| Abdomen 2 views (74019) |
$393 |
$393 |
3.6× |
| Ankle 2 views (73600) |
$280 |
$280 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,557 |
$2,557 |
6.1× |
| Bone survey complete (77075) |
$684 |
$684 |
6.2× |
| Bone survey infant (77076) |
$1,098 |
$1,098 |
10.0× |
| Cervical spine 2 or 3 views (72040) |
$424 |
$424 |
4.6× |
| Chest 1 view (71045) |
$275 |
$275 |
3.0× |
| Clavicle complete (73000) |
$345 |
$345 |
3.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,273 |
$1,273 |
11.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,637 |
$4,637 |
12.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,986 |
$2,986 |
11.9× |
| CT abdomen w contrast (74160) |
$2,036 |
$2,036 |
11.0× |
| CT abdomen w wo contrast (74170) |
$2,660 |
$2,660 |
14.4× |
| CT abdomen w/o contrast (74150) |
$1,704 |
$1,704 |
15.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,707 |
$3,707 |
20.0× |
| CT angiography upper extremity lt (73206) |
$1,292 |
$1,292 |
7.0× |
| CT c-spine w/contrast (72126) |
$2,604 |
$2,604 |
7.1× |
| CT c-spine w/o contrast (72125) |
$2,256 |
$2,256 |
20.4× |
| CT cervical spine w&w/o contrast (72127) |
$3,126 |
$3,126 |
16.9× |
| CT chest w contrast (71260) |
$2,147 |
$2,147 |
11.6× |
| CT chest w/wo contrast (71270) |
$2,907 |
$2,907 |
15.7× |
| CT head/brain with contrast (70460) |
$1,903 |
$1,903 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,291 |
$2,291 |
12.4× |
| CT iac w contrast (70481) |
$2,173 |
$2,173 |
11.7× |
| CT limited/localized follow up study (76380) |
$1,006 |
$1,006 |
11.0× |
| CT lower ext w/o (73700) |
$1,551 |
$1,551 |
14.1× |
| CT lower extremity w wo contrast (73702) |
$2,657 |
$2,657 |
14.4× |
| CT lower extremity w/contrast material (73701) |
$2,108 |
$2,108 |
11.4× |
| CT lumbar spine w & w/o contrast (72133) |
$3,134 |
$3,134 |
16.9× |
| CT lumbar spine w/contrast (72132) |
$2,602 |
$2,602 |
7.1× |
| CT lumbar spine w/o contrast (72131) |
$2,038 |
$2,038 |
18.5× |
| CT maxillofacial w contrast (70487) |
$2,129 |
$2,129 |
11.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,259 |
$1,259 |
6.8× |
| CT maxillofacial wo contrast (70486) |
$1,717 |
$1,717 |
15.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,204 |
$2,204 |
11.9× |
| CT orbits w/o contrast (70480) |
$1,370 |
$1,370 |
12.4× |
| CT pelvis w/o contrast (72192) |
$1,615 |
$1,615 |
14.6× |
| CT pelvis w/wo contrast (72194) |
$2,248 |
$2,248 |
12.1× |
| CT scan of arm combo (73202) |
$2,219 |
$2,219 |
12.0× |
| CT soft tissue neck w contrast (70491) |
$2,029 |
$2,029 |
11.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,880 |
$2,880 |
15.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,695 |
$1,695 |
15.4× |
| CT thoracic spine w/contrast (72129) |
$2,127 |
$2,127 |
11.5× |
| CT thoracic spine w/o contrast (72128) |
$2,081 |
$2,081 |
18.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,602 |
$2,602 |
14.1× |
| CT thorax w/o contrast (71250) |
$1,746 |
$1,746 |
15.8× |
| CT upper ext wo (73200) |
$1,645 |
$1,645 |
14.9× |
| CT upper extremity with contrast (73201) |
$1,834 |
$1,834 |
5.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,855 |
$3,855 |
20.8× |
| Cta Abdomen (74175) |
$1,641 |
$1,641 |
8.9× |
| CTA abdomen pelvis (74174) |
$2,059 |
$2,059 |
5.6× |
| CTA chest (71275) |
$3,163 |
$3,163 |
17.1× |
| Cta Head (70496) |
$1,811 |
$1,811 |
9.8× |
| Cta Neck (70498) |
$2,713 |
$2,713 |
14.7× |
| Cta Pelvis (72191) |
$1,703 |
$1,703 |
9.2× |
| Facial bones min 3 views (70150) |
$458 |
$458 |
4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$380 |
$380 |
3.4× |
| Foot 2 views (73620) |
$322 |
$322 |
3.5× |
| Forearm 2 views (73090) |
$328 |
$328 |
3.6× |
| Hand 2 views (73120) |
$328 |
$328 |
3.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$328 |
$328 |
3.0× |
| Knee 3 views (73562) |
$455 |
$455 |
5.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,990 |
$1,990 |
2.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,081 |
$2,081 |
5.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,584 |
$3,584 |
9.7× |
| MRA head w & w/o contrast (70546) |
$4,642 |
$4,642 |
12.6× |
| MRA head w/o contrast (70544) |
$2,681 |
$2,681 |
10.6× |
| MRA head with contrast (70545) |
$2,453 |
$2,453 |
6.7× |
| MRA neck w contrast (70548) |
$2,123 |
$2,123 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,451 |
$3,451 |
9.4× |
| MRA neck w/o contrast (70547) |
$2,615 |
$2,615 |
10.4× |
| MRI abdomen w contrast (74182) |
$1,866 |
$1,866 |
5.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,490 |
$5,490 |
14.9× |
| MRI abdomen w/o contrast (74181) |
$2,614 |
$2,614 |
10.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,945 |
$1,945 |
2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,992 |
$2,992 |
8.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,637 |
$1,637 |
6.5× |
| MRI breast wo contrast unilateral (77046) |
$1,485 |
$1,485 |
5.9× |
| MRI c-spine with contrast (72142) |
$3,248 |
$3,248 |
8.8× |
| MRI cervical spine w/o contrast (72141) |
$2,769 |
$2,769 |
11.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,961 |
$3,961 |
10.8× |
| MRI chest w/o contrast (71550) |
$2,557 |
$2,557 |
10.2× |
| MRI chest with contrast (71551) |
$3,008 |
$3,008 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,668 |
$1,668 |
4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,313 |
$2,313 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,527 |
$2,527 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,571 |
$2,571 |
10.2× |
| MRI orbit face neck w contrast (70542) |
$2,042 |
$2,042 |
5.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,929 |
$3,929 |
10.7× |
| MRI pelvis w/contrast (72196) |
$1,653 |
$1,653 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,637 |
$4,637 |
12.6× |
| MRI pelvis w/o contrast (72195) |
$2,443 |
$2,443 |
9.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,861 |
$5,861 |
15.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,333 |
$3,333 |
9.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,681 |
$5,681 |
15.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,247 |
$3,247 |
8.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,738 |
$5,738 |
15.6× |
| MRI temporomandibular joint (70336) |
$2,666 |
$2,666 |
10.6× |
| MRI thoracic spine w/o contrast (72146) |
$3,021 |
$3,021 |
12.0× |
| MRI up ext w/o contrast (73218) |
$2,518 |
$2,518 |
10.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,557 |
$2,557 |
10.2× |
| MRI, joint upper extrem combo (73223) |
$2,769 |
$2,769 |
7.5× |
| Neck soft tissue (70360) |
$337 |
$337 |
3.7× |
| Osseous survey limited (77074) |
$471 |
$471 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$242 |
$242 |
2.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$383 |
$383 |
4.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$353 |
$353 |
3.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$394 |
$394 |
4.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$306 |
$306 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$527 |
$527 |
4.8× |
| Radex fingr minimum 2 views (73140) |
$256 |
$256 |
2.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$416 |
$416 |
4.5× |
| Radex Hand Minimum 3 Views (73130) |
$383 |
$383 |
4.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$348 |
$348 |
3.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$493 |
$493 |
4.5× |
| Radex Humerus Minimum 2 Views (73060) |
$323 |
$323 |
3.5× |
| Radex Kne 1/2 Views (73560) |
$381 |
$381 |
4.1× |
| Radex Kne Compl 4/More Views (73564) |
$494 |
$494 |
4.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$352 |
$352 |
3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$355 |
$355 |
3.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$341 |
$341 |
3.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$403 |
$403 |
4.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$269 |
$269 |
2.9× |
| Radex Toe Minimum 2 Views (73660) |
$256 |
$256 |
2.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$233 |
$233 |
2.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$384 |
$384 |
4.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$271 |
$271 |
3.0× |
| Radiologic exam chest 2 views (71046) |
$331 |
$331 |
3.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$353 |
$353 |
3.8× |
| Ribs bilateral 3 views (71110) |
$438 |
$438 |
4.0× |
| Scapula (73010) |
$308 |
$308 |
2.8× |
| Shoulder 1 view (73020) |
$276 |
$276 |
3.0× |
| Spine thoracic 3 views (72072) |
$552 |
$552 |
5.0× |
| Ultrasound breast complete (76641) |
$530 |
$530 |
4.8× |
| Ultrasound, abdomen limited (76705) |
$705 |
$705 |
6.4× |
| Umbilical-artery Doppler (OB) (76820) |
$323 |
$323 |
2.9× |
| Us breast unilateral limited (76642) |
$330 |
$330 |
3.6× |
| Us chest (76604) |
$325 |
$325 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$394 |
$394 |
3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$411 |
$411 |
3.7× |
| Us ob detailed single fetus (76811) |
$1,072 |
$1,072 |
4.3× |
| Us ob limited (76815) |
$731 |
$731 |
6.6× |
| Us ob transvaginal (76817) |
$794 |
$794 |
7.2× |
| Us pelvic non ob complete (76856) |
$749 |
$749 |
6.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$366 |
$366 |
3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$793 |
$793 |
7.2× |
| Us retroperitoneal complete (76770) |
$794 |
$794 |
7.2× |
| Us retroperitoneal limited (76775) |
$682 |
$682 |
6.2× |
| Us scrotum and contents (76870) |
$585 |
$585 |
5.3× |
| Us soft tissue head/neck (76536) |
$611 |
$611 |
5.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$545 |
$545 |
4.9× |
| Wrist 2 views (73100) |
$343.50 |
$343.50 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$551 |
$551 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$321 |
$321 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$267 |
$267 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$408 |
$408 |
4.4× |
| X-ray exam of femur 2/> (73552) |
$443 |
$443 |
4.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$291 |
$291 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$298 |
$298 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$200 |
$200 |
2.2× |
| X-ray leg, infant (73592) |
$233 |
$233 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$450 |
$450 |
4.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$633 |
$633 |
5.7× |
| X-ray nose-rectum child f.b. (76010) |
$139 |
$139 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$363 |
$363 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$255 |
$255 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$485 |
$485 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$590 |
$590 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$353 |
$353 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$332 |
$332 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$575 |
$575 |
6.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$720 |
$720 |
6.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$416 |
$416 |
3.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$323 |
$323 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$309 |
$309 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$288 |
$288 |
2.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$211 |
$211 |
1.9× |
| Xr c-spine 4 or 5 views (72050) |
$526 |
$526 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$636 |
$636 |
5.8× |