| Abdomen 2 views (74019) |
$388.80 |
$648 |
4.0× |
| Ankle 2 views (73600) |
$265.80 |
$443 |
3.3× |
| Bone age studies (77072) |
$247.80 |
$413 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$333 |
$555 |
4.1× |
| Chest 1 view (71045) |
$213.60 |
$356 |
2.6× |
| Chest 3 views (71047) |
$388.80 |
$648 |
4.8× |
| Clavicle complete (73000) |
$294 |
$490 |
3.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,011.80 |
$3,353 |
20.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,270.40 |
$8,784 |
16.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,292.80 |
$5,488 |
14.7× |
| CT abdomen w contrast (74160) |
$1,892.40 |
$3,154 |
11.5× |
| CT abdomen w wo contrast (74170) |
$2,256.60 |
$3,761 |
13.7× |
| CT abdomen w/o contrast (74150) |
$1,533 |
$2,555 |
15.6× |
| CT angiography upper extremity lt (73206) |
$2,098.80 |
$3,498 |
12.8× |
| CT c-spine w/o contrast (72125) |
$2,537.40 |
$4,229 |
25.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,693.40 |
$4,489 |
16.4× |
| CT cervical spine with contrast (72126) |
$2,461.80 |
$4,103 |
7.5× |
| CT chest w/wo contrast (71270) |
$2,899.80 |
$4,833 |
17.6× |
| CT chest with contrast (71260) |
$2,422.80 |
$4,038 |
14.7× |
| CT head/brain with contrast (70460) |
$1,577.40 |
$2,629 |
9.6× |
| CT head/brain without and with contrast (70470) |
$2,240.40 |
$3,734 |
13.6× |
| CT lower ext w/o (73700) |
$1,463.40 |
$2,439 |
14.9× |
| CT lower extremity with contrast (73701) |
$2,067.60 |
$3,446 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$2,088.60 |
$3,481 |
21.3× |
| CT maxillofacial w contrast (70487) |
$2,067.60 |
$3,446 |
12.6× |
| CT maxillofacial w/o contrast (70486) |
$1,595.40 |
$2,659 |
16.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,346.60 |
$3,911 |
14.3× |
| CT neck soft tissue w contrast (70491) |
$2,067.60 |
$3,446 |
12.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,346.60 |
$3,911 |
14.3× |
| CT orbits w/o contrast (70480) |
$1,636.20 |
$2,727 |
16.7× |
| CT pelvis w & w/o contrast (72194) |
$3,015.60 |
$5,026 |
18.3× |
| CT pelvis w/o contrast (72192) |
$1,700.40 |
$2,834 |
17.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,346.60 |
$3,911 |
14.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,636.20 |
$2,727 |
16.7× |
| CT thoracic spine w/o contrast (72128) |
$2,247 |
$3,745 |
22.9× |
| CT thorax w/o contrast (71250) |
$2,011.80 |
$3,353 |
20.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,463.40 |
$2,439 |
14.9× |
| CT upper extremity with contrast (73201) |
$2,067.60 |
$3,446 |
6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,219.40 |
$3,699 |
13.5× |
| CTA abdomen pelvis (74174) |
$4,842.60 |
$8,071 |
14.8× |
| CTA chest (71275) |
$2,693.40 |
$4,489 |
16.4× |
| Cta Head (70496) |
$2,098.20 |
$3,497 |
12.7× |
| CTA lwr ext w&w/o contrast (73706) |
$4,195.80 |
$6,993 |
25.5× |
| Cta Neck (70498) |
$2,098.20 |
$3,497 |
12.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$579.60 |
$966 |
5.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$89.40 |
$149 |
1.1× |
| Dxa bone density study axial skeleton (77085) |
$293.40 |
$489 |
3.0× |
| Foot 2 views (73620) |
$231.60 |
$386 |
2.8× |
| Forearm 2 views (73090) |
$285.60 |
$476 |
3.5× |
| Hand 2 views (73120) |
$229.80 |
$383 |
2.3× |
| Hand 3 views (73130) |
$300.60 |
$501 |
3.7× |
| Humerus Min 2 Views Left (73060) |
$294 |
$490 |
3.6× |
| Knee 3 views (73562) |
$231.60 |
$386 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$3,052.20 |
$5,087 |
13.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,166.60 |
$3,611 |
9.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,052.20 |
$5,087 |
13.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,205.20 |
$5,342 |
9.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,205.20 |
$5,342 |
14.3× |
| MRI upper ext joint w/o contrast (73221) |
$3,205.20 |
$5,342 |
14.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,306.40 |
$3,844 |
10.3× |
| Neck soft tissue (70360) |
$265.80 |
$443 |
3.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$809.40 |
$1,349 |
8.3× |
| Osseous survey infant (77076) |
$339 |
$565 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$294 |
$490 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$541.20 |
$902 |
5.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$573.90 |
$956.50 |
5.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$1,273.20 |
$2,122 |
13.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$477.60 |
$796 |
4.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$294 |
$490 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$397.80 |
$663 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$251.40 |
$419 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$294 |
$490 |
3.6× |
| Ribs bilateral 3 views (71110) |
$581.40 |
$969 |
5.9× |
| Sacroiliac Joints < 3 Views (72200) |
$161.40 |
$269 |
1.6× |
| Scanogram (77073) |
$320.40 |
$534 |
3.3× |
| Scapula complete (73010) |
$294 |
$490 |
3.0× |
| Spine thoracic 3 views (72072) |
$449.40 |
$749 |
4.6× |
| Ultrasound, abdomen limited (76705) |
$664.20 |
$1,107 |
6.8× |
| Us abdl aorta screen aaa (76706) |
$405 |
$675 |
4.1× |
| Us breast unilateral complete (76641) |
$462.60 |
$771 |
4.7× |
| Us breast unilateral limited (76642) |
$462.60 |
$771 |
5.7× |
| Us chest (76604) |
$898.80 |
$1,498 |
9.2× |
| Us compl joint r-t w/image documentation (76881) |
$227.40 |
$379 |
2.3× |
| Us ob transvaginal (76817) |
$813 |
$1,355 |
8.3× |
| Us pelvic non ob complete (76856) |
$918.60 |
$1,531 |
9.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$637.20 |
$1,062 |
6.5× |
| Us pregnancy ltd (76815) |
$643.20 |
$1,072 |
6.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$809.40 |
$1,349 |
8.3× |
| Us retroperitoneal complete (76770) |
$581.40 |
$969 |
5.9× |
| Us retroperitoneal limited (76775) |
$406.20 |
$677 |
4.1× |
| Us scrotum and contents (76870) |
$907.20 |
$1,512 |
9.2× |
| Us soft tissue head/neck (76536) |
$723.60 |
$1,206 |
7.4× |
| Us xtr non-vasc lmtd (76882) |
$149.40 |
$249 |
1.5× |
| Wrist 2 views (73100) |
$285.60 |
$476 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$684.60 |
$1,141 |
7.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$317.40 |
$529 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$255 |
$425 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$333 |
$555 |
4.1× |
| X-ray exam hip uni 1 view (73501) |
$213 |
$355 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$234 |
$390 |
2.9× |
| X-ray exam hip uni 4/> views (73503) |
$243 |
$405 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$571.80 |
$953 |
5.8× |
| X-ray exam of femur 1 (73551) |
$140.40 |
$234 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$432.60 |
$721 |
4.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$301.20 |
$502 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$285.60 |
$476 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$364.80 |
$608 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$399 |
$665 |
4.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$361.20 |
$602 |
4.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$348 |
$580 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$648 |
$1,080 |
6.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$366 |
$610 |
3.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$294 |
$490 |
3.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$304.20 |
$507 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$383.40 |
$639 |
4.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$468.60 |
$781 |
4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$664.20 |
$1,107 |
6.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$364.80 |
$608 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$333 |
$555 |
4.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$294 |
$490 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$477 |
$795 |
5.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$259.80 |
$433 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$477.60 |
$796 |
4.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$259.80 |
$433 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$294 |
$490 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$247.80 |
$413 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$315 |
$525 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$173.40 |
$289 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$331.20 |
$552 |
4.1× |
| Xr c-spine 6 or more views (72052) |
$581.40 |
$969 |
5.9× |
| Xr finger(s) 2+ views (73140) |
$238.20 |
$397 |
2.9× |
| Xr shoulder 1 view (73020) |
$190.20 |
$317 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$445.80 |
$743 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$301.20 |
$502 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$205.80 |
$343 |
2.5× |