| Abdomen 2 views (74019) |
$348.75 |
$465 |
3.3× |
| Ankle 2 views (73600) |
$223.50 |
$298 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$327 |
$436 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,408 |
$4,544 |
9.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,936.25 |
$3,915 |
12.3× |
| CT abdomen w/o contrast (74150) |
$1,468.50 |
$1,958 |
14.0× |
| CT c-spine w/o contrast (72125) |
$1,468.50 |
$1,958 |
14.0× |
| CT chest w/wo contrast (71270) |
$1,618.50 |
$2,158 |
9.2× |
| CT chest with contrast (71260) |
$1,521 |
$2,028 |
8.6× |
| CT iac w contrast (70481) |
$1,323 |
$1,764 |
7.5× |
| CT lower ext w/o (73700) |
$1,275.75 |
$1,701 |
12.1× |
| CT lower extremity with contrast (73701) |
$1,323 |
$1,764 |
7.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,482 |
$1,976 |
8.4× |
| CT lumbar spine w/o contrast (72131) |
$1,323 |
$1,764 |
12.6× |
| CT maxillofacial w contrast (70487) |
$1,323 |
$1,764 |
7.5× |
| CT maxillofacial w/o contrast (70486) |
$1,423.50 |
$1,898 |
13.6× |
| CT pelvis w & w/o contrast (72194) |
$1,704 |
$2,272 |
9.7× |
| CT pelvis w/o contrast (72192) |
$1,468.50 |
$1,958 |
14.0× |
| CT thoracic spine w/o contrast (72128) |
$1,212.75 |
$1,617 |
11.5× |
| CT thorax w/o contrast (71250) |
$1,451.25 |
$1,935 |
13.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,275.75 |
$1,701 |
12.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,978.50 |
$2,638 |
11.2× |
| Cta Abdomen (74175) |
$1,880.25 |
$2,507 |
10.7× |
| CTA abdomen pelvis (74174) |
$2,820 |
$3,760 |
8.0× |
| CTA chest (71275) |
$2,033.25 |
$2,711 |
11.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$365.25 |
$487 |
3.5× |
| Foot 2 views (73620) |
$234 |
$312 |
2.7× |
| Forearm 2 views (73090) |
$236.25 |
$315 |
2.7× |
| Hand 2 views (73120) |
$153 |
$204 |
1.5× |
| Hand 3 views (73130) |
$207.75 |
$277 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$207.75 |
$277 |
2.4× |
| Knee 3 views (73562) |
$258 |
$344 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,784.25 |
$2,379 |
7.4× |
| Pelvis 1 or 2 views (72170) |
$170.25 |
$227 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$193.50 |
$258 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$234 |
$312 |
2.7× |
| Scapula complete (73010) |
$199.50 |
$266 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$48 |
$64 |
2.1× |
| Spine thoracic 3 views (72072) |
$278.25 |
$371 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$544.50 |
$726 |
5.2× |
| Us breast unilateral complete (76641) |
$397.50 |
$530 |
3.8× |
| Us breast unilateral limited (76642) |
$364.50 |
$486 |
4.2× |
| Us ob transvaginal (76817) |
$544.50 |
$726 |
5.2× |
| Us pelvic non ob complete (76856) |
$585 |
$780 |
5.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$343.50 |
$458 |
3.3× |
| Us pregnancy ltd (76815) |
$413.25 |
$551 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$854.25 |
$1,139 |
8.1× |
| Us retroperitoneal complete (76770) |
$544.50 |
$726 |
5.2× |
| Us retroperitoneal limited (76775) |
$528 |
$704 |
5.0× |
| Us scrotum and contents (76870) |
$585 |
$780 |
5.6× |
| Us soft tissue head/neck (76536) |
$467.25 |
$623 |
4.4× |
| Us xtr non-vasc lmtd (76882) |
$413.25 |
$551 |
3.9× |
| Wrist 2 views (73100) |
$223.50 |
$298 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$524.25 |
$699 |
5.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$268.50 |
$358 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$223.50 |
$298 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$268.50 |
$358 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$134.25 |
$179 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$190.50 |
$254 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$261 |
$348 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$276.75 |
$369 |
3.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$167.25 |
$223 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$280.50 |
$374 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$327.75 |
$437 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$221.25 |
$295 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$241.50 |
$322 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$207 |
$276 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$235.50 |
$314 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$170.25 |
$227 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$268.50 |
$358 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$174.75 |
$233 |
2.0× |
| Xr shoulder 1 view (73020) |
$170.25 |
$227 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$376.50 |
$502 |
3.6× |
| Xr tibia/fibula 2 views (73590) |
$179.25 |
$239 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$236.25 |
$315 |
2.7× |