| Abdomen 2 views (74019) |
$278.25 |
$371 |
2.8× |
| Ankle 2 views (73600) |
$181.50 |
$242 |
2.2× |
| Cervical spine 2 or 3 views (72040) |
$249 |
$332 |
3.0× |
| Chest 1 view (71045) |
$186 |
$248 |
2.2× |
| Clavicle complete (73000) |
$223.50 |
$298 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,095.75 |
$1,461 |
10.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,636.25 |
$3,515 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,797 |
$2,396 |
7.8× |
| CT abdomen w contrast (74160) |
$1,518.75 |
$2,025 |
9.0× |
| CT abdomen w wo contrast (74170) |
$1,708.50 |
$2,278 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,176.75 |
$1,569 |
11.7× |
| CT c-spine w/o contrast (72125) |
$1,513.50 |
$2,018 |
15.1× |
| CT cervical spine with contrast (72126) |
$804 |
$1,072 |
2.4× |
| CT chest w/wo contrast (71270) |
$1,611 |
$2,148 |
9.5× |
| CT chest with contrast (71260) |
$1,602.75 |
$2,137 |
9.5× |
| CT head/brain with contrast (70460) |
$804 |
$1,072 |
4.8× |
| CT head/brain without and with contrast (70470) |
$1,623.75 |
$2,165 |
9.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$247.88 |
$330.50 |
3.0× |
| CT lower ext w/o (73700) |
$1,218.75 |
$1,625 |
12.1× |
| CT lower extremity w wo contrast (73702) |
$993 |
$1,324 |
5.9× |
| CT lower extremity with contrast (73701) |
$923.25 |
$1,231 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$923.25 |
$1,231 |
5.5× |
| CT lumbar spine w/o contrast (72131) |
$1,573.50 |
$2,098 |
15.6× |
| CT lumbar spine with contrast (72132) |
$1,983 |
$2,644 |
5.9× |
| CT maxillofacial w contrast (70487) |
$804 |
$1,072 |
4.8× |
| CT maxillofacial w/o contrast (70486) |
$1,209.75 |
$1,613 |
12.0× |
| CT maxillofacial w/wo contrast (70488) |
$919.50 |
$1,226 |
5.5× |
| CT neck soft tissue w contrast (70491) |
$1,476 |
$1,968 |
8.7× |
| CT pelvis w & w/o contrast (72194) |
$923.25 |
$1,231 |
5.5× |
| CT pelvis w/o contrast (72192) |
$1,074.75 |
$1,433 |
10.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$256.50 |
$342 |
3.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,062.75 |
$1,417 |
6.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,264.50 |
$1,686 |
12.6× |
| CT thoracic spine w/contrast (72129) |
$804 |
$1,072 |
4.8× |
| CT thoracic spine w/o contrast (72128) |
$1,158.75 |
$1,545 |
11.5× |
| CT thoracic spine w/wo contrast (72130) |
$923.25 |
$1,231 |
5.5× |
| CT thorax w/o contrast (71250) |
$1,294.50 |
$1,726 |
12.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$923.25 |
$1,231 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,257 |
$1,676 |
12.5× |
| CT upper extremity with contrast (73201) |
$804 |
$1,072 |
2.4× |
| Cta Abdomen (74175) |
$1,446 |
$1,928 |
8.6× |
| CTA chest (71275) |
$1,434 |
$1,912 |
8.5× |
| Cta Head (70496) |
$1,264.50 |
$1,686 |
7.5× |
| CTA lwr ext w&w/o contrast (73706) |
$1,698.75 |
$2,265 |
10.1× |
| Cta Neck (70498) |
$1,400.25 |
$1,867 |
8.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$75.75 |
$101 |
0.9× |
| Foot 2 views (73620) |
$198 |
$264 |
2.4× |
| Forearm 2 views (73090) |
$207 |
$276 |
2.5× |
| Hand 2 views (73120) |
$164.25 |
$219 |
1.6× |
| Hand 3 views (73130) |
$211.50 |
$282 |
2.5× |
| Humerus Min 2 Views Left (73060) |
$207 |
$276 |
2.5× |
| Knee 3 views (73562) |
$244.50 |
$326 |
2.9× |
| Neck soft tissue (70360) |
$135 |
$180 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$451.50 |
$602 |
4.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$256.50 |
$342 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$485.25 |
$647 |
4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$130.50 |
$174 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$181.50 |
$242 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$295.50 |
$394 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$227.25 |
$303 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$151.50 |
$202 |
1.8× |
| Ribs bilateral 3 views (71110) |
$278.25 |
$371 |
2.8× |
| Scapula complete (73010) |
$135 |
$180 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$421.50 |
$562 |
4.2× |
| Us abdl aorta screen aaa (76706) |
$464.25 |
$619 |
4.6× |
| Us chest (76604) |
$421.50 |
$562 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$506.25 |
$675 |
5.0× |
| Us pelvic non ob complete (76856) |
$548.25 |
$731 |
5.5× |
| Us retroperitoneal complete (76770) |
$548.25 |
$731 |
5.5× |
| Us scrotum and contents (76870) |
$336.75 |
$449 |
3.3× |
| Us soft tissue head/neck (76536) |
$548.25 |
$731 |
5.5× |
| Wrist 2 views (73100) |
$198 |
$264 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$215.25 |
$287 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$176.25 |
$235 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$223.50 |
$298 |
2.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$485.25 |
$647 |
4.8× |
| X-ray exam hip uni 1 view (73501) |
$156.75 |
$209 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$156.75 |
$209 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$256.50 |
$342 |
2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$485.25 |
$647 |
4.8× |
| X-ray exam of femur 1 (73551) |
$151.50 |
$202 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$219.75 |
$293 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$223.50 |
$298 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$227.25 |
$303 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$127.50 |
$170 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$244.50 |
$326 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$135 |
$180 |
1.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$136.50 |
$182 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$111 |
$148 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$223.50 |
$298 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$194.25 |
$259 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$227.25 |
$303 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$130.50 |
$174 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$162.75 |
$217 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$111 |
$148 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$252.75 |
$337 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$104.25 |
$139 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$287.25 |
$383 |
2.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$168.75 |
$225 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$201.75 |
$269 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$189.75 |
$253 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$405 |
$540 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$219.75 |
$293 |
2.6× |
| Xr tmj bilateral (70330) |
$162.75 |
$217 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$207 |
$276 |
2.5× |