| Abdomen 2 views (74019) |
$223.23 |
$297.64 |
2.4× |
| Ankle 2 views (73600) |
$193.50 |
$258 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$728.25 |
$971 |
2.0× |
| Bone age studies (77072) |
$180.75 |
$241 |
1.9× |
| Bone survey complete (77075) |
$1,125 |
$1,500 |
12.0× |
| Cervical spine 2 or 3 views (72040) |
$264.91 |
$353.21 |
3.4× |
| Chest 1 view (71045) |
$63.94 |
$85.25 |
0.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$228.75 |
$305 |
1.5× |
| Clavicle complete (73000) |
$214.50 |
$286 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,445.25 |
$1,927 |
4.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,247.66 |
$1,663.54 |
5.8× |
| CT abdomen w contrast (74160) |
$1,206 |
$1,608 |
7.7× |
| CT abdomen w wo contrast (74170) |
$1,430.25 |
$1,907 |
9.1× |
| CT abdomen w/o contrast (74150) |
$1,101 |
$1,468 |
11.8× |
| CT c-spine w/o contrast (72125) |
$1,363.44 |
$1,817.92 |
14.6× |
| CT cervical spine w&w/o contrast (72127) |
$769.50 |
$1,026 |
4.9× |
| CT cervical spine with contrast (72126) |
$720 |
$960 |
2.3× |
| CT chest w/wo contrast (71270) |
$1,523.25 |
$2,031 |
9.7× |
| CT chest with contrast (71260) |
$1,585.74 |
$2,114.32 |
10.1× |
| CT head/brain with contrast (70460) |
$1,206 |
$1,608 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,541.25 |
$2,055 |
9.8× |
| CT iac w contrast (70481) |
$584.25 |
$779 |
3.7× |
| CT lower ext w/o (73700) |
$800.28 |
$1,067.04 |
8.5× |
| CT lower extremity w wo contrast (73702) |
$1,044 |
$1,392 |
6.6× |
| CT lower extremity with contrast (73701) |
$825 |
$1,100 |
5.3× |
| CT lumbar spine w & w/o contrast (72133) |
$755.25 |
$1,007 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,289.34 |
$1,719.12 |
13.8× |
| CT lumbar spine with contrast (72132) |
$720 |
$960 |
2.3× |
| CT maxillofacial w contrast (70487) |
$652.50 |
$870 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$748.41 |
$997.88 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$744 |
$992 |
4.7× |
| CT neck soft tissue w contrast (70491) |
$1,026.28 |
$1,368.38 |
6.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$727.50 |
$970 |
4.6× |
| CT orbits w/o contrast (70480) |
$561 |
$748 |
6.0× |
| CT pelvis w & w/o contrast (72194) |
$1,020 |
$1,360 |
6.5× |
| CT pelvis w/o contrast (72192) |
$949.40 |
$1,265.87 |
10.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,031.25 |
$1,375 |
6.6× |
| CT soft tissue neck w/o contrast (70490) |
$673.50 |
$898 |
7.2× |
| CT thoracic spine w/contrast (72129) |
$772.50 |
$1,030 |
4.9× |
| CT thoracic spine w/o contrast (72128) |
$777.13 |
$1,036.17 |
8.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,017 |
$1,356 |
6.5× |
| CT thorax w/o contrast (71250) |
$1,067.04 |
$1,422.72 |
11.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,080 |
$1,440 |
6.9× |
| CT upper extremity w/o contrast rt (73200) |
$626.25 |
$835 |
6.7× |
| CT upper extremity with contrast (73201) |
$825 |
$1,100 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$870.75 |
$1,161 |
5.5× |
| Cta Abdomen (74175) |
$945.75 |
$1,261 |
6.0× |
| CTA abdomen pelvis (74174) |
$981.75 |
$1,309 |
3.1× |
| CTA chest (71275) |
$1,168 |
$1,557.33 |
7.4× |
| Cta Head (70496) |
$1,544.25 |
$2,059 |
9.8× |
| CTA lwr ext w&w/o contrast (73706) |
$822.75 |
$1,097 |
5.2× |
| Cta Neck (70498) |
$1,476.75 |
$1,969 |
9.4× |
| Cta Pelvis (72191) |
$656.25 |
$875 |
4.2× |
| Esophagus (74220) |
$399 |
$532 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$587.25 |
$783 |
2.7× |
| Foot 2 views (73620) |
$270.75 |
$361 |
3.5× |
| Forearm 2 views (73090) |
$70.95 |
$94.60 |
0.9× |
| Hand 2 views (73120) |
$214.50 |
$286 |
2.3× |
| Hand 3 views (73130) |
$159.32 |
$212.42 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$300 |
$400 |
3.8× |
| Knee 3 views (73562) |
$99.41 |
$132.55 |
1.3× |
| MRA head w & w/o contrast (70546) |
$2,724.75 |
$3,633 |
8.7× |
| MRA head w/o contrast (70544) |
$3,000 |
$4,000 |
14.0× |
| MRA neck w contrast (70548) |
$1,729.50 |
$2,306 |
5.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,997 |
$3,996 |
9.6× |
| MRA neck w/o contrast (70547) |
$1,447.50 |
$1,930 |
6.8× |
| MRI abdomen w contrast (74182) |
$959.25 |
$1,279 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,000 |
$4,000 |
9.6× |
| MRI abdomen w/o contrast (74181) |
$755.25 |
$1,007 |
3.5× |
| MRI any jnt lwr ext with con lt (73722) |
$1,075.50 |
$1,434 |
1.5× |
| MRI c-spine with contrast (72142) |
$959.25 |
$1,279 |
3.1× |
| MRI cervical spine w/o contrast (72141) |
$3,000 |
$4,000 |
14.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,804.50 |
$2,406 |
5.8× |
| MRI chest w/o contrast (71550) |
$878.25 |
$1,171 |
4.1× |
| MRI chest with contrast (71551) |
$1,075.50 |
$1,434 |
1.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,625 |
$3,500 |
12.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,258.50 |
$1,678 |
5.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,724.75 |
$3,633 |
8.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,572 |
$2,096 |
5.0× |
| MRI pelvis w contrast (72196) |
$959.25 |
$1,279 |
3.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,187.50 |
$4,250 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$3,000 |
$4,000 |
14.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,880.25 |
$2,507 |
6.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,187.50 |
$4,250 |
10.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,084.50 |
$1,446 |
3.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,187.50 |
$4,250 |
10.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$959.25 |
$1,279 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,187.50 |
$4,250 |
10.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,000 |
$4,000 |
14.0× |
| MRI upper ext joint w/o contrast (73221) |
$3,000 |
$4,000 |
14.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,635 |
$2,180 |
5.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$755.25 |
$1,007 |
3.5× |
| Neck soft tissue (70360) |
$129 |
$172 |
1.7× |
| Osseous survey limited (77074) |
$678 |
$904 |
7.2× |
| Pelvis 1 or 2 views (72170) |
$300 |
$400 |
3.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,000 |
$4,000 |
9.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$135 |
$180 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$378 |
$504 |
4.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$117.98 |
$157.30 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$180.75 |
$241 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$204 |
$272 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$70.95 |
$94.60 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$370.50 |
$494 |
4.8× |
| Radiologic exam colon single contrast study (74270) |
$399 |
$532 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$129 |
$172 |
1.7× |
| Ribs bilateral 3 views (71110) |
$340.50 |
$454 |
3.6× |
| Scanogram (77073) |
$406.50 |
$542 |
4.3× |
| Scapula complete (73010) |
$180.75 |
$241 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$131.25 |
$175 |
5.6× |
| Small bowel series (74250) |
$228.75 |
$305 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$800.28 |
$1,067.04 |
8.5× |
| Unlisted Ultrasound Procedure (76999) |
$202.50 |
$270 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$579.75 |
$773 |
3.7× |
| Us abdl aorta screen aaa (76706) |
$472.50 |
$630 |
5.0× |
| Us breast unilateral complete (76641) |
$713.25 |
$951 |
7.6× |
| Us breast unilateral limited (76642) |
$351.04 |
$468.06 |
4.5× |
| Us chest (76604) |
$302.25 |
$403 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$337.50 |
$450 |
3.6× |
| Us ob transvaginal (76817) |
$504 |
$672 |
5.4× |
| Us pelvic non ob complete (76856) |
$504 |
$672 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$202.50 |
$270 |
2.2× |
| Us pregnancy ltd (76815) |
$504 |
$672 |
5.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$504 |
$672 |
5.4× |
| Us retroperitoneal complete (76770) |
$388.16 |
$517.55 |
4.1× |
| Us retroperitoneal limited (76775) |
$272.25 |
$363 |
2.9× |
| Us scrotum and contents (76870) |
$504 |
$672 |
5.4× |
| Us soft tissue head/neck (76536) |
$622.44 |
$829.92 |
6.6× |
| Us spinal canal and contents (76800) |
$202.50 |
$270 |
2.2× |
| Us xtr non-vasc lmtd (76882) |
$300 |
$400 |
3.2× |
| Wrist 2 views (73100) |
$193.50 |
$258 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$112.50 |
$150 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$129 |
$172 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$159.32 |
$212.42 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$399 |
$532 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$116.25 |
$155 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$264.91 |
$353.21 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$238.97 |
$318.63 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$129 |
$172 |
1.7× |
| X-ray exam of femur 1 (73551) |
$116.25 |
$155 |
1.5× |
| X-ray eye for foreign body (70030) |
$300 |
$400 |
3.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$340.50 |
$454 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$129 |
$172 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$264.91 |
$353.21 |
3.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$214.50 |
$286 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$129.52 |
$172.70 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$251.94 |
$335.92 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$405 |
$540 |
4.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$300 |
$400 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$180.75 |
$241 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$180.75 |
$241 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$204 |
$272 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$340.50 |
$454 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$477 |
$636 |
5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$300 |
$400 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$300 |
$400 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$264.91 |
$353.21 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$129 |
$172 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$477 |
$636 |
5.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$180.75 |
$241 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$300 |
$400 |
3.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$214.50 |
$286 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$129 |
$172 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$264.91 |
$353.21 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$219 |
$292 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$264.91 |
$353.21 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$340.50 |
$454 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$165 |
$220 |
2.1× |
| Xr shoulder 1 view (73020) |
$116.25 |
$155 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$420.52 |
$560.69 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$159.32 |
$212.42 |
2.0× |
| Xr tmj bilateral (70330) |
$129 |
$172 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$70.95 |
$94.60 |
0.9× |