| Abdomen 2 views (74019) |
$401.25 |
$535 |
3.2× |
| Bone age studies (77072) |
$486 |
$648 |
3.9× |
| Cervical spine 2 or 3 views (72040) |
$600.75 |
$801 |
5.8× |
| Chest 1 view (71045) |
$236.25 |
$315 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$968.25 |
$1,291 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,017 |
$1,356 |
8.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,883 |
$7,844 |
14.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,364.50 |
$4,486 |
11.8× |
| CT abdomen w contrast (74160) |
$2,370.75 |
$3,161 |
11.3× |
| CT abdomen w wo contrast (74170) |
$3,205.50 |
$4,274 |
15.2× |
| CT angio hrt w/3d image (75574) |
$3,201 |
$4,268 |
7.7× |
| CT c-spine w/o contrast (72125) |
$1,784.25 |
$2,379 |
14.2× |
| CT chest w contrast (71260) |
$2,171.25 |
$2,895 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,164.50 |
$2,886 |
10.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$702.75 |
$937 |
1.7× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$393.75 |
$525 |
3.8× |
| CT iac w contrast (70481) |
$2,658.75 |
$3,545 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,782.75 |
$2,377 |
14.2× |
| CT maxillofacial w contrast (70487) |
$2,261.25 |
$3,015 |
10.8× |
| CT maxillofacial wo contrast (70486) |
$1,850.25 |
$2,467 |
14.8× |
| CT orbits w/o contrast (70480) |
$2,274.75 |
$3,033 |
18.2× |
| CT pelvis w/o contrast (72192) |
$1,671 |
$2,228 |
13.3× |
| CT soft tissue neck w contrast (70491) |
$2,199.75 |
$2,933 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,810.50 |
$2,414 |
14.5× |
| CT thoracic spine w/o contrast (72128) |
$1,784.25 |
$2,379 |
14.2× |
| CT thorax w/o contrast (71250) |
$1,784.25 |
$2,379 |
14.2× |
| CT unlisted procedure (76497) |
$2,774.25 |
$3,699 |
26.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,549 |
$4,732 |
16.9× |
| Cta Abdomen (74175) |
$3,312.75 |
$4,417 |
15.8× |
| CTA abdomen pelvis (74174) |
$3,469.50 |
$4,626 |
8.3× |
| CTA chest (71275) |
$3,194.25 |
$4,259 |
15.2× |
| Cta Head (70496) |
$4,451.25 |
$5,935 |
21.2× |
| Cta Neck (70498) |
$4,476 |
$5,968 |
21.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$734.25 |
$979 |
5.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$507 |
$676 |
4.9× |
| Esophagus (74220) |
$1,299.75 |
$1,733 |
6.2× |
| Facial bones min 3 views (70150) |
$837.75 |
$1,117 |
6.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$329.25 |
$439 |
2.6× |
| Knee 3 views (73562) |
$526.50 |
$702 |
5.0× |
| MRA head w & w/o contrast (70546) |
$5,632.50 |
$7,510 |
13.5× |
| MRA neck w contrast (70548) |
$3,908.25 |
$5,211 |
9.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,627.25 |
$7,503 |
13.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,135.25 |
$6,847 |
12.3× |
| MRI abdomen w/o contrast (74181) |
$3,334.50 |
$4,446 |
11.7× |
| MRI cervical spine w/o contrast (72141) |
$3,403.50 |
$4,538 |
11.9× |
| MRI chest w/o & w/contrast material (71552) |
$5,944.50 |
$7,926 |
14.2× |
| MRI chest w/o contrast (71550) |
$4,169.25 |
$5,559 |
14.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,055.75 |
$6,741 |
12.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,125.50 |
$6,834 |
12.3× |
| MRI pelvis w/o contrast (72195) |
$3,818.25 |
$5,091 |
13.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,971 |
$6,628 |
11.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,914 |
$6,552 |
11.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,584.75 |
$6,113 |
11.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,413.25 |
$4,551 |
11.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,604.50 |
$4,806 |
12.6× |
| N-invas est c ffr sw aly CTA (75580) |
$5,105.25 |
$6,807 |
5.0× |
| Neck soft tissue (70360) |
$522 |
$696 |
5.0× |
| Ob us nuchal meas 1 gest (76813) |
$431.62 |
$575.50 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$486 |
$648 |
3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$726.75 |
$969 |
1.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$484.50 |
$646 |
4.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$520.50 |
$694 |
4.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$449.25 |
$599 |
4.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$316.50 |
$422 |
2.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$455.25 |
$607 |
3.6× |
| Radex Kne 1/2 Views (73560) |
$403.50 |
$538 |
3.9× |
| Radex Kne Compl 4/More Views (73564) |
$571.50 |
$762 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$510.75 |
$681 |
4.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$511.50 |
$682 |
4.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$576.75 |
$769 |
5.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$501 |
$668 |
4.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$249 |
$332 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$405 |
$540 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$314.25 |
$419 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,124.25 |
$1,499 |
5.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$501 |
$668 |
4.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$580.50 |
$774 |
2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$237 |
$316 |
10.1× |
| Spine thoracic 3 views (72072) |
$582 |
$776 |
4.6× |
| Ultrasound Exam Aaa Screen (76706) |
$298.50 |
$398 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$549.38 |
$732.50 |
4.4× |
| Us breast unilateral limited (76642) |
$204.38 |
$272.50 |
2.0× |
| Us chest (76604) |
$331.50 |
$442 |
2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$123.75 |
$165 |
1.0× |
| Us ob detailed single fetus (76811) |
$176.25 |
$235 |
0.6× |
| Us ob limited (76815) |
$313.88 |
$418.50 |
2.5× |
| Us ob transvaginal (76817) |
$347.62 |
$463.50 |
2.8× |
| Us pelvic non ob complete (76856) |
$842.25 |
$1,123 |
6.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$383.62 |
$511.50 |
3.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$426.38 |
$568.50 |
3.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$406.12 |
$541.50 |
3.2× |
| Us retroperitoneal complete (76770) |
$999 |
$1,332 |
8.0× |
| Us scrotum and contents (76870) |
$441.38 |
$588.50 |
3.5× |
| Us soft tissue head/neck (76536) |
$539.62 |
$719.50 |
4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$337.50 |
$450 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$582 |
$776 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$523.50 |
$698 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$632.25 |
$843 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$532.50 |
$710 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$510.75 |
$681 |
4.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$638.25 |
$851 |
5.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$582 |
$776 |
4.6× |
| Xr c-spine 4 or 5 views (72050) |
$789 |
$1,052 |
6.3× |
| Xr c-spine 6 or more views (72052) |
$899.25 |
$1,199 |
7.2× |