| Abdomen 2 views (74019) |
$296.40 |
$456 |
3.1× |
| Ankle 2 views (73600) |
$219.70 |
$338 |
2.7× |
| Bone age studies (77072) |
$279.50 |
$430 |
2.9× |
| Bone survey complete (77075) |
$619.45 |
$953 |
6.4× |
| Cervical spine 2 or 3 views (72040) |
$312.65 |
$481 |
3.9× |
| Chest 1 view (71045) |
$169 |
$260 |
2.1× |
| Chest 3 views (71047) |
$299.65 |
$461 |
3.7× |
| Clavicle complete (73000) |
$242.45 |
$373 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$429 |
$660 |
4.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,912.35 |
$6,019 |
12.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,581.15 |
$3,971 |
11.8× |
| CT abdomen w contrast (74160) |
$1,960.40 |
$3,016 |
12.2× |
| CT abdomen w wo contrast (74170) |
$2,132.65 |
$3,281 |
13.2× |
| CT abdomen w/o contrast (74150) |
$1,766.05 |
$2,717 |
18.4× |
| CT angiography upper extremity lt (73206) |
$2,113.80 |
$3,252 |
13.1× |
| CT c-spine w/o contrast (72125) |
$1,628.90 |
$2,506 |
16.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,322.45 |
$3,573 |
14.4× |
| CT cervical spine with contrast (72126) |
$1,690.65 |
$2,601 |
5.3× |
| CT chest w/wo contrast (71270) |
$1,983.80 |
$3,052 |
12.3× |
| CT chest with contrast (71260) |
$1,906.45 |
$2,933 |
11.8× |
| CT head/brain with contrast (70460) |
$1,472.25 |
$2,265 |
9.1× |
| CT head/brain without and with contrast (70470) |
$1,924.65 |
$2,961 |
11.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$65 |
$100 |
0.8× |
| CT iac w contrast (70481) |
$1,667.90 |
$2,566 |
10.3× |
| CT limited/localized follow up study (76380) |
$563.55 |
$867 |
7.0× |
| CT lower ext w/o (73700) |
$1,285.05 |
$1,977 |
13.4× |
| CT lower extremity w wo contrast (73702) |
$1,784.90 |
$2,746 |
11.1× |
| CT lower extremity with contrast (73701) |
$1,636.70 |
$2,518 |
10.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,435.55 |
$3,747 |
15.1× |
| CT lumbar spine w/o contrast (72131) |
$1,663.35 |
$2,559 |
17.3× |
| CT lumbar spine with contrast (72132) |
$1,788.80 |
$2,752 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,703 |
$2,620 |
10.6× |
| CT maxillofacial w/o contrast (70486) |
$1,084.52 |
$1,668.50 |
11.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,519.70 |
$2,338 |
9.4× |
| CT neck soft tissue w contrast (70491) |
$1,795.30 |
$2,762 |
11.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,110.55 |
$3,247 |
13.1× |
| CT orbits w/o contrast (70480) |
$1,624.35 |
$2,499 |
16.9× |
| CT pelvis w & w/o contrast (72194) |
$2,024.10 |
$3,114 |
12.5× |
| CT pelvis w/o contrast (72192) |
$1,580.15 |
$2,431 |
16.4× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$267.80 |
$412 |
3.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,020.85 |
$3,109 |
12.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,475.50 |
$2,270 |
15.3× |
| CT thoracic spine w/contrast (72129) |
$1,823.25 |
$2,805 |
11.3× |
| CT thoracic spine w/o contrast (72128) |
$1,693.90 |
$2,606 |
17.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,239.90 |
$3,446 |
13.9× |
| CT thorax w/o contrast (71250) |
$1,589.90 |
$2,446 |
16.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,739.40 |
$2,676 |
10.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,268.80 |
$1,952 |
13.2× |
| CT upper extremity with contrast (73201) |
$1,647.75 |
$2,535 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,717 |
$4,180 |
16.8× |
| Cta Abdomen (74175) |
$2,217.15 |
$3,411 |
13.7× |
| CTA abdomen pelvis (74174) |
$3,268.20 |
$5,028 |
10.2× |
| CTA chest (71275) |
$2,357.55 |
$3,627 |
14.6× |
| Cta Head (70496) |
$2,012.40 |
$3,096 |
12.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,819.70 |
$4,338 |
8.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,921.40 |
$2,956 |
11.9× |
| Cta Neck (70498) |
$2,012.40 |
$3,096 |
12.5× |
| Cta Pelvis (72191) |
$2,100.15 |
$3,231 |
13.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$332.80 |
$512 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$186.55 |
$287 |
2.3× |
| Foot 2 views (73620) |
$216.45 |
$333 |
2.7× |
| Forearm 2 views (73090) |
$232.70 |
$358 |
2.9× |
| Hand 2 views (73120) |
$184.60 |
$284 |
1.9× |
| Hand 3 views (73130) |
$263.25 |
$405 |
3.3× |
| Humerus Min 2 Views Left (73060) |
$254.15 |
$391 |
3.2× |
| Knee 3 views (73562) |
$276.90 |
$426 |
3.5× |
| Neck soft tissue (70360) |
$230.75 |
$355 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$263.90 |
$406 |
2.7× |
| Osseous survey infant (77076) |
$169 |
$260 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$217.10 |
$334 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$282.75 |
$435 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$365.95 |
$563 |
3.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$332.15 |
$511 |
3.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$269.10 |
$414 |
2.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$521.95 |
$803 |
5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$360.75 |
$555 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$209.95 |
$323 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$390 |
$600 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$209.95 |
$323 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$261.30 |
$402 |
3.3× |
| Ribs bilateral 3 views (71110) |
$358.15 |
$551 |
3.7× |
| Scapula complete (73010) |
$289.90 |
$446 |
3.0× |
| Screening digital breast tomosynthesis (77063) |
$66.30 |
$102 |
2.8× |
| Spine thoracic 3 views (72072) |
$334.75 |
$515 |
3.5× |
| Thoracolumbar 2 views (72080) |
$191.10 |
$294 |
2.4× |
| Tmj unilateral (70328) |
$202.15 |
$311 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$536.90 |
$826 |
5.6× |
| Us abdl aorta screen aaa (76706) |
$460.20 |
$708 |
4.8× |
| Us breast unilateral complete (76641) |
$143.65 |
$221 |
1.5× |
| Us breast unilateral limited (76642) |
$327.60 |
$504 |
4.1× |
| Us chest (76604) |
$437.45 |
$673 |
4.5× |
| Us compl joint r-t w/image documentation (76881) |
$381.55 |
$587 |
4.0× |
| Us ob transvaginal (76817) |
$371.80 |
$572 |
3.9× |
| Us pelvic non ob complete (76856) |
$538.85 |
$829 |
5.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$411.45 |
$633 |
4.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$446.55 |
$687 |
4.6× |
| Us retroperitoneal complete (76770) |
$415.35 |
$639 |
4.3× |
| Us retroperitoneal limited (76775) |
$397.15 |
$611 |
4.1× |
| Us scrotum and contents (76870) |
$550.55 |
$847 |
5.7× |
| Us soft tissue head/neck (76536) |
$583.70 |
$898 |
6.1× |
| Us xtr non-vasc lmtd (76882) |
$368.55 |
$567 |
3.8× |
| Wrist 2 views (73100) |
$208.65 |
$321 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$375.05 |
$577 |
3.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$291.85 |
$449 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$216.45 |
$333 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$295.75 |
$455 |
3.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$461.50 |
$710 |
4.8× |
| X-ray exam hip uni 1 view (73501) |
$184.60 |
$284 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$241.15 |
$371 |
3.0× |
| X-ray exam hip uni 4/> views (73503) |
$315.90 |
$486 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$423.15 |
$651 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$499.20 |
$768 |
5.2× |
| X-ray exam of femur 1 (73551) |
$215.80 |
$332 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$315.90 |
$486 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$227.50 |
$350 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$276.90 |
$426 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$228.80 |
$352 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$356.85 |
$549 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$179.40 |
$276 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$139.10 |
$214 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$279.50 |
$430 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$511.55 |
$787 |
5.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$308.10 |
$474 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$261.95 |
$403 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$230.10 |
$354 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$336.05 |
$517 |
3.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$321.75 |
$495 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$238.55 |
$367 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$276.90 |
$426 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$420.55 |
$647 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$308.10 |
$474 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$265.85 |
$409 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$266.50 |
$410 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$372.45 |
$573 |
4.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$380.25 |
$585 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$260 |
$400 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$183.30 |
$282 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$272.35 |
$419 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$265.20 |
$408 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$202.15 |
$311 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$254.15 |
$391 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$494 |
$760 |
5.1× |
| Xr chest 4+ views (71048) |
$318.50 |
$490 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$208.65 |
$321 |
2.6× |
| Xr shoulder 1 view (73020) |
$229.45 |
$353 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$417.30 |
$642 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$245.05 |
$377 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$213.85 |
$329 |
2.7× |