| Abdomen 2 views (74019) |
$178 |
$445 |
1.7× |
| Ankle 2 views (73600) |
$94.40 |
$236 |
1.1× |
| Bone age studies (77072) |
$162.40 |
$406 |
1.5× |
| Bone survey complete (77075) |
$220.80 |
$552 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$135.20 |
$338 |
1.5× |
| Chest 1 view (71045) |
$84 |
$210 |
1.0× |
| Chest 3 views (71047) |
$172 |
$430 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$287.60 |
$719 |
1.6× |
| Clavicle complete (73000) |
$110.80 |
$277 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$482.40 |
$1,206 |
4.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,020.40 |
$2,551 |
2.9× |
| CT abdomen and pelvis without contrast (74176) |
$696 |
$1,740 |
2.9× |
| CT abdomen w contrast (74160) |
$858.40 |
$2,146 |
4.9× |
| CT abdomen w wo contrast (74170) |
$1,159.60 |
$2,899 |
6.6× |
| CT c-spine w/o contrast (72125) |
$702.80 |
$1,757 |
6.7× |
| CT chest w/wo contrast (71270) |
$1,066.80 |
$2,667 |
6.1× |
| CT chest with contrast (71260) |
$742 |
$1,855 |
4.2× |
| CT head/brain with contrast (70460) |
$695.60 |
$1,739 |
3.9× |
| CT lower ext w/o (73700) |
$543.60 |
$1,359 |
5.2× |
| CT lower extremity with contrast (73701) |
$649.60 |
$1,624 |
3.7× |
| CT lumbar spine w/o contrast (72131) |
$808 |
$2,020 |
7.7× |
| CT maxillofacial w/o contrast (70486) |
$557.20 |
$1,393 |
5.3× |
| CT maxillofacial w/wo contrast (70488) |
$868.80 |
$2,172 |
4.9× |
| CT neck soft tissue w contrast (70491) |
$527.60 |
$1,319 |
3.0× |
| CT orbits w/o contrast (70480) |
$741.60 |
$1,854 |
7.1× |
| CT pelvis w/o contrast (72192) |
$511.20 |
$1,278 |
4.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$480 |
$1,200 |
5.5× |
| CT thoracic spine w/o contrast (72128) |
$889.60 |
$2,224 |
8.5× |
| CT thorax w/o contrast (71250) |
$525.20 |
$1,313 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$715.20 |
$1,788 |
6.8× |
| CTA abdomen pelvis (74174) |
$876.80 |
$2,192 |
2.5× |
| CTA chest (71275) |
$676.20 |
$1,690.50 |
3.8× |
| Cta Head (70496) |
$691.80 |
$1,729.50 |
3.9× |
| CTA lwr ext w&w/o contrast (73706) |
$889.20 |
$2,223 |
5.0× |
| Cta Neck (70498) |
$527.60 |
$1,319 |
3.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$197.60 |
$494 |
1.9× |
| Dxa bone density study axial skeleton (77085) |
$231.60 |
$579 |
2.2× |
| Fetal biophysical profile non-stress testing (76818) |
$177.20 |
$443 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$187 |
$467.50 |
1.8× |
| Foot 2 views (73620) |
$126.80 |
$317 |
1.5× |
| Forearm 2 views (73090) |
$123.20 |
$308 |
1.4× |
| Hand 2 views (73120) |
$118.40 |
$296 |
1.1× |
| Hand 3 views (73130) |
$153.60 |
$384 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$84 |
$210 |
1.0× |
| Hysterosalpingogram (74740) |
$218.40 |
$546 |
0.9× |
| Knee 3 views (73562) |
$146 |
$365 |
1.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$928 |
$2,320 |
2.6× |
| MRI abdomen w/o contrast (74181) |
$556.40 |
$1,391 |
2.3× |
| MRI cervical spine w/o contrast (72141) |
$382 |
$955 |
1.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$974 |
$2,435 |
4.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$881.20 |
$2,203 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$543.60 |
$1,359 |
2.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,203.20 |
$3,008 |
3.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,106.80 |
$2,767 |
3.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,257.20 |
$3,143 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,391.20 |
$3,478 |
4.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$947.20 |
$2,368 |
2.7× |
| MRI thoracic spine w/o contrast (72146) |
$889.20 |
$2,223 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$973.60 |
$2,434 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$935.20 |
$2,338 |
3.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$297 |
$742.50 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$133.60 |
$334 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,252.40 |
$3,131 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$116.80 |
$292 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$152.40 |
$381 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$138 |
$345 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$152.80 |
$382 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$525.20 |
$1,313 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$121.20 |
$303 |
1.4× |
| Radiological examination surgical specimen (76098) |
$218.40 |
$546 |
0.4× |
| Scapula complete (73010) |
$116.80 |
$292 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$34.80 |
$87 |
1.5× |
| Small bowel series (74250) |
$202 |
$505 |
1.1× |
| Ultrasound elastography first target lesion (76982) |
$116.80 |
$292 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$188 |
$470 |
1.8× |
| Us breast unilateral complete (76641) |
$318 |
$795 |
3.0× |
| Us breast unilateral limited (76642) |
$186 |
$465 |
2.1× |
| Us chest (76604) |
$129.20 |
$323 |
1.2× |
| Us ob transvaginal (76817) |
$320 |
$800 |
3.0× |
| Us pelvic non ob complete (76856) |
$378.40 |
$946 |
3.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$154.40 |
$386 |
1.5× |
| Us pregnancy ltd (76815) |
$214 |
$535 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$371.40 |
$928.50 |
3.5× |
| Us retroperitoneal complete (76770) |
$340 |
$850 |
3.2× |
| Us scrotum and contents (76870) |
$351.60 |
$879 |
3.3× |
| Us soft tissue head/neck (76536) |
$219.20 |
$548 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$186 |
$465 |
1.8× |
| Wrist 2 views (73100) |
$116.80 |
$292 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$130 |
$325 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$142.40 |
$356 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$125.20 |
$313 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$118 |
$295 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$150.80 |
$377 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$148.80 |
$372 |
1.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$122 |
$305 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$88.40 |
$221 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$138.40 |
$346 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$121.20 |
$303 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$100.40 |
$251 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$106.40 |
$266 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$127.60 |
$319 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$133.60 |
$334 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$186 |
$465 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$142 |
$355 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$156.40 |
$391 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$152.40 |
$381 |
1.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$264.40 |
$661 |
2.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$103.60 |
$259 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$136 |
$340 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$90.80 |
$227 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$180.80 |
$452 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$132.40 |
$331 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$87.80 |
$219.50 |
1.0× |