| Abdomen 2 views (74019) |
$469.20 |
$782 |
4.5× |
| Ankle 2 views (73600) |
$339 |
$565 |
3.9× |
| Arthrogram hip (73525) |
$499.20 |
$832 |
1.4× |
| Arthrogram shoulder (73040) |
$499.20 |
$832 |
1.4× |
| Arthrogram wrist (73115) |
$450.60 |
$751 |
1.3× |
| Bone survey complete (77075) |
$1,404.60 |
$2,341 |
13.4× |
| Cervical spine 2 or 3 views (72040) |
$504 |
$840 |
5.8× |
| Chest 1 view (71045) |
$360.60 |
$601 |
4.1× |
| Chest 3 views (71047) |
$418.20 |
$697 |
4.8× |
| Clavicle complete (73000) |
$322.80 |
$538 |
3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$204.60 |
$341 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,007.20 |
$10,012 |
17.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,523.40 |
$7,539 |
18.9× |
| CT abdomen w contrast (74160) |
$2,727.60 |
$4,546 |
15.5× |
| CT abdomen w wo contrast (74170) |
$3,082.80 |
$5,138 |
17.5× |
| CT abdomen w/o contrast (74150) |
$2,372.40 |
$3,954 |
22.6× |
| CT angiography upper extremity lt (73206) |
$4,476.60 |
$7,461 |
25.4× |
| CT c-spine w/o contrast (72125) |
$2,535 |
$4,225 |
24.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,294.60 |
$5,491 |
18.7× |
| CT cervical spine with contrast (72126) |
$2,914.80 |
$4,858 |
8.3× |
| CT chest w/wo contrast (71270) |
$3,057 |
$5,095 |
17.3× |
| CT chest with contrast (71260) |
$2,703 |
$4,505 |
15.3× |
| CT head/brain with contrast (70460) |
$2,469 |
$4,115 |
14.0× |
| CT head/brain without and with contrast (70470) |
$2,790.60 |
$4,651 |
15.8× |
| CT iac w contrast (70481) |
$2,459.40 |
$4,099 |
14.0× |
| CT lower ext w/o (73700) |
$2,183.40 |
$3,639 |
20.8× |
| CT lower extremity w wo contrast (73702) |
$2,838 |
$4,730 |
16.1× |
| CT lower extremity with contrast (73701) |
$2,511 |
$4,185 |
14.3× |
| CT lumbar spine w & w/o contrast (72133) |
$3,531.60 |
$5,886 |
20.0× |
| CT lumbar spine w/o contrast (72131) |
$2,715.60 |
$4,526 |
25.9× |
| CT lumbar spine with contrast (72132) |
$3,122.40 |
$5,204 |
8.9× |
| CT maxillofacial w contrast (70487) |
$2,343 |
$3,905 |
13.3× |
| CT maxillofacial w/o contrast (70486) |
$2,038.20 |
$3,397 |
19.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,649.60 |
$4,416 |
15.0× |
| CT neck soft tissue w contrast (70491) |
$2,708.40 |
$4,514 |
15.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,779.80 |
$4,633 |
15.8× |
| CT orbits w/o contrast (70480) |
$2,138.40 |
$3,564 |
20.4× |
| CT pelvis w & w/o contrast (72194) |
$3,054 |
$5,090 |
17.3× |
| CT pelvis w/o contrast (72192) |
$2,349.60 |
$3,916 |
22.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,062.40 |
$5,104 |
17.4× |
| CT soft tissue neck w/o contrast (70490) |
$2,355 |
$3,925 |
22.4× |
| CT thoracic spine w/contrast (72129) |
$3,092.40 |
$5,154 |
17.6× |
| CT thoracic spine w/o contrast (72128) |
$2,688.60 |
$4,481 |
25.6× |
| CT thoracic spine w/wo contrast (72130) |
$3,495 |
$5,825 |
19.8× |
| CT thorax w/o contrast (71250) |
$2,351.40 |
$3,919 |
22.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,612.40 |
$4,354 |
14.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,010 |
$3,350 |
19.1× |
| CT upper extremity with contrast (73201) |
$2,310.60 |
$3,851 |
6.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,917.20 |
$4,862 |
16.6× |
| Cta Abdomen (74175) |
$3,733.80 |
$6,223 |
21.2× |
| CTA abdomen pelvis (74174) |
$5,529 |
$9,215 |
15.8× |
| CTA chest (71275) |
$3,402.60 |
$5,671 |
19.3× |
| Cta Head (70496) |
$3,389.40 |
$5,649 |
19.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,139.60 |
$3,566 |
6.1× |
| CTA lwr ext w&w/o contrast (73706) |
$3,852 |
$6,420 |
21.9× |
| Cta Neck (70498) |
$3,459.60 |
$5,766 |
19.6× |
| Cta Pelvis (72191) |
$3,370.20 |
$5,617 |
19.1× |
| Diskography lumbar (72295) |
$2,061.60 |
$3,436 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$908.40 |
$1,514 |
8.6× |
| Esophagus (74220) |
$531 |
$885 |
3.0× |
| Fluoroscopy up to 1 hr (76000) |
$259.80 |
$433 |
1.1× |
| Foot 2 views (73620) |
$291.60 |
$486 |
3.3× |
| Forearm 2 views (73090) |
$388.80 |
$648 |
4.4× |
| Hand 2 views (73120) |
$332.40 |
$554 |
3.2× |
| Hand 3 views (73130) |
$340.20 |
$567 |
3.9× |
| Humerus Min 2 Views Left (73060) |
$340.20 |
$567 |
3.9× |
| Knee 3 views (73562) |
$244.80 |
$408 |
2.8× |
| MRA head w & w/o contrast (70546) |
$3,172.80 |
$5,288 |
9.1× |
| MRA head w/o contrast (70544) |
$2,373 |
$3,955 |
9.9× |
| MRA head with contrast (70545) |
$2,728.20 |
$4,547 |
7.8× |
| MRA neck w contrast (70548) |
$2,806.20 |
$4,677 |
8.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,172.80 |
$5,288 |
9.1× |
| MRA neck w/o contrast (70547) |
$2,440.80 |
$4,068 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,560.40 |
$5,934 |
10.2× |
| MRI abdomen w/o contrast (74181) |
$2,739 |
$4,565 |
11.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,301.80 |
$5,503 |
4.2× |
| MRI c-spine with contrast (72142) |
$3,339.60 |
$5,566 |
9.5× |
| MRI cervical spine w/o contrast (72141) |
$2,902.80 |
$4,838 |
12.1× |
| MRI chest w/o contrast (71550) |
$2,514 |
$4,190 |
10.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,760.60 |
$4,601 |
11.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,509.20 |
$4,182 |
10.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,261 |
$5,435 |
9.3× |
| MRI pelvis w contrast (72196) |
$2,805 |
$4,675 |
8.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,170.40 |
$5,284 |
9.0× |
| MRI pelvis w/o contrast (72195) |
$2,439 |
$4,065 |
10.2× |
| MRI scan of arm joint before and after contrast (73223) |
$3,732 |
$6,220 |
10.6× |
| MRI scan of leg joint before and after contrast (73723) |
$3,805.80 |
$6,343 |
10.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,775.20 |
$6,292 |
10.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,388.80 |
$5,648 |
9.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,829.80 |
$6,383 |
10.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,597.60 |
$5,996 |
10.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,768.40 |
$4,614 |
11.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,870.40 |
$4,784 |
12.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,974.20 |
$4,957 |
8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,287.20 |
$3,812 |
9.5× |
| Neck soft tissue (70360) |
$224.40 |
$374 |
2.6× |
| Osseous survey limited (77074) |
$1,444.20 |
$2,407 |
13.8× |
| Pelvis 1 or 2 views (72170) |
$400.80 |
$668 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,304.20 |
$5,507 |
9.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$560.40 |
$934 |
5.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$601.80 |
$1,003 |
5.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$629.40 |
$1,049 |
6.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$847.20 |
$1,412 |
8.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$436.80 |
$728 |
4.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$364.20 |
$607 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$574.20 |
$957 |
5.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$389.40 |
$649 |
4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$531 |
$885 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$849 |
$1,415 |
4.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$426.60 |
$711 |
4.9× |
| Ribs bilateral 3 views (71110) |
$592.20 |
$987 |
5.6× |
| Scanogram (77073) |
$589.20 |
$982 |
5.6× |
| Scapula complete (73010) |
$316.20 |
$527 |
3.0× |
| Small bowel series (74250) |
$700.80 |
$1,168 |
4.0× |
| Spine thoracic 3 views (72072) |
$560.40 |
$934 |
5.3× |
| Thoracolumbar 2 views (72080) |
$447.60 |
$746 |
5.1× |
| Ultrasound, abdomen limited (76705) |
$607.80 |
$1,013 |
5.8× |
| Upper Extremity Infant (73092) |
$388.80 |
$648 |
3.7× |
| Us abdl aorta screen aaa (76706) |
$607.80 |
$1,013 |
5.8× |
| Us breast unilateral complete (76641) |
$333 |
$555 |
3.2× |
| Us breast unilateral limited (76642) |
$216 |
$360 |
2.5× |
| Us chest (76604) |
$225.60 |
$376 |
2.1× |
| Us ob transvaginal (76817) |
$497.40 |
$829 |
4.7× |
| Us pelvic non ob complete (76856) |
$755.40 |
$1,259 |
7.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$396.60 |
$661 |
3.8× |
| Us pregnancy ltd (76815) |
$574.20 |
$957 |
5.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$637.80 |
$1,063 |
6.1× |
| Us retroperitoneal complete (76770) |
$849.60 |
$1,416 |
8.1× |
| Us retroperitoneal limited (76775) |
$659.40 |
$1,099 |
6.3× |
| Us scrotum and contents (76870) |
$688.20 |
$1,147 |
6.6× |
| Us soft tissue head/neck (76536) |
$596.40 |
$994 |
5.7× |
| Us xtr non-vasc lmtd (76882) |
$607.80 |
$1,013 |
5.8× |
| Wrist 2 views (73100) |
$382.20 |
$637 |
4.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$574.20 |
$957 |
5.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$421.80 |
$703 |
4.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$453 |
$755 |
5.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$388.80 |
$648 |
4.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$185.40 |
$309 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$637.20 |
$1,062 |
6.1× |
| X-ray exam hip uni 1 view (73501) |
$300.60 |
$501 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$501.60 |
$836 |
5.7× |
| X-ray eye for foreign body (70030) |
$352.20 |
$587 |
4.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$530.40 |
$884 |
5.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$423.60 |
$706 |
4.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$388.80 |
$648 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$310.20 |
$517 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$291 |
$485 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$244.80 |
$408 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$447.60 |
$746 |
4.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$514.20 |
$857 |
4.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$560.40 |
$934 |
5.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$340.20 |
$567 |
3.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$530.40 |
$884 |
5.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$688.80 |
$1,148 |
6.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$401.40 |
$669 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$360.60 |
$601 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$707.40 |
$1,179 |
6.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$423.60 |
$706 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$423.60 |
$706 |
4.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$407.40 |
$679 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$506.40 |
$844 |
5.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$315.60 |
$526 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$657 |
$1,095 |
6.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$601.80 |
$1,003 |
5.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$301.20 |
$502 |
3.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$417 |
$695 |
4.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$401.40 |
$669 |
4.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$447.60 |
$746 |
4.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$310.20 |
$517 |
3.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$373.20 |
$622 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$1,296 |
$2,160 |
12.3× |
| Xr chest 4+ views (71048) |
$447.60 |
$746 |
4.3× |
| Xr finger(s) 2+ views (73140) |
$256.80 |
$428 |
2.9× |
| Xr shoulder 1 view (73020) |
$388.80 |
$648 |
4.4× |
| Xr spine cervical 4 or 5 views (72050) |
$847.20 |
$1,412 |
8.1× |
| Xr tibia/fibula 2 views (73590) |
$492 |
$820 |
5.6× |
| Xr tmj bilateral (70330) |
$530.40 |
$884 |
6.1× |
| Xray knee 1 or 2 views rt (73560) |
$162 |
$270 |
1.9× |