| Abdomen 2 views (74019) |
$214.20 |
$306 |
2.1× |
| Ankle 2 views (73600) |
$141.40 |
$202 |
1.7× |
| Bone age studies (77072) |
$184.10 |
$263 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$185.50 |
$265 |
2.2× |
| Chest 1 view (71045) |
$178.50 |
$255 |
2.1× |
| Chest xray 3 views (71047) |
$210 |
$300 |
2.5× |
| Clavicle complete (73000) |
$184.10 |
$263 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$184.80 |
$264 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,793.70 |
$3,991 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,802.50 |
$2,575 |
7.9× |
| CT abdomen w contrast (74160) |
$1,262.10 |
$1,803 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,514.10 |
$2,163 |
9.0× |
| CT abdomen w/o contrast (74150) |
$980 |
$1,400 |
9.8× |
| CT c-spine w/o contrast (72125) |
$916.30 |
$1,309 |
9.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,204.70 |
$1,721 |
7.2× |
| CT chest w contrast (71260) |
$1,314.60 |
$1,878 |
7.8× |
| CT chest w/wo contrast (71270) |
$1,514.10 |
$2,163 |
9.0× |
| CT head/brain without and with contrast (70470) |
$1,297.80 |
$1,854 |
7.7× |
| CT iac w contrast (70481) |
$1,096.20 |
$1,566 |
6.5× |
| CT lower ext w/o (73700) |
$931 |
$1,330 |
9.3× |
| CT lower extremity w wo contrast (73702) |
$1,384.60 |
$1,978 |
8.2× |
| CT lower extremity w/contrast material (73701) |
$1,096.20 |
$1,566 |
6.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,204.70 |
$1,721 |
7.2× |
| CT lumbar spine w/contrast (72132) |
$1,096.20 |
$1,566 |
3.3× |
| CT lumbar spine w/o contrast (72131) |
$973.70 |
$1,391 |
9.7× |
| CT maxillofacial w contrast (70487) |
$1,096.20 |
$1,566 |
6.5× |
| CT maxillofacial wo contrast (70486) |
$931 |
$1,330 |
9.3× |
| CT orbits w/o contrast (70480) |
$931 |
$1,330 |
9.3× |
| CT pelvis w/o contrast (72192) |
$973.70 |
$1,391 |
9.7× |
| CT soft tissue neck w contrast (70491) |
$1,204.70 |
$1,721 |
7.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,262.10 |
$1,803 |
7.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,096.20 |
$1,566 |
10.9× |
| CT thoracic spine w/o contrast (72128) |
$916.30 |
$1,309 |
9.1× |
| CT thorax w/o contrast (71250) |
$1,148.70 |
$1,641 |
11.5× |
| CT upper ext wo (73200) |
$931 |
$1,330 |
9.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,260 |
$1,800 |
7.5× |
| Cta Abdomen (74175) |
$1,262.10 |
$1,803 |
7.5× |
| CTA chest (71275) |
$1,262.10 |
$1,803 |
7.5× |
| Cta Head (70496) |
$1,260 |
$1,800 |
7.5× |
| Cta Neck (70498) |
$1,260 |
$1,800 |
7.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$288.40 |
$412 |
2.9× |
| Facial bones min 3 views (70150) |
$184.10 |
$263 |
1.8× |
| Foot 2 views (73620) |
$141.40 |
$202 |
1.7× |
| Forearm 2 views (73090) |
$140 |
$200 |
1.7× |
| Hand 2 views (73120) |
$137.20 |
$196 |
1.4× |
| Knee 3 views (73562) |
$199.50 |
$285 |
2.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,960 |
$2,800 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,297.80 |
$1,854 |
5.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,960 |
$2,800 |
5.9× |
| MRI cervical spine w/o contrast (72141) |
$1,470 |
$2,100 |
6.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,802.50 |
$2,575 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,470 |
$2,100 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,960 |
$2,800 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,297.80 |
$1,854 |
5.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,802.50 |
$2,575 |
5.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,960 |
$2,800 |
5.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,470 |
$2,100 |
6.4× |
| MRI up ext w/o contrast (73218) |
$1,081.50 |
$1,545 |
4.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,470 |
$2,100 |
6.4× |
| Neck soft tissue (70360) |
$184.10 |
$263 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$184.10 |
$263 |
1.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$169.40 |
$242 |
2.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$169.40 |
$242 |
2.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$169.40 |
$242 |
2.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$184.10 |
$263 |
2.2× |
| Radex fingr minimum 2 views (73140) |
$166.60 |
$238 |
2.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$169.40 |
$242 |
2.0× |
| Radex Hand Minimum 3 Views (73130) |
$166.60 |
$238 |
2.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$137.20 |
$196 |
1.6× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$180.60 |
$258 |
1.8× |
| Radex Humerus Minimum 2 Views (73060) |
$184.10 |
$263 |
2.2× |
| Radex Kne 1/2 Views (73560) |
$141.40 |
$202 |
1.7× |
| Radex Kne Compl 4/More Views (73564) |
$198.80 |
$284 |
2.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$184.10 |
$263 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$184.10 |
$263 |
2.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$184.10 |
$263 |
1.8× |
| Radex Sho Compl Minimum 2 Views (73030) |
$184.10 |
$263 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$141.40 |
$202 |
1.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$166.60 |
$238 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$184.10 |
$263 |
2.2× |
| Radiologic exam chest 2 views (71046) |
$192.50 |
$275 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$169.40 |
$242 |
2.0× |
| Scapula (73010) |
$184.10 |
$263 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$46.90 |
$67 |
2.0× |
| Shoulder 1 view (73020) |
$141.40 |
$202 |
1.7× |
| Spine thoracic 3 views (72072) |
$213.50 |
$305 |
2.1× |
| Ultrasound breast complete (76641) |
$280.70 |
$401 |
2.8× |
| Ultrasound Exam Aaa Screen (76706) |
$497.70 |
$711 |
5.0× |
| Ultrasound, abdomen limited (76705) |
$380.10 |
$543 |
3.8× |
| Us chest (76604) |
$346.50 |
$495 |
3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$377.30 |
$539 |
3.8× |
| Us pelvic non ob complete (76856) |
$427 |
$610 |
4.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$377.30 |
$539 |
3.8× |
| Us retroperitoneal complete (76770) |
$497.70 |
$711 |
5.0× |
| Us retroperitoneal limited (76775) |
$408.80 |
$584 |
4.1× |
| Us scrotum and contents (76870) |
$377.30 |
$539 |
3.8× |
| Us soft tissue head/neck (76536) |
$369.60 |
$528 |
3.7× |
| Wrist 2 views (73100) |
$137.20 |
$196 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$243.60 |
$348 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$140.70 |
$201 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$184.10 |
$263 |
2.2× |
| X-ray exam of femur 2/> (73552) |
$169.40 |
$242 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$141.40 |
$202 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$141.40 |
$202 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$184.10 |
$263 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$213.50 |
$305 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$283.50 |
$405 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$210 |
$300 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$184.10 |
$263 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$184.10 |
$263 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$184.10 |
$263 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$255.50 |
$365 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$184.10 |
$263 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$141.40 |
$202 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$184.10 |
$263 |
1.8× |
| Xr c-spine 4 or 5 views (72050) |
$245 |
$350 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$280.70 |
$401 |
2.8× |
| Xr chest 4+ views (71048) |
$228.90 |
$327 |
2.3× |