| Abdomen 2 views (74019) |
$309 |
$441 |
2.9× |
| Ankle 2 views (73600) |
$258 |
$368 |
3.0× |
| Bone age studies (77072) |
$253 |
$361 |
2.4× |
| Bone survey complete (77075) |
$610 |
$872 |
5.8× |
| Cervical spine 2 or 3 views (72040) |
$309 |
$441 |
3.5× |
| Chest 1 view (71045) |
$232 |
$331 |
2.7× |
| Chest 3 views (71047) |
$298 |
$426 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$851 |
$1,215 |
4.8× |
| Clavicle complete (73000) |
$263 |
$376 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$75 |
$107 |
0.7× |
| Corpora cavernosography (74445) |
$293 |
$419 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,430 |
$4,900 |
9.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,433 |
$3,476 |
10.2× |
| CT abdomen w contrast (74160) |
$1,792 |
$2,560 |
10.2× |
| CT abdomen w wo contrast (74170) |
$2,113 |
$3,018 |
12.0× |
| CT abdomen w/o contrast (74150) |
$1,455 |
$2,078 |
13.9× |
| CT angiography upper extremity lt (73206) |
$1,882 |
$2,689 |
10.7× |
| CT c-spine w/o contrast (72125) |
$1,592 |
$2,274 |
15.2× |
| CT cervical spine with contrast (72126) |
$1,750 |
$2,500 |
5.0× |
| CT chest w/wo contrast (71270) |
$2,120 |
$3,029 |
12.0× |
| CT chest with contrast (71260) |
$1,756 |
$2,508.50 |
10.0× |
| CT head/brain with contrast (70460) |
$1,527 |
$2,181 |
8.7× |
| CT head/brain without and with contrast (70470) |
$1,857 |
$2,653 |
10.5× |
| CT iac w contrast (70481) |
$1,673 |
$2,390 |
9.5× |
| CT lower ext w/o (73700) |
$1,378 |
$1,969 |
13.1× |
| CT lower extremity w wo contrast (73702) |
$1,911 |
$2,730 |
10.8× |
| CT lower extremity with contrast (73701) |
$1,629 |
$2,327 |
9.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,228 |
$3,183 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,579 |
$2,255 |
15.0× |
| CT lumbar spine with contrast (72132) |
$1,833 |
$2,618 |
5.2× |
| CT maxillofacial w contrast (70487) |
$1,679 |
$2,398 |
9.5× |
| CT maxillofacial w/o contrast (70486) |
$1,359 |
$1,941 |
12.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,917 |
$2,739 |
10.9× |
| CT neck soft tissue w contrast (70491) |
$1,706 |
$2,437 |
9.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,798 |
$2,569 |
10.2× |
| CT orbits w/o contrast (70480) |
$1,397 |
$1,996 |
13.3× |
| CT pelvis w & w/o contrast (72194) |
$1,991 |
$2,845 |
11.3× |
| CT pelvis w/o contrast (72192) |
$1,441 |
$2,058 |
13.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,896 |
$2,708 |
10.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,369 |
$1,955 |
13.0× |
| CT thoracic spine w/contrast (72129) |
$1,735 |
$2,478 |
9.8× |
| CT thoracic spine w/o contrast (72128) |
$1,537 |
$2,196 |
14.6× |
| CT thorax w/o contrast (71250) |
$1,420 |
$2,029 |
13.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,920 |
$2,743 |
10.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,366 |
$1,952 |
13.0× |
| CT upper extremity with contrast (73201) |
$1,588 |
$2,269 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,132 |
$3,045 |
12.1× |
| Cta Abdomen (74175) |
$2,079 |
$2,970 |
11.8× |
| CTA abdomen pelvis (74174) |
$3,032 |
$4,331 |
8.7× |
| CTA chest (71275) |
$2,139 |
$3,056 |
12.1× |
| Cta Head (70496) |
$2,066 |
$2,951 |
11.7× |
| Cta Neck (70498) |
$2,038 |
$2,912 |
11.6× |
| Cta Pelvis (72191) |
$1,971 |
$2,816 |
11.2× |
| Cystography minimum 3 views rs&i (74430) |
$621 |
$887 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$395 |
$564 |
3.8× |
| Fetal biophysical profile non-stress testing (76818) |
$561 |
$802 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$511 |
$730 |
2.1× |
| Foot 2 views (73620) |
$255 |
$364 |
2.9× |
| Forearm 2 views (73090) |
$278 |
$397 |
3.2× |
| Hand 2 views (73120) |
$281 |
$402 |
2.7× |
| Hand 3 views (73130) |
$309 |
$442 |
3.5× |
| Humerus Min 2 Views Left (73060) |
$274 |
$392 |
3.1× |
| Knee 3 views (73562) |
$325 |
$464 |
3.7× |
| MRI fetal sngl/1st gestation (74712) |
$23 |
$33 |
0.1× |
| Neck soft tissue (70360) |
$262 |
$374 |
3.0× |
| Nm whole blood volume (78122) |
$8 |
$12 |
0.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$381 |
$544 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$274 |
$392 |
2.6× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$3 |
$4 |
0.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$229 |
$327 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$342 |
$488 |
3.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$356 |
$508 |
3.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$294 |
$420 |
2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$346 |
$494 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$248 |
$355 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$270 |
$386 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$267 |
$381 |
3.1× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$5 |
$7 |
0.0× |
| Ribs bilateral 3 views (71110) |
$375 |
$536 |
3.6× |
| Sacroiliac Joints < 3 Views (72200) |
$153 |
$218 |
1.5× |
| Scapula complete (73010) |
$280 |
$400 |
2.7× |
| Spine thoracic 3 views (72072) |
$361 |
$515 |
3.4× |
| Thoracolumbar 2 views (72080) |
$295 |
$421 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$590 |
$843 |
5.6× |
| Us breast unilateral limited (76642) |
$442 |
$632 |
5.1× |
| Us chest (76604) |
$435 |
$621 |
4.1× |
| Us compl joint r-t w/image documentation (76881) |
$507 |
$725 |
4.8× |
| Us elastography parenchyma (76981) |
$206 |
$294 |
2.0× |
| Us ob detailed single fetus (76811) |
$636 |
$909 |
2.7× |
| Us ob transvaginal (76817) |
$469 |
$670 |
4.5× |
| Us pelvic non ob complete (76856) |
$652 |
$932 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$412 |
$588 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$532 |
$760 |
5.1× |
| Us retroperitoneal complete (76770) |
$641 |
$915 |
6.1× |
| Us retroperitoneal limited (76775) |
$507 |
$724 |
4.8× |
| Us scrotum and contents (76870) |
$607 |
$867 |
5.8× |
| Us soft tissue head/neck (76536) |
$573 |
$818 |
5.5× |
| Us xtr non-vasc lmtd (76882) |
$507 |
$725 |
4.8× |
| Wrist 2 views (73100) |
$258 |
$369 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$427 |
$610 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$257 |
$367 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$308 |
$440 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$255 |
$364 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$305 |
$436 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$277 |
$395 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$380 |
$543 |
3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$380 |
$543 |
3.6× |
| X-ray exam of femur 1 (73551) |
$214 |
$306 |
2.4× |
| X-ray eye for foreign body (70030) |
$225 |
$321 |
2.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$353 |
$504 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$264 |
$377 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$307 |
$438 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$241 |
$345 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$231 |
$330 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$382 |
$546 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$239 |
$342 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$343 |
$490 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$529 |
$755 |
5.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$287 |
$410 |
3.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$348 |
$497 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$324 |
$463 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$286 |
$408 |
3.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$38 |
$54 |
0.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$461 |
$659 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$297 |
$424 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$285 |
$407 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$311 |
$444 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$268.50 |
$383.50 |
3.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$206 |
$294 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$400 |
$571 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$299 |
$427 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$248 |
$355 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$277 |
$396 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$312 |
$446 |
3.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$380 |
$543 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$228 |
$326 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$299 |
$427 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$493 |
$705 |
4.7× |
| Xr chest 4+ views (71048) |
$356 |
$508 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$231 |
$330 |
2.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$75 |
$107 |
0.7× |
| Xr shoulder 1 view (73020) |
$230 |
$328 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$431 |
$615 |
4.1× |
| Xr tibia/fibula 2 views (73590) |
$289 |
$413 |
3.3× |
| Xr tmj bilateral (70330) |
$321 |
$459 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$270 |
$385 |
3.1× |