| Abdomen 2 views (74019) |
$400 |
$400 |
3.8× |
| Ankle 2 views (73600) |
$344 |
$344 |
3.9× |
| Cervical spine 2 or 3 views (72040) |
$335 |
$335 |
3.8× |
| Chest 1 view (71045) |
$293 |
$293 |
3.4× |
| Chest 3 views (71047) |
$410 |
$410 |
4.7× |
| Clavicle complete (73000) |
$357 |
$357 |
4.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,200 |
$4,200 |
12.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,000 |
$3,000 |
12.5× |
| CT abdomen w contrast (74160) |
$1,980 |
$1,980 |
11.2× |
| CT abdomen w wo contrast (74170) |
$2,100 |
$2,100 |
11.9× |
| CT abdomen w/o contrast (74150) |
$1,782 |
$1,782 |
17.0× |
| CT c-spine w/o contrast (72125) |
$2,450 |
$2,450 |
23.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,600 |
$2,600 |
14.8× |
| CT cervical spine with contrast (72126) |
$2,500 |
$2,500 |
7.1× |
| CT chest w/wo contrast (71270) |
$3,168 |
$3,168 |
18.0× |
| CT chest with contrast (71260) |
$1,980 |
$1,980 |
11.2× |
| CT head/brain with contrast (70460) |
$1,980 |
$1,980 |
11.2× |
| CT head/brain without and with contrast (70470) |
$3,821.50 |
$3,821.50 |
21.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,980 |
$1,980 |
5.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,782 |
$1,782 |
20.4× |
| CT iac w contrast (70481) |
$1,980 |
$1,980 |
11.2× |
| CT lower ext w/o (73700) |
$1,615.50 |
$1,615.50 |
15.4× |
| CT lower extremity with contrast (73701) |
$2,231 |
$2,231 |
12.7× |
| CT lumbar spine w/o contrast (72131) |
$2,079 |
$2,079 |
19.8× |
| CT lumbar spine with contrast (72132) |
$2,277 |
$2,277 |
6.5× |
| CT maxillofacial w contrast (70487) |
$1,980 |
$1,980 |
11.2× |
| CT maxillofacial w/o contrast (70486) |
$1,881 |
$1,881 |
17.9× |
| CT neck soft tissue w contrast (70491) |
$2,871 |
$2,871 |
16.3× |
| CT orbits w/o contrast (70480) |
$1,782 |
$1,782 |
17.0× |
| CT pelvis w & w/o contrast (72194) |
$3,153 |
$3,153 |
17.9× |
| CT pelvis w/o contrast (72192) |
$2,178 |
$2,178 |
20.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,732.50 |
$1,732.50 |
16.5× |
| CT thoracic spine w/contrast (72129) |
$2,300 |
$2,300 |
13.1× |
| CT thoracic spine w/o contrast (72128) |
$2,277 |
$2,277 |
21.7× |
| CT thoracic spine w/wo contrast (72130) |
$2,400 |
$2,400 |
13.6× |
| CT thorax w/o contrast (71250) |
$1,782 |
$1,782 |
17.0× |
| CT upper extremity w/o contrast rt (73200) |
$2,838 |
$2,838 |
27.0× |
| CT upper extremity with contrast (73201) |
$2,231 |
$2,231 |
6.4× |
| Cta Head (70496) |
$1,287 |
$1,287 |
7.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,574 |
$2,574 |
7.3× |
| Cta Neck (70498) |
$1,287 |
$1,287 |
7.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$684 |
$684 |
6.5× |
| Foot 2 views (73620) |
$355 |
$355 |
4.1× |
| Forearm 2 views (73090) |
$335 |
$335 |
3.8× |
| Hand 2 views (73120) |
$330 |
$330 |
3.1× |
| Hand 3 views (73130) |
$393 |
$393 |
4.5× |
| Humerus Min 2 Views Left (73060) |
$361 |
$361 |
4.1× |
| Knee 3 views (73562) |
$355 |
$355 |
4.1× |
| Neck soft tissue (70360) |
$335 |
$335 |
3.8× |
| Nm whole blood volume (78122) |
$2 |
$2 |
0.0× |
| Pelvis 1 or 2 views (72170) |
$361 |
$361 |
3.4× |
| Pr red cell survival study (78130) |
$80 |
$80 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$438 |
$438 |
4.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$541 |
$541 |
5.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$422 |
$422 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$371 |
$371 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$300 |
$300 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$400 |
$400 |
4.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$283 |
$283 |
3.2× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$5 |
$5 |
0.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$2 |
$2 |
0.0× |
| Ribs bilateral 3 views (71110) |
$361 |
$361 |
3.4× |
| Scapula complete (73010) |
$503 |
$503 |
4.8× |
| Spine thoracic 3 views (72072) |
$386 |
$386 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$829 |
$829 |
7.9× |
| Urethrocystography voiding (74455) |
$116 |
$116 |
0.5× |
| Us breast unilateral complete (76641) |
$465 |
$465 |
4.4× |
| Us breast unilateral limited (76642) |
$401 |
$401 |
4.6× |
| Us chest (76604) |
$749 |
$749 |
7.1× |
| Us compl joint r-t w/image documentation (76881) |
$963 |
$963 |
9.2× |
| Us ob transvaginal (76817) |
$964 |
$964 |
9.2× |
| Us pelvic non ob complete (76856) |
$910 |
$910 |
8.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$409 |
$409 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,011 |
$1,011 |
9.6× |
| Us retroperitoneal complete (76770) |
$792 |
$792 |
7.5× |
| Us scrotum and contents (76870) |
$669 |
$669 |
6.4× |
| Us soft tissue head/neck (76536) |
$685 |
$685 |
6.5× |
| Us xtr non-vasc lmtd (76882) |
$589 |
$589 |
5.6× |
| Wrist 2 views (73100) |
$335 |
$335 |
3.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$452 |
$452 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$348 |
$348 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$386 |
$386 |
4.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$244 |
$244 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$489 |
$489 |
5.6× |
| X-ray exam hip uni 1 view (73501) |
$219 |
$219 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$309 |
$309 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$479 |
$479 |
4.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$206 |
$206 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$361 |
$361 |
4.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$386 |
$386 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$196 |
$196 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$386 |
$386 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$396 |
$396 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$206 |
$206 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$467 |
$467 |
4.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$309 |
$309 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$122 |
$122 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$368 |
$368 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$412 |
$412 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$361 |
$361 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$721 |
$721 |
8.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$366 |
$366 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$412 |
$412 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$412 |
$412 |
3.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$308 |
$308 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$317 |
$317 |
3.6× |
| Xr c-spine 6 or more views (72052) |
$335 |
$335 |
3.2× |
| Xr finger(s) 2+ views (73140) |
$348 |
$348 |
4.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$244 |
$244 |
2.3× |
| Xr tibia/fibula 2 views (73590) |
$335 |
$335 |
3.8× |
| Xr tmj bilateral (70330) |
$336 |
$336 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$342 |
$342 |
3.9× |