| Abdomen 2 views (74019) |
$575 |
$575 |
5.3× |
| Ankle 2 views (73600) |
$281 |
$281 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$450 |
$450 |
5.0× |
| Chest 1 view (71045) |
$350 |
$350 |
3.9× |
| Clavicle complete (73000) |
$317.50 |
$317.50 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,400 |
$2,400 |
22.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,941.50 |
$5,941.50 |
16.4× |
| CT abdomen and pelvis without contrast (74176) |
$5,000 |
$5,000 |
20.2× |
| CT abdomen w contrast (74160) |
$3,637 |
$3,637 |
20.0× |
| CT abdomen w wo contrast (74170) |
$4,707 |
$4,707 |
25.8× |
| CT abdomen w/o contrast (74150) |
$3,022 |
$3,022 |
27.8× |
| CT c-spine w/o contrast (72125) |
$3,149.50 |
$3,149.50 |
29.0× |
| CT cervical spine w&w/o contrast (72127) |
$3,637 |
$3,637 |
20.0× |
| CT cervical spine with contrast (72126) |
$3,389.50 |
$3,389.50 |
9.4× |
| CT chest w/wo contrast (71270) |
$3,686.50 |
$3,686.50 |
20.2× |
| CT chest with contrast (71260) |
$3,569.50 |
$3,569.50 |
19.6× |
| CT head/brain with contrast (70460) |
$2,894.50 |
$2,894.50 |
15.9× |
| CT head/brain without and with contrast (70470) |
$3,228 |
$3,228 |
17.7× |
| CT iac w contrast (70481) |
$3,544 |
$3,544 |
19.5× |
| CT lower ext w/o (73700) |
$3,049 |
$3,049 |
28.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,791 |
$3,791 |
20.8× |
| CT lumbar spine w/o contrast (72131) |
$2,850 |
$2,850 |
26.3× |
| CT lumbar spine with contrast (72132) |
$3,389.50 |
$3,389.50 |
9.4× |
| CT maxillofacial w contrast (70487) |
$2,983 |
$2,983 |
16.4× |
| CT maxillofacial w/o contrast (70486) |
$2,524.50 |
$2,524.50 |
23.3× |
| CT maxillofacial w/wo contrast (70488) |
$3,394 |
$3,394 |
18.6× |
| CT neck soft tissue w contrast (70491) |
$3,479.50 |
$3,479.50 |
19.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,527.50 |
$3,527.50 |
19.4× |
| CT orbits w/o contrast (70480) |
$3,092 |
$3,092 |
28.5× |
| CT pelvis w & w/o contrast (72194) |
$3,637 |
$3,637 |
20.0× |
| CT pelvis w/o contrast (72192) |
$2,825.50 |
$2,825.50 |
26.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,389.50 |
$3,389.50 |
18.6× |
| CT soft tissue neck w/o contrast (70490) |
$3,029 |
$3,029 |
27.9× |
| CT thoracic spine w/contrast (72129) |
$3,389.50 |
$3,389.50 |
18.6× |
| CT thoracic spine w/o contrast (72128) |
$2,910.50 |
$2,910.50 |
26.8× |
| CT thoracic spine w/wo contrast (72130) |
$3,637 |
$3,637 |
20.0× |
| CT thorax w/o contrast (71250) |
$2,991.50 |
$2,991.50 |
27.6× |
| CT upper extremity w/o contrast rt (73200) |
$2,614 |
$2,614 |
24.1× |
| CTA abdomen pelvis (74174) |
$6,432 |
$6,432 |
17.8× |
| CTA chest (71275) |
$4,500 |
$4,500 |
24.7× |
| Cta Head (70496) |
$3,325.50 |
$3,325.50 |
18.3× |
| Cta Neck (70498) |
$3,374.50 |
$3,374.50 |
18.5× |
| Fluoroscopy up to 1 hr (76000) |
$842 |
$842 |
3.4× |
| Foot 2 views (73620) |
$327.50 |
$327.50 |
3.6× |
| Forearm 2 views (73090) |
$382.50 |
$382.50 |
4.2× |
| Hand 3 views (73130) |
$425 |
$425 |
4.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,821.50 |
$1,821.50 |
3.2× |
| Humerus Min 2 Views Left (73060) |
$425 |
$425 |
4.7× |
| Knee 3 views (73562) |
$531.50 |
$531.50 |
5.9× |
| MRA head w & w/o contrast (70546) |
$3,644.50 |
$3,644.50 |
10.1× |
| MRA head w/o contrast (70544) |
$3,457.50 |
$3,457.50 |
14.0× |
| MRA head with contrast (70545) |
$3,705 |
$3,705 |
10.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,264 |
$4,264 |
11.8× |
| MRA neck w/o contrast (70547) |
$3,450 |
$3,450 |
13.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,662.50 |
$4,662.50 |
12.9× |
| MRI abdomen w/o contrast (74181) |
$4,372 |
$4,372 |
17.6× |
| MRI c-spine with contrast (72142) |
$4,346 |
$4,346 |
12.0× |
| MRI cervical spine w/o contrast (72141) |
$3,900 |
$3,900 |
15.7× |
| MRI chest w/o contrast (71550) |
$3,789 |
$3,789 |
15.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,306 |
$3,306 |
13.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,789 |
$3,789 |
15.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,637 |
$4,637 |
12.8× |
| MRI orbit/face/neck w/contrast (70542) |
$3,850 |
$3,850 |
10.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,637 |
$4,637 |
12.8× |
| MRI pelvis w/o contrast (72195) |
$3,789 |
$3,789 |
15.3× |
| MRI scan of arm joint before and after contrast (73223) |
$4,174.50 |
$4,174.50 |
11.5× |
| MRI scan of leg joint before and after contrast (73723) |
$3,789 |
$3,789 |
10.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,637 |
$4,637 |
12.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,346 |
$4,346 |
12.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,564 |
$4,564 |
12.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,346 |
$4,346 |
12.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,637 |
$4,637 |
12.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,789 |
$3,789 |
15.3× |
| MRI tmj (70336) |
$3,206.50 |
$3,206.50 |
12.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,400 |
$3,400 |
13.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,789 |
$3,789 |
10.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,517.50 |
$3,517.50 |
14.2× |
| Myocardial Spect Multiple Studies (78452) |
$5,550 |
$5,550 |
4.1× |
| Neck soft tissue (70360) |
$382.50 |
$382.50 |
4.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$684 |
$684 |
6.3× |
| Pelvis 1 or 2 views (72170) |
$362 |
$362 |
3.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,789 |
$3,789 |
10.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$700 |
$700 |
7.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$648 |
$648 |
6.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$647 |
$647 |
6.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$351.50 |
$351.50 |
3.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$437 |
$437 |
4.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$430 |
$430 |
4.8× |
| Ribs bilateral 3 views (71110) |
$575 |
$575 |
5.3× |
| Scapula complete (73010) |
$455.50 |
$455.50 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$900 |
$900 |
8.3× |
| Us abdl aorta screen aaa (76706) |
$850 |
$850 |
7.8× |
| Us breast unilateral complete (76641) |
$850 |
$850 |
7.8× |
| Us breast unilateral limited (76642) |
$425 |
$425 |
4.7× |
| Us chest (76604) |
$820 |
$820 |
7.6× |
| Us ob transvaginal (76817) |
$865 |
$865 |
8.0× |
| Us pelvic non ob complete (76856) |
$1,100 |
$1,100 |
10.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$550 |
$550 |
5.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,121 |
$1,121 |
10.3× |
| Us retroperitoneal complete (76770) |
$1,170 |
$1,170 |
10.8× |
| Us retroperitoneal limited (76775) |
$793.50 |
$793.50 |
7.3× |
| Us scrotum and contents (76870) |
$925 |
$925 |
8.5× |
| Us soft tissue head/neck (76536) |
$825 |
$825 |
7.6× |
| Us transrectal (76872) |
$825 |
$825 |
7.6× |
| Us xtr non-vasc lmtd (76882) |
$600 |
$600 |
5.5× |
| Wrist 2 views (73100) |
$360 |
$360 |
4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$393 |
$393 |
4.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$485 |
$485 |
5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$355 |
$355 |
3.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$471.50 |
$471.50 |
5.2× |
| X-ray exam hip uni 1 view (73501) |
$675 |
$675 |
7.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$846.50 |
$846.50 |
9.4× |
| X-ray exam of femur 1 (73551) |
$325 |
$325 |
3.6× |
| X-ray eye for foreign body (70030) |
$308 |
$308 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$643 |
$643 |
5.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$453.50 |
$453.50 |
5.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$286.50 |
$286.50 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$600 |
$600 |
5.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$460 |
$460 |
5.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$456 |
$456 |
4.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$386.50 |
$386.50 |
4.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$530 |
$530 |
4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$764.50 |
$764.50 |
7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$850 |
$850 |
7.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$425 |
$425 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$476.50 |
$476.50 |
5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$517.50 |
$517.50 |
5.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$300 |
$300 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$512.50 |
$512.50 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$374 |
$374 |
3.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$397 |
$397 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$449 |
$449 |
5.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$697.50 |
$697.50 |
6.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$300 |
$300 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$427.50 |
$427.50 |
4.7× |
| Xr finger(s) 2+ views (73140) |
$298.50 |
$298.50 |
3.3× |
| Xr shoulder 1 view (73020) |
$390 |
$390 |
4.3× |
| Xr spine cervical 4 or 5 views (72050) |
$804.50 |
$804.50 |
7.4× |
| Xr tibia/fibula 2 views (73590) |
$420 |
$420 |
4.6× |
| Xray knee 1 or 2 views rt (73560) |
$397.50 |
$397.50 |
4.4× |