| Abdomen 2 views (74019) |
$136.50 |
$210 |
1.4× |
| Ankle 2 views (73600) |
$116.35 |
$179 |
1.4× |
| Bone survey complete (77075) |
$891.80 |
$1,372 |
8.9× |
| Cervical spine 2 or 3 views (72040) |
$291.20 |
$448 |
3.5× |
| Chest 1 view (71045) |
$79.30 |
$122 |
0.9× |
| Chest 3 views (71047) |
$245.70 |
$378 |
2.9× |
| Clavicle complete (73000) |
$154.70 |
$238 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$330.85 |
$509 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,587.35 |
$5,519 |
10.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,527.85 |
$3,889 |
11.0× |
| CT abdomen w contrast (74160) |
$2,132.65 |
$3,281 |
12.6× |
| CT abdomen w wo contrast (74170) |
$2,499.25 |
$3,845 |
14.8× |
| CT abdomen w/o contrast (74150) |
$1,768 |
$2,720 |
17.6× |
| CT c-spine w/o contrast (72125) |
$1,768.65 |
$2,721 |
17.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,691.65 |
$4,141 |
16.0× |
| CT cervical spine with contrast (72126) |
$1,978.60 |
$3,044 |
5.9× |
| CT chest w/wo contrast (71270) |
$2,197 |
$3,380 |
13.0× |
| CT chest with contrast (71260) |
$2,067 |
$3,180 |
12.3× |
| CT head/brain with contrast (70460) |
$1,822.60 |
$2,804 |
10.8× |
| CT head/brain without and with contrast (70470) |
$2,137.85 |
$3,289 |
12.7× |
| CT iac w contrast (70481) |
$1,961.05 |
$3,017 |
11.6× |
| CT lower ext w/o (73700) |
$1,682.20 |
$2,588 |
16.7× |
| CT lower extremity w wo contrast (73702) |
$1,989.65 |
$3,061 |
11.8× |
| CT lower extremity with contrast (73701) |
$1,805.70 |
$2,778 |
10.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,533.05 |
$3,897 |
15.0× |
| CT lumbar spine w/o contrast (72131) |
$1,966.90 |
$3,026 |
19.6× |
| CT lumbar spine with contrast (72132) |
$1,997.45 |
$3,073 |
6.0× |
| CT maxillofacial w contrast (70487) |
$1,848.60 |
$2,844 |
11.0× |
| CT maxillofacial w/o contrast (70486) |
$1,274.65 |
$1,961 |
12.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,299.05 |
$3,537 |
13.6× |
| CT neck soft tissue w contrast (70491) |
$1,581.45 |
$2,433 |
9.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,369.25 |
$3,645 |
14.0× |
| CT orbits w/o contrast (70480) |
$916.50 |
$1,410 |
9.1× |
| CT pelvis w & w/o contrast (72194) |
$2,295.15 |
$3,531 |
13.6× |
| CT pelvis w/o contrast (72192) |
$1,738.10 |
$2,674 |
17.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,165.15 |
$3,331 |
12.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,247.35 |
$1,919 |
12.4× |
| CT thoracic spine w/contrast (72129) |
$2,103.40 |
$3,236 |
12.5× |
| CT thoracic spine w/o contrast (72128) |
$1,732.90 |
$2,666 |
17.2× |
| CT thoracic spine w/wo contrast (72130) |
$2,020.20 |
$3,108 |
12.0× |
| CT thorax w/o contrast (71250) |
$1,663.35 |
$2,559 |
16.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,756.30 |
$2,702 |
10.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,627.60 |
$2,504 |
16.2× |
| CT upper extremity with contrast (73201) |
$1,651.65 |
$2,541 |
4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,038.10 |
$4,674 |
18.0× |
| CTA abdomen pelvis (74174) |
$3,777.80 |
$5,812 |
11.3× |
| CTA chest (71275) |
$2,191.80 |
$3,372 |
13.0× |
| Cta Head (70496) |
$2,146.95 |
$3,303 |
12.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,252.90 |
$3,466 |
6.7× |
| CTA lwr ext w&w/o contrast (73706) |
$2,060.50 |
$3,170 |
12.2× |
| Cta Neck (70498) |
$2,252.90 |
$3,466 |
13.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$220.02 |
$338.50 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$222.30 |
$342 |
2.7× |
| Dxa bone density study axial skeleton (77085) |
$462.80 |
$712 |
4.6× |
| Foot 2 views (73620) |
$173.55 |
$267 |
2.1× |
| Forearm 2 views (73090) |
$284.70 |
$438 |
3.4× |
| Hand 2 views (73120) |
$131.30 |
$202 |
1.3× |
| Hand 3 views (73130) |
$163.15 |
$251 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$113.10 |
$174 |
1.4× |
| Knee 3 views (73562) |
$132.60 |
$204 |
1.6× |
| Neck soft tissue (70360) |
$105.30 |
$162 |
1.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$328.25 |
$505 |
3.3× |
| Osseous survey infant (77076) |
$358.15 |
$551 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$105.30 |
$162 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$319.15 |
$491 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$350.35 |
$539 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$209.30 |
$322 |
2.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$692.90 |
$1,066 |
6.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$373.10 |
$574 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$90.35 |
$139 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$177.45 |
$273 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$105.95 |
$163 |
1.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$494.65 |
$761 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$273.65 |
$421 |
3.3× |
| Ribs bilateral 3 views (71110) |
$386.10 |
$594 |
3.8× |
| Sacroiliac Joints < 3 Views (72200) |
$228.80 |
$352 |
2.3× |
| Scapula complete (73010) |
$265.52 |
$408.50 |
2.6× |
| Spine thoracic 3 views (72072) |
$317.20 |
$488 |
3.2× |
| Thoracolumbar 2 views (72080) |
$273 |
$420 |
3.3× |
| Tmj unilateral (70328) |
$185.25 |
$285 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$198.25 |
$305 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$394.55 |
$607 |
3.9× |
| Us breast unilateral complete (76641) |
$397.80 |
$612 |
4.0× |
| Us breast unilateral limited (76642) |
$331.50 |
$510 |
4.0× |
| Us chest (76604) |
$244.40 |
$376 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$542.10 |
$834 |
5.4× |
| Us pelvic non ob complete (76856) |
$636.35 |
$979 |
6.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$298.35 |
$459 |
3.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$541.45 |
$833 |
5.4× |
| Us retroperitoneal complete (76770) |
$282.75 |
$435 |
2.8× |
| Us retroperitoneal limited (76775) |
$241.80 |
$372 |
2.4× |
| Us scrotum and contents (76870) |
$331.50 |
$510 |
3.3× |
| Us soft tissue head/neck (76536) |
$198.25 |
$305 |
2.0× |
| Us xtr non-vasc lmtd (76882) |
$448.50 |
$690 |
4.5× |
| Wrist 2 views (73100) |
$145.60 |
$224 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$181.35 |
$279 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$159.90 |
$246 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$147.55 |
$227 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$174.20 |
$268 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$610.35 |
$939 |
6.1× |
| X-ray exam hip uni 1 view (73501) |
$117.98 |
$181.50 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$136.50 |
$210 |
1.6× |
| X-ray exam hip uni 4/> views (73503) |
$219.05 |
$337 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$310.05 |
$477 |
3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$384.80 |
$592 |
3.8× |
| X-ray exam of femur 1 (73551) |
$241.80 |
$372 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$270.40 |
$416 |
2.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$251.55 |
$387 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$180.70 |
$278 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$255.45 |
$393 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$286 |
$440 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$159.90 |
$246 |
1.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$563.55 |
$867 |
5.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$208.65 |
$321 |
2.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$224.25 |
$345 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$338 |
$520 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$152.10 |
$234 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$123.50 |
$190 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$325.65 |
$501 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$441.35 |
$679 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$306.15 |
$471 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$261.95 |
$403 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$258.70 |
$398 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$330.20 |
$508 |
3.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$236.60 |
$364 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$286 |
$440 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$189.80 |
$292 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$213.85 |
$329 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$122.85 |
$189 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$286.65 |
$441 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$429 |
$660 |
4.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$100.10 |
$154 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$172.25 |
$265 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$449.15 |
$691 |
4.5× |
| Xr chest 4+ views (71048) |
$307.45 |
$473 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$107.90 |
$166 |
1.3× |
| Xr shoulder 1 view (73020) |
$210.28 |
$323.50 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$356.85 |
$549 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$158.28 |
$243.50 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$109.20 |
$168 |
1.3× |