| Abdomen 2 views (74019) |
$250.80 |
$456 |
2.3× |
| Ankle 2 views (73600) |
$161.15 |
$293 |
1.8× |
| Bone age studies (77072) |
$161.15 |
$293 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$199.10 |
$362 |
2.2× |
| Chest 1 view (71045) |
$161.15 |
$293 |
1.8× |
| Clavicle complete (73000) |
$161.15 |
$293 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,387 |
$4,340 |
6.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,758.35 |
$3,197 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,249.60 |
$2,272 |
6.8× |
| CT abdomen w/o contrast (74150) |
$618.75 |
$1,125 |
5.6× |
| CT angiography upper extremity lt (73206) |
$2,230.80 |
$4,056 |
12.1× |
| CT c-spine w/o contrast (72125) |
$818.95 |
$1,489 |
7.4× |
| CT chest w/wo contrast (71270) |
$1,255.65 |
$2,283 |
6.8× |
| CT chest with contrast (71260) |
$1,197.90 |
$2,178 |
6.5× |
| CT head/brain with contrast (70460) |
$1,333.75 |
$2,425 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,249.60 |
$2,272 |
6.8× |
| CT iac w contrast (70481) |
$1,147.30 |
$2,086 |
6.2× |
| CT lower ext w/o (73700) |
$665.50 |
$1,210 |
6.0× |
| CT lower extremity w wo contrast (73702) |
$1,221 |
$2,220 |
6.6× |
| CT lower extremity with contrast (73701) |
$944.90 |
$1,718 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$818.95 |
$1,489 |
7.4× |
| CT lumbar spine with contrast (72132) |
$1,073.60 |
$1,952 |
2.9× |
| CT maxillofacial w contrast (70487) |
$1,112.10 |
$2,022 |
6.0× |
| CT maxillofacial w/o contrast (70486) |
$810.15 |
$1,473 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,169.85 |
$2,127 |
6.3× |
| CT neck soft tissue w contrast (70491) |
$917.95 |
$1,669 |
5.0× |
| CT orbits w/o contrast (70480) |
$730.95 |
$1,329 |
6.6× |
| CT pelvis w & w/o contrast (72194) |
$1,249.60 |
$2,272 |
6.8× |
| CT pelvis w/o contrast (72192) |
$730.95 |
$1,329 |
6.6× |
| CT soft tissue neck w/o contrast (70490) |
$618.75 |
$1,125 |
5.6× |
| CT thoracic spine w/contrast (72129) |
$871.20 |
$1,584 |
4.7× |
| CT thoracic spine w/o contrast (72128) |
$647.90 |
$1,178 |
5.9× |
| CT thorax w/o contrast (71250) |
$772.75 |
$1,405 |
7.0× |
| CT upper extremity w/o contrast rt (73200) |
$693 |
$1,260 |
6.3× |
| CT upper extremity with contrast (73201) |
$983.95 |
$1,789 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,728.65 |
$3,143 |
9.3× |
| Cta Abdomen (74175) |
$2,230.80 |
$4,056 |
12.1× |
| CTA abdomen pelvis (74174) |
$2,230.80 |
$4,056 |
6.1× |
| CTA chest (71275) |
$2,341.90 |
$4,258 |
12.7× |
| Cta Head (70496) |
$2,339.70 |
$4,254 |
12.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,230.80 |
$4,056 |
12.1× |
| Cta Neck (70498) |
$2,341.90 |
$4,258 |
12.7× |
| Cta Pelvis (72191) |
$1,045 |
$1,900 |
5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$300.30 |
$546 |
2.7× |
| Foot 2 views (73620) |
$161.15 |
$293 |
1.8× |
| Forearm 2 views (73090) |
$161.15 |
$293 |
1.8× |
| Hand 2 views (73120) |
$161.15 |
$293 |
1.5× |
| Hand 3 views (73130) |
$201.85 |
$367 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$161.15 |
$293 |
1.8× |
| Knee 3 views (73562) |
$193.05 |
$351 |
2.1× |
| Neck soft tissue (70360) |
$161.15 |
$293 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$201.85 |
$367 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$435.05 |
$791 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$469.15 |
$853 |
4.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$199.65 |
$363 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$336.60 |
$612 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$184.80 |
$336 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$161.15 |
$293 |
1.8× |
| Spine thoracic 3 views (72072) |
$161.15 |
$293 |
1.5× |
| Thoracolumbar 2 views (72080) |
$161.15 |
$293 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$233.20 |
$424 |
2.1× |
| Umbilical-artery Doppler (OB) (76820) |
$202.40 |
$368 |
1.8× |
| Us ob transvaginal (76817) |
$202.40 |
$368 |
1.8× |
| Us pelvic non ob complete (76856) |
$315.70 |
$574 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$109.45 |
$199 |
1.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$253 |
$460 |
2.3× |
| Us retroperitoneal complete (76770) |
$272.25 |
$495 |
2.5× |
| Us scrotum and contents (76870) |
$217.80 |
$396 |
2.0× |
| Us soft tissue head/neck (76536) |
$251.35 |
$457 |
2.3× |
| Us xtr non-vasc lmtd (76882) |
$198 |
$360 |
1.8× |
| Wrist 2 views (73100) |
$201.85 |
$367 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$336.60 |
$612 |
3.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$201.85 |
$367 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$161.15 |
$293 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$201.85 |
$367 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$312.95 |
$569 |
3.4× |
| X-ray exam of femur 1 (73551) |
$141.35 |
$257 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$161.15 |
$293 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$196.35 |
$357 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$161.15 |
$293 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$201.85 |
$367 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$201.85 |
$367 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$269.50 |
$490 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$161.15 |
$293 |
1.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$242 |
$440 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$240.90 |
$438 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$254.10 |
$462 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$161.15 |
$293 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$161.15 |
$293 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$226.05 |
$411 |
2.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$161.15 |
$293 |
1.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$161.15 |
$293 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$161.15 |
$293 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$161.15 |
$293 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$215.60 |
$392 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$394.35 |
$717 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$161.15 |
$293 |
1.8× |
| Xr shoulder 1 view (73020) |
$161.15 |
$293 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$336.60 |
$612 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$201.85 |
$367 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$201.85 |
$367 |
2.2× |