| Bone age studies (77072) |
$163.80 |
$182 |
1.7× |
| Bone survey complete (77075) |
$593.10 |
$659 |
6.2× |
| Cervical spine 2 or 3 views (72040) |
$187.20 |
$208 |
2.3× |
| Clavicle complete (73000) |
$142.20 |
$158 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$783 |
$870 |
2.4× |
| CT abdomen and pelvis without contrast (74176) |
$688.50 |
$765 |
3.1× |
| CT abdomen w wo contrast (74170) |
$783 |
$870 |
4.9× |
| CT abdomen w/o contrast (74150) |
$688.50 |
$765 |
7.2× |
| CT angio hrt w/3d image (75574) |
$661.50 |
$735 |
2.1× |
| CT c-spine w/o contrast (72125) |
$688.50 |
$765 |
7.2× |
| CT cervical spine w&w/o contrast (72127) |
$783 |
$870 |
4.9× |
| CT cervical spine with contrast (72126) |
$733.50 |
$815 |
2.3× |
| CT chest w/wo contrast (71270) |
$783 |
$870 |
4.9× |
| CT chest with contrast (71260) |
$733.50 |
$815 |
4.5× |
| CT head/brain with contrast (70460) |
$733.50 |
$815 |
4.5× |
| CT head/brain without and with contrast (70470) |
$783 |
$870 |
4.9× |
| CT iac w contrast (70481) |
$733.50 |
$815 |
4.5× |
| CT lower ext w/o (73700) |
$688.50 |
$765 |
7.2× |
| CT lower extremity with contrast (73701) |
$733.50 |
$815 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$688.50 |
$765 |
7.2× |
| CT maxillofacial w contrast (70487) |
$733.50 |
$815 |
4.5× |
| CT maxillofacial w/o contrast (70486) |
$688.50 |
$765 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$733.50 |
$815 |
4.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$783 |
$870 |
4.9× |
| CT orbits w/o contrast (70480) |
$688.50 |
$765 |
7.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$783 |
$870 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$688.50 |
$765 |
7.2× |
| CT thoracic spine w/contrast (72129) |
$733.50 |
$815 |
4.5× |
| CT thoracic spine w/o contrast (72128) |
$688.50 |
$765 |
7.2× |
| CT thorax w/o contrast (71250) |
$688.50 |
$765 |
7.2× |
| CT upper extremity w/o contrast rt (73200) |
$688.50 |
$765 |
7.2× |
| CT upper extremity with contrast (73201) |
$733.50 |
$815 |
2.3× |
| CTA abdomen pelvis (74174) |
$2,034 |
$2,260 |
6.3× |
| CTA chest (71275) |
$1,417.50 |
$1,575 |
8.8× |
| Cta Pelvis (72191) |
$688.50 |
$765 |
4.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$283.50 |
$315 |
2.9× |
| Forearm 2 views (73090) |
$145.80 |
$162 |
1.8× |
| Hand 3 views (73130) |
$165.60 |
$184 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$165.60 |
$184 |
2.1× |
| Knee 3 views (73562) |
$175.50 |
$195 |
2.2× |
| MRA head w & w/o contrast (70546) |
$972 |
$1,080 |
3.0× |
| MRA head w/o contrast (70544) |
$972 |
$1,080 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$972 |
$1,080 |
3.0× |
| MRA neck w/o contrast (70547) |
$972 |
$1,080 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$733.50 |
$815 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$733.50 |
$815 |
3.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$733.50 |
$815 |
3.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$922.50 |
$1,025 |
2.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$922.50 |
$1,025 |
2.9× |
| MRI pelvis w/o contrast (72195) |
$733.50 |
$815 |
3.3× |
| MRI scan of arm joint before and after contrast (73223) |
$922.50 |
$1,025 |
2.9× |
| MRI scan of leg joint before and after contrast (73723) |
$922.50 |
$1,025 |
2.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$922.50 |
$1,025 |
2.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$922.50 |
$1,025 |
2.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$922.50 |
$1,025 |
2.9× |
| MRI thoracic spine w/o contrast (72146) |
$733.50 |
$815 |
3.3× |
| MRI tmj (70336) |
$733.50 |
$815 |
3.3× |
| MRI upper ext joint w/o contrast (73221) |
$733.50 |
$815 |
3.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$900 |
$1,000 |
2.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$733.50 |
$815 |
3.3× |
| Neck soft tissue (70360) |
$151.20 |
$168 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$148.50 |
$165 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$922.50 |
$1,025 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$335.70 |
$373 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$165.60 |
$184 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$247.50 |
$275 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$158.40 |
$176 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$148.50 |
$165 |
1.9× |
| Scapula complete (73010) |
$142.20 |
$158 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$213.30 |
$237 |
9.1× |
| Spine thoracic 3 views (72072) |
$236.70 |
$263 |
2.5× |
| Tmj unilateral (70328) |
$227.70 |
$253 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$153 |
$170 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$144 |
$160 |
1.5× |
| Us breast unilateral complete (76641) |
$121.50 |
$135 |
1.3× |
| Us chest (76604) |
$144 |
$160 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$144 |
$160 |
1.5× |
| Us pelvic non ob complete (76856) |
$189 |
$210 |
2.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$144 |
$160 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$94.50 |
$105 |
1.0× |
| Us retroperitoneal complete (76770) |
$189 |
$210 |
2.0× |
| Us retroperitoneal limited (76775) |
$153 |
$170 |
1.6× |
| Us scrotum and contents (76870) |
$162 |
$180 |
1.7× |
| Us soft tissue head/neck (76536) |
$562.50 |
$625 |
5.9× |
| Us transrectal (76872) |
$144 |
$160 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$144 |
$160 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$308.70 |
$343 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$171.90 |
$191 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$165.60 |
$184 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$177.30 |
$197 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$148.50 |
$165 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$189.45 |
$210.50 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$222.30 |
$247 |
2.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$165.60 |
$184 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$142.20 |
$158 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$253.80 |
$282 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$142.20 |
$158 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$205.20 |
$228 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$350.10 |
$389 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$172.80 |
$192 |
2.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$318.60 |
$354 |
4.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$213.30 |
$237 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$156.60 |
$174 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$234 |
$260 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$287.10 |
$319 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$170.10 |
$189 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$167.40 |
$186 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$165.60 |
$184 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$227.70 |
$253 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$247.50 |
$275 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$167.40 |
$186 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$170.10 |
$189 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$170.10 |
$189 |
2.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$198 |
$220 |
2.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$142.20 |
$158 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$167.40 |
$186 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$317.70 |
$353 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$142.20 |
$158 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$270 |
$300 |
2.8× |
| Xr tibia/fibula 2 views (73590) |
$166.50 |
$185 |
2.1× |
| Xr tmj bilateral (70330) |
$236.70 |
$263 |
3.0× |