| Abdomen 2 views (74019) |
$106.40 |
$190 |
1.1× |
| Ankle 2 views (73600) |
$145.88 |
$260.50 |
1.7× |
| Bone survey complete (77075) |
$227.92 |
$407 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$196 |
$350 |
2.3× |
| Chest 1 view (71045) |
$100.80 |
$180 |
1.2× |
| Chest 3 views (71047) |
$117.60 |
$210 |
1.4× |
| Clavicle complete (73000) |
$152.32 |
$272 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$865.20 |
$1,545 |
2.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,274.72 |
$4,062 |
9.9× |
| CT abdomen w contrast (74160) |
$966 |
$1,725 |
5.7× |
| CT abdomen w wo contrast (74170) |
$1,020.32 |
$1,822 |
6.0× |
| CT abdomen w/o contrast (74150) |
$924 |
$1,650 |
9.2× |
| CT c-spine w/o contrast (72125) |
$810.32 |
$1,447 |
8.1× |
| CT cervical spine with contrast (72126) |
$1,538.42 |
$2,747.17 |
4.6× |
| CT chest w/wo contrast (71270) |
$1,109.36 |
$1,981 |
6.6× |
| CT chest with contrast (71260) |
$1,061.20 |
$1,895 |
6.3× |
| CT head/brain with contrast (70460) |
$954.80 |
$1,705 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,044.40 |
$1,865 |
6.2× |
| CT lower ext w/o (73700) |
$1,274 |
$2,275 |
12.7× |
| CT lower extremity w wo contrast (73702) |
$1,484 |
$2,650 |
8.8× |
| CT lower extremity with contrast (73701) |
$1,468.88 |
$2,623 |
8.7× |
| CT lumbar spine w & w/o contrast (72133) |
$864.64 |
$1,544 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$826.56 |
$1,476 |
8.2× |
| CT maxillofacial w contrast (70487) |
$726.32 |
$1,297 |
4.3× |
| CT maxillofacial w/o contrast (70486) |
$696.08 |
$1,243 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$898.80 |
$1,605 |
5.3× |
| CT pelvis w & w/o contrast (72194) |
$1,027.60 |
$1,835 |
6.1× |
| CT pelvis w/o contrast (72192) |
$934.08 |
$1,668 |
9.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,055.04 |
$1,884 |
6.3× |
| CT soft tissue neck w/o contrast (70490) |
$710.08 |
$1,268 |
7.1× |
| CT thoracic spine w/contrast (72129) |
$814.24 |
$1,454 |
4.8× |
| CT thoracic spine w/o contrast (72128) |
$826.56 |
$1,476 |
8.2× |
| CT thorax w/o contrast (71250) |
$934.08 |
$1,668 |
9.3× |
| CT upper extremity w/o contrast rt (73200) |
$961.80 |
$1,717.50 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,278.34 |
$2,282.75 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$329.84 |
$589 |
2.0× |
| CTA chest (71275) |
$1,070.16 |
$1,911 |
6.3× |
| Cta Head (70496) |
$1,028.72 |
$1,837 |
6.1× |
| Cta Neck (70498) |
$910.56 |
$1,626 |
5.4× |
| Foot 2 views (73620) |
$145.88 |
$260.50 |
1.7× |
| Forearm 2 views (73090) |
$145.88 |
$260.50 |
1.7× |
| Hand 2 views (73120) |
$139.93 |
$249.88 |
1.4× |
| Hand 3 views (73130) |
$165.20 |
$295 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$153.44 |
$274 |
1.8× |
| Knee 3 views (73562) |
$145.88 |
$260.50 |
1.7× |
| Neck soft tissue (70360) |
$152.88 |
$273 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$138.88 |
$248 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$201.60 |
$360 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$203.59 |
$363.56 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$100.80 |
$180 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$112 |
$200 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$109.20 |
$195 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$145.88 |
$260.50 |
1.7× |
| Scapula complete (73010) |
$138.88 |
$248 |
1.4× |
| Spine thoracic 3 views (72072) |
$220.08 |
$393 |
2.2× |
| Thoracolumbar 2 views (72080) |
$152.88 |
$273 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$357.84 |
$639 |
3.6× |
| Us breast unilateral limited (76642) |
$123.20 |
$220 |
1.5× |
| Us chest (76604) |
$357.84 |
$639 |
3.6× |
| Us pelvic non ob complete (76856) |
$357.84 |
$639 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$150.64 |
$269 |
1.5× |
| Us retroperitoneal complete (76770) |
$820.69 |
$1,465.52 |
8.2× |
| Us scrotum and contents (76870) |
$194.32 |
$347 |
1.9× |
| Us soft tissue head/neck (76536) |
$219.52 |
$392 |
2.2× |
| Us xtr non-vasc lmtd (76882) |
$195.44 |
$349 |
1.9× |
| Wrist 2 views (73100) |
$145.88 |
$260.50 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$241.92 |
$432 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$158.76 |
$283.50 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$138.88 |
$248 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$145.88 |
$260.50 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$145.88 |
$260.50 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$173.32 |
$309.50 |
2.1× |
| X-ray exam hip uni 4/> views (73503) |
$252.43 |
$450.76 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$336 |
$600 |
3.3× |
| X-ray exam of femur 1 (73551) |
$72.80 |
$130 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$224 |
$400 |
2.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$128.46 |
$229.40 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$158.76 |
$283.50 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$181.16 |
$323.50 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$196 |
$350 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$141.12 |
$252 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$145.88 |
$260.50 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$231 |
$412.50 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$272.16 |
$486 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$151.20 |
$270 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$152.32 |
$272 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$152.88 |
$273 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$224 |
$400 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$141.12 |
$252 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$145.88 |
$260.50 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$152.32 |
$272 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$151.20 |
$270 |
1.8× |
| Xr shoulder 1 view (73020) |
$145.88 |
$260.50 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$241.92 |
$432 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$145.88 |
$260.50 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$140.84 |
$251.50 |
1.7× |