| Abdomen 2 views (74019) |
$324.80 |
$406 |
3.0× |
| Ankle 2 views (73600) |
$222.40 |
$278 |
2.5× |
| Bone survey complete (77075) |
$566 |
$707.50 |
5.3× |
| Cervical spine 2 or 3 views (72040) |
$300 |
$375 |
3.4× |
| Chest 1 view (71045) |
$203.20 |
$254 |
2.3× |
| Chest 3 views (71047) |
$318.40 |
$398 |
3.6× |
| Clavicle complete (73000) |
$215.20 |
$269 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,363.20 |
$4,204 |
9.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,884 |
$3,605 |
11.8× |
| CT abdomen w contrast (74160) |
$1,952 |
$2,440 |
10.9× |
| CT abdomen w wo contrast (74170) |
$2,402.40 |
$3,003 |
13.4× |
| CT abdomen w/o contrast (74150) |
$1,500.80 |
$1,876 |
14.1× |
| CT angiography upper extremity lt (73206) |
$1,888 |
$2,360 |
10.5× |
| CT c-spine w/o contrast (72125) |
$1,730.40 |
$2,163 |
16.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,269.60 |
$2,837 |
12.7× |
| CT cervical spine with contrast (72126) |
$1,840.80 |
$2,301 |
5.2× |
| CT chest w/wo contrast (71270) |
$2,248.80 |
$2,811 |
12.5× |
| CT chest with contrast (71260) |
$2,112.80 |
$2,641 |
11.8× |
| CT head/brain with contrast (70460) |
$1,440 |
$1,800 |
8.0× |
| CT head/brain without and with contrast (70470) |
$1,940 |
$2,425 |
10.8× |
| CT iac w contrast (70481) |
$1,964 |
$2,455 |
11.0× |
| CT lower ext w/o (73700) |
$1,860.80 |
$2,326 |
17.4× |
| CT lower extremity w wo contrast (73702) |
$1,640 |
$2,050 |
9.2× |
| CT lower extremity with contrast (73701) |
$1,780.80 |
$2,226 |
9.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,340.80 |
$2,926 |
13.1× |
| CT lumbar spine w/o contrast (72131) |
$1,632 |
$2,040 |
15.3× |
| CT lumbar spine with contrast (72132) |
$1,919.20 |
$2,399 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,616.80 |
$2,021 |
9.0× |
| CT maxillofacial w/o contrast (70486) |
$1,489.60 |
$1,862 |
13.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,096 |
$2,620 |
11.7× |
| CT neck soft tissue w contrast (70491) |
$1,820 |
$2,275 |
10.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,788 |
$2,235 |
10.0× |
| CT orbits w/o contrast (70480) |
$1,560 |
$1,950 |
14.6× |
| CT pelvis w & w/o contrast (72194) |
$2,223.20 |
$2,779 |
12.4× |
| CT pelvis w/o contrast (72192) |
$1,532 |
$1,915 |
14.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,954.40 |
$2,443 |
10.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,456.80 |
$1,821 |
13.6× |
| CT thoracic spine w/contrast (72129) |
$1,981.60 |
$2,477 |
11.1× |
| CT thoracic spine w/o contrast (72128) |
$1,769.60 |
$2,212 |
16.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,181.60 |
$2,727 |
12.2× |
| CT thorax w/o contrast (71250) |
$1,460 |
$1,825 |
13.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,846.40 |
$2,308 |
10.3× |
| CT upper extremity w/o contrast rt (73200) |
$2,000 |
$2,500 |
18.7× |
| CT upper extremity with contrast (73201) |
$1,554.40 |
$1,943 |
4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,783.20 |
$3,479 |
15.5× |
| Cta Abdomen (74175) |
$2,017.60 |
$2,522 |
11.3× |
| CTA chest (71275) |
$2,004.40 |
$2,505.50 |
11.2× |
| Cta Head (70496) |
$2,014.40 |
$2,518 |
11.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,816.80 |
$2,271 |
10.1× |
| Cta Neck (70498) |
$1,997.60 |
$2,497 |
11.1× |
| Cta Pelvis (72191) |
$2,136 |
$2,670 |
11.9× |
| Foot 2 views (73620) |
$193.60 |
$242 |
2.2× |
| Forearm 2 views (73090) |
$224.80 |
$281 |
2.5× |
| Hand 2 views (73120) |
$234.40 |
$293 |
2.2× |
| Hand 3 views (73130) |
$268 |
$335 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$264 |
$330 |
3.0× |
| Knee 3 views (73562) |
$324.80 |
$406 |
3.7× |
| Neck soft tissue (70360) |
$200 |
$250 |
2.2× |
| Osseous survey infant (77076) |
$359.20 |
$449 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$252.80 |
$316 |
2.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$327.20 |
$409 |
3.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$312.80 |
$391 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$283.20 |
$354 |
2.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$304.80 |
$381 |
2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$239.20 |
$299 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$263.20 |
$329 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$360 |
$450 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$252.80 |
$316 |
2.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$256.80 |
$321 |
2.9× |
| Ribs bilateral 3 views (71110) |
$385.60 |
$482 |
3.6× |
| Sacroiliac Joints < 3 Views (72200) |
$247.20 |
$309 |
2.3× |
| Scapula complete (73010) |
$252 |
$315 |
2.4× |
| Sella turcica (70240) |
$240 |
$300 |
2.7× |
| Spine thoracic 3 views (72072) |
$340 |
$425 |
3.2× |
| Thoracolumbar 2 views (72080) |
$205.60 |
$257 |
2.3× |
| Tmj unilateral (70328) |
$188 |
$235 |
2.1× |
| Wrist 2 views (73100) |
$228 |
$285 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$412.80 |
$516 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$270.40 |
$338 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$264.80 |
$331 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$254.40 |
$318 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$274.40 |
$343 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$264 |
$330 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$283.20 |
$354 |
3.2× |
| X-ray exam hip uni 4/> views (73503) |
$379.20 |
$474 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$340 |
$425 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$474.40 |
$593 |
4.4× |
| X-ray exam of femur 1 (73551) |
$280.80 |
$351 |
3.2× |
| X-ray eye for foreign body (70030) |
$216 |
$270 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$280 |
$350 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$203.20 |
$254 |
2.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$309.60 |
$387 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$257.60 |
$322 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$269.20 |
$336.50 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$334.40 |
$418 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$240 |
$300 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$210.40 |
$263 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$301.60 |
$377 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$554.40 |
$693 |
5.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$318.40 |
$398 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$248 |
$310 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$521.60 |
$652 |
5.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$359.20 |
$449 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$315.20 |
$394 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$277.60 |
$347 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$316 |
$395 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$440 |
$550 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$263.20 |
$329 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$249.60 |
$312 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$250.40 |
$313 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$320 |
$400 |
3.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$248 |
$310 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$360 |
$450 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$288 |
$360 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$189.60 |
$237 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$254.40 |
$318 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$264 |
$330 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$264 |
$330 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$366.40 |
$458 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$210.40 |
$263 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$254.40 |
$318 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$515.20 |
$644 |
4.8× |
| Xr chest 4+ views (71048) |
$381.60 |
$477 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$241.60 |
$302 |
2.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$200 |
$250 |
1.9× |
| Xr optic foramina (70190) |
$220 |
$275 |
2.5× |
| Xr shoulder 1 view (73020) |
$217.60 |
$272 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$396.80 |
$496 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$274.40 |
$343 |
3.1× |
| Xr tmj bilateral (70330) |
$362.40 |
$453 |
4.1× |
| Xray knee 1 or 2 views rt (73560) |
$290.40 |
$363 |
3.3× |