
2.7× |
| Osseous survey limited (77074) |
$266.22 |
$266.22 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$175.24 |
$175.24 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,644.06 |
$1,644.06 |
4.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$184.70 |
$184.70 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$178.56 |
$178.56 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$177.38 |
$177.38 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$180.45 |
$180.45 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$135.04 |
$135.04 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$181.41 |
$181.41 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$136.08 |
$136.08 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$145.89 |
$145.89 |
1.7× |
| Radiological examination surgical specimen (76098) |
$684.02 |
$684.02 |
1.2× |
| Ribs bilateral 3 views (71110) |
$202.18 |
$202.18 |
1.9× |
| Scanogram (77073) |
$254.84 |
$254.84 |
2.4× |
| Scapula complete (73010) |
$187.96 |
$187.96 |
1.8× |
| Sella turcica (70240) |
$134.10 |
$134.10 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$289.21 |
$289.21 |
2.8× |
| Unlisted Ultrasound Procedure (76999) |
$182.34 |
$182.34 |
2.1× |
| Upper Extremity Infant (73092) |
$174.32 |
$174.32 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$236.39 |
$236.39 |
2.3× |
| Us breast unilateral complete (76641) |
$203.36 |
$203.36 |
1.9× |
| Us chest (76604) |
$238.30 |
$238.30 |
2.3× |
| Us compl joint r-t w/image documentation (76881) |
$310.46 |
$310.46 |
3.0× |
| Us ob transvaginal (76817) |
$275.08 |
$275.08 |
2.6× |
| Us pelvic non ob complete (76856) |
$270.82 |
$270.82 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$208.08 |
$208.08 |
2.0× |
| Us pregnancy ltd (76815) |
$197.71 |
$197.71 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$303.64 |
$303.64 |
2.9× |
| Us retroperitoneal complete (76770) |
$299.14 |
$299.14 |
2.8× |
| Us retroperitoneal limited (76775) |
$213.73 |
$213.73 |
2.0× |
| Us scrotum and contents (76870) |
$196.78 |
$196.78 |
1.9× |
| Us soft tissue head/neck (76536) |
$262.78 |
$262.78 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$200.54 |
$200.54 |
1.9× |
| Vertebral fracture assessment via dxa (77086) |
$132.69 |
$132.69 |
1.5× |
| Wrist 2 views (73100) |
$143.97 |
$143.97 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$185.18 |
$185.18 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$134.08 |
$134.08 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$161.08 |
$161.08 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$143.97 |
$143.97 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$146.82 |
$146.82 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$136.46 |
$136.46 |
1.6× |
| X-ray eye for foreign body (70030) |
$133.62 |
$133.62 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$217.48 |
$217.48 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$177.12 |
$177.12 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$160.18 |
$160.18 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$143.07 |
$143.07 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$133.62 |
$133.62 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$193.61 |
$193.61 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$136.78 |
$136.78 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$132.21 |
$132.21 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$178.56 |
$178.56 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$220.76 |
$220.76 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$190.10 |
$190.10 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$149.29 |
$149.29 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$133.62 |
$133.62 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$181.38 |
$181.38 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$180.45 |
$180.45 |
1.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$294.38 |
$294.38 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$136.46 |
$136.46 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$181.41 |
$181.41 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$296.72 |
$296.72 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$178.58 |
$178.58 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$133.14 |
$133.14 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$146.82 |
$146.82 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$152.14 |
$152.14 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$133.14 |
$133.14 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$218.88 |
$218.88 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$175.72 |
$175.72 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$135.99 |
$135.99 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$134.58 |
$134.58 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$176.96 |
$176.96 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$155.44 |
$155.44 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$161.08 |
$161.08 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$256.84 |
$256.84 |
2.4× |
| Xr chest 4+ views (71048) |
$270.79 |
$270.79 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$156.34 |
$156.34 |
1.8× |
| Xr shoulder 1 view (73020) |
$142.11 |
$142.11 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$218.42 |
$218.42 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$143.07 |
$143.07 |
1.6× |
| Xr tmj bilateral (70330) |
$137.42 |
$137.42 |
1.6× |
| Xray knee 1 or 2 views rt (73560) |
$143.97 |
$143.97 |
1.6× |