| Ankle 2 views (73600) |
— |
$551 |
— |
| Bone Imaging Whole Body (78306) |
$538.53 |
$3,776 |
1.0× |
| Chest 1 view (71045) |
$118.46 |
$2,284 |
1.1× |
| Chest 2 views (71046) |
$117.69 |
$914 |
1.1× |
| Chest 4 or more views (71048) |
$148.10 |
$764 |
1.1× |
| Clavicle complete (73000) |
$31.74 |
$615 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$507.14 |
$9,246 |
1.1× |
| CT abdomen and pelvis without contrast (74176) |
$294.36 |
$16,536 |
1.0× |
| CT abdomen w contrast (74160) |
$425.70 |
$4,695 |
1.9× |
| CT abdomen w wo contrast (74170) |
$250.50 |
$5,108 |
1.1× |
| CT abdomen w/o contrast (74150) |
— |
$4,463 |
— |
| CT Angio Chest (71275) |
$282.39 |
$5,024 |
1.3× |
| CT chest w contrast (71260) |
$400.26 |
$6,270.90 |
1.8× |
| CT lower ext w/o (73700) |
$148.10 |
$5,514 |
1.1× |
| CT lumbar spine w/o contrast (72131) |
$213.59 |
$3,871 |
1.6× |
| CT maxillofacial wo contrast (70486) |
$149.51 |
$3,601 |
1.1× |
| CT pelvis w/o contrast (72192) |
$188.90 |
$3,943 |
1.4× |
| CT soft tissue neck w contrast (70491) |
$328.16 |
$3,816 |
1.5× |
| CT thorax w/o contrast (71250) |
$171.06 |
$4,698 |
1.3× |
| Forearm 2 views (73090) |
— |
$1,216 |
— |
| Knee 3 Views (73562) |
$119.04 |
$1,566 |
1.1× |
| MRI abdomen w/o contrast (74181) |
$323.55 |
$5,806 |
1.1× |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$9,668 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$510.47 |
$9,668 |
1.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$323.55 |
$9,572 |
1.1× |
| MRI cervical spine w/o cont (72141) |
$391.35 |
$7,875 |
1.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$323.55 |
$9,668 |
1.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$8,687 |
— |
| MRI pelvis w/o & w contrast (72197) |
$844.55 |
$8,565 |
1.9× |
| MRI pelvis w/o contrast (72195) |
$412.70 |
$6,995 |
1.3× |
| MRI thoracic spine w/o contrast (72146) |
— |
$6,131 |
— |
| MRI, abdomen, combo (74183) |
$490.82 |
$8,178 |
1.1× |
| MRI, dorsal spine combo (72157) |
$735.47 |
$8,285 |
1.6× |
| MRI, joint upper extrem (73221) |
$375.39 |
$9,668 |
1.2× |
| MRI, lumbar spine combo (72158) |
$514.10 |
$8,357 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,815.93 |
$4,999 |
1.1× |
| Pelvis 1 or 2 views (72170) |
— |
$781 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$153.08 |
$1,087 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$120.38 |
$1,314 |
1.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$566 |
— |
| Radex elbow complete minimum 3 views (73080) |
$120.38 |
$1,356 |
1.1× |
| Radex fingr minimum 2 views (73140) |
$113.70 |
$892 |
1.0× |
| Radex foot complete minimum 3 views (73630) |
$117.71 |
$1,402 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$117.03 |
$1,358 |
1.0× |
| Radex shoulder complete minimum 2 views (73030) |
$118.32 |
$1,460 |
1.1× |
| Radex Toe Minimum 2 Views (73660) |
— |
$1,250 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
$95.49 |
$748 |
0.9× |
| Radiologic exam knee complete 4/more views (73564) |
$137.18 |
$1,782 |
1.0× |
| Radiologic examination knee 1/2 views (73560) |
$102.33 |
$596 |
0.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$1,398 |
— |
| Thoracic spine 3 views (72072) |
$148.10 |
$867 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$538.53 |
$1,542 |
1.0× |
| Ultrasound Breast Limited (76642) |
$115.95 |
$2,548 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$149.34 |
$3,014 |
1.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$150.93 |
$2,058 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$188.90 |
$825 |
1.4× |
| Us ob transvaginal (76817) |
$188.90 |
$1,044 |
1.4× |
| Us pelvic non ob complete (76856) |
$142.95 |
$1,673 |
1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$188.90 |
$1,438 |
1.4× |
| Us retroperitoneal limited (76775) |
$149.39 |
$1,508 |
1.1× |
| Us scrotum and contents (76870) |
$188.90 |
$1,640 |
1.4× |
| Us thyroid (76536) |
$149.04 |
$1,668 |
1.1× |
| Us transrectal (76872) |
$148.10 |
$1,692 |
1.1× |
| Wrist 2 views (73100) |
— |
$616 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$602 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$714 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$1,396 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$120.38 |
$635 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$148.10 |
$3,760 |
1.1× |
| Xr c-spine 4 or 5 views (72050) |
$136.20 |
$1,294 |
1.0× |