| Abdomen 2 views (74019) |
$184 |
$263 |
1.8× |
| Ankle 2 views (73600) |
$104 |
$149 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$220 |
$314 |
2.5× |
| Chest 1 view (71045) |
$169 |
$242 |
1.9× |
| Clavicle complete (73000) |
$237 |
$338 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,222 |
$6,032 |
12.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,680 |
$2,400 |
7.0× |
| CT abdomen w contrast (74160) |
$1,101 |
$1,573 |
6.2× |
| CT abdomen w wo contrast (74170) |
$2,390 |
$3,414 |
13.6× |
| CT abdomen w/o contrast (74150) |
$718 |
$1,025 |
6.8× |
| CT c-spine w/o contrast (72125) |
$1,301 |
$1,859 |
12.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,874 |
$2,677 |
10.6× |
| CT cervical spine with contrast (72126) |
$1,533 |
$2,190 |
4.4× |
| CT chest w/wo contrast (71270) |
$1,640 |
$2,343 |
9.3× |
| CT chest with contrast (71260) |
$1,808 |
$2,583 |
10.3× |
| CT head/brain with contrast (70460) |
$1,404 |
$2,005 |
8.0× |
| CT head/brain without and with contrast (70470) |
$2,664 |
$3,806 |
15.1× |
| CT lower ext w/o (73700) |
$1,015 |
$1,450 |
9.7× |
| CT lower extremity w wo contrast (73702) |
$1,404 |
$2,005 |
8.0× |
| CT lower extremity with contrast (73701) |
$1,217 |
$1,739 |
6.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,446 |
$2,066 |
8.2× |
| CT lumbar spine w/o contrast (72131) |
$1,376 |
$1,965 |
13.1× |
| CT lumbar spine with contrast (72132) |
$1,419 |
$2,027 |
4.0× |
| CT maxillofacial w contrast (70487) |
$1,470 |
$2,100 |
8.3× |
| CT maxillofacial w/o contrast (70486) |
$1,195 |
$1,707 |
11.4× |
| CT neck soft tissue w contrast (70491) |
$2,623 |
$3,747 |
14.9× |
| CT pelvis w & w/o contrast (72194) |
$2,036 |
$2,909 |
11.6× |
| CT pelvis w/o contrast (72192) |
$1,015 |
$1,450 |
9.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,480 |
$2,114 |
8.4× |
| CT soft tissue neck w/o contrast (70490) |
$2,813 |
$4,019 |
26.8× |
| CT thoracic spine w/contrast (72129) |
$1,546 |
$2,208 |
8.8× |
| CT thoracic spine w/o contrast (72128) |
$2,031 |
$2,902 |
19.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,966 |
$2,809 |
11.2× |
| CT thorax w/o contrast (71250) |
$1,027 |
$1,467 |
9.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,196 |
$1,709 |
6.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,470 |
$3,529 |
23.5× |
| CT upper extremity with contrast (73201) |
$1,054 |
$1,506 |
3.0× |
| CTA abdomen pelvis (74174) |
$3,325 |
$4,750 |
9.5× |
| CTA chest (71275) |
$1,575 |
$2,250 |
8.9× |
| Cta Head (70496) |
$1,907 |
$2,725 |
10.8× |
| Cta Neck (70498) |
$1,907 |
$2,725 |
10.8× |
| Esophagus (74220) |
$788 |
$1,125 |
4.5× |
| Foot 2 views (73620) |
$134 |
$192 |
1.5× |
| Forearm 2 views (73090) |
$221 |
$316 |
2.5× |
| Hand 2 views (73120) |
$183 |
$261 |
1.7× |
| Hand 3 views (73130) |
$221 |
$316 |
2.5× |
| Humerus Min 2 Views Left (73060) |
$213 |
$304 |
2.4× |
| Knee 3 views (73562) |
$210 |
$300 |
2.4× |
| MRA head w/o contrast (70544) |
$964 |
$1,377 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,268 |
$1,811 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,759 |
$3,942 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$964 |
$1,377 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$1,653 |
$2,362 |
6.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,268 |
$1,811 |
3.6× |
| MRI chest w/o contrast (71550) |
$964 |
$1,377 |
4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,168 |
$3,097 |
9.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,268 |
$1,811 |
3.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,268 |
$1,811 |
3.6× |
| MRI pelvis w/o contrast (72195) |
$964 |
$1,377 |
4.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,268 |
$1,811 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,268 |
$1,811 |
3.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,268 |
$1,811 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,268 |
$1,811 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$964 |
$1,377 |
2.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,112 |
$3,017 |
8.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,610 |
$2,300 |
6.7× |
| Neck soft tissue (70360) |
$167 |
$238 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$186 |
$266 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,268 |
$1,811 |
3.6× |
| Pr red cell survival study (78130) |
$39 |
$55 |
0.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$170 |
$243 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$181 |
$258 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$1,190 |
$1,700 |
6.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$980 |
$1,400 |
5.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$169 |
$242 |
1.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$5 |
$7 |
0.0× |
| Ribs bilateral 3 views (71110) |
$244 |
$348 |
2.3× |
| Scapula complete (73010) |
$151 |
$215 |
1.4× |
| Small bowel series (74250) |
$945 |
$1,350 |
5.4× |
| Ultrasound, abdomen limited (76705) |
$424 |
$605 |
4.0× |
| Us breast unilateral limited (76642) |
$234 |
$334 |
2.7× |
| Us chest (76604) |
$271 |
$387 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$540 |
$772 |
5.1× |
| Us pelvic non ob complete (76856) |
$491 |
$701 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$258 |
$368 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$175 |
$250 |
1.7× |
| Us retroperitoneal complete (76770) |
$362.50 |
$518 |
3.5× |
| Us scrotum and contents (76870) |
$615 |
$878 |
5.9× |
| Us soft tissue head/neck (76536) |
$448 |
$640 |
4.3× |
| Us xtr non-vasc lmtd (76882) |
$290 |
$414 |
2.8× |
| Wrist 2 views (73100) |
$131 |
$187 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$137 |
$196 |
1.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$199 |
$284 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$169 |
$242 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$244 |
$349 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$190 |
$272 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$177 |
$253 |
2.0× |
| X-ray exam of femur 1 (73551) |
$151 |
$216 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$153 |
$218 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$167 |
$239 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$197 |
$282 |
2.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$92 |
$131 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$167 |
$239 |
1.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$159 |
$227 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$219 |
$313 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$137.50 |
$196.50 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$169 |
$242 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$240 |
$343 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$295 |
$422 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$151 |
$215 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$201 |
$287 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$384 |
$548 |
4.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$293 |
$419 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$218 |
$311 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$169 |
$242 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$88 |
$126 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$125 |
$179 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$179 |
$255 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$204 |
$291 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$161 |
$230 |
1.8× |
| Xr shoulder 1 view (73020) |
$157.50 |
$224.50 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$151 |
$215 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$186 |
$265 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$169 |
$242 |
1.9× |