| Abdomen 2 views (74019) |
$125.46 |
$306 |
1.2× |
| Ankle 2 views (73600) |
$94.30 |
$230 |
1.1× |
| Bone age studies (77072) |
$113.16 |
$276 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$97.99 |
$239 |
1.2× |
| Chest 1 view (71045) |
$76.26 |
$186 |
0.9× |
| Chest 3 views (71047) |
$77.08 |
$188 |
0.9× |
| Clavicle complete (73000) |
$57.81 |
$141 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,940.94 |
$4,734 |
5.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,138.57 |
$2,777 |
5.0× |
| CT abdomen w contrast (74160) |
$1,131.19 |
$2,759 |
6.7× |
| CT abdomen w wo contrast (74170) |
$1,705.19 |
$4,159 |
10.1× |
| CT abdomen w/o contrast (74150) |
$345.97 |
$843.82 |
3.4× |
| CT c-spine w/o contrast (72125) |
$810.98 |
$1,978 |
8.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,333.32 |
$3,252 |
7.9× |
| CT cervical spine with contrast (72126) |
$1,048.37 |
$2,557 |
3.1× |
| CT chest w/wo contrast (71270) |
$1,430.49 |
$3,489 |
8.5× |
| CT chest with contrast (71260) |
$964.73 |
$2,353 |
5.7× |
| CT head/brain with contrast (70460) |
$931.11 |
$2,271 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,243.53 |
$3,033 |
7.4× |
| CT lower ext w/o (73700) |
$375.56 |
$916 |
3.7× |
| CT lower extremity w wo contrast (73702) |
$698.64 |
$1,704 |
4.1× |
| CT lower extremity with contrast (73701) |
$582.20 |
$1,420 |
3.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,483.79 |
$3,619 |
8.8× |
| CT lumbar spine w/o contrast (72131) |
$965.96 |
$2,356 |
9.6× |
| CT lumbar spine with contrast (72132) |
$1,170.55 |
$2,855 |
3.5× |
| CT maxillofacial w contrast (70487) |
$603.52 |
$1,472 |
3.6× |
| CT maxillofacial w/o contrast (70486) |
$738.82 |
$1,802 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$732.67 |
$1,787 |
4.3× |
| CT neck soft tissue w contrast (70491) |
$1,368.58 |
$3,338 |
8.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,127.50 |
$2,750 |
6.7× |
| CT orbits w/o contrast (70480) |
$1,000.40 |
$2,440 |
9.9× |
| CT pelvis w & w/o contrast (72194) |
$718.73 |
$1,753 |
4.3× |
| CT pelvis w/o contrast (72192) |
$464.53 |
$1,133 |
4.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,648.61 |
$4,021 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,134.88 |
$2,768 |
11.3× |
| CT thoracic spine w/contrast (72129) |
$1,323.89 |
$3,229 |
7.8× |
| CT thoracic spine w/o contrast (72128) |
$779 |
$1,900 |
7.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,199.25 |
$2,925 |
7.1× |
| CT thorax w/o contrast (71250) |
$712.99 |
$1,739 |
7.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$698.64 |
$1,704 |
4.1× |
| CT upper extremity w/o contrast rt (73200) |
$465.76 |
$1,136 |
4.6× |
| CT upper extremity with contrast (73201) |
$582.20 |
$1,420 |
1.7× |
| CTA chest (71275) |
$1,275.72 |
$3,111.52 |
7.6× |
| Cta Head (70496) |
$1,279.59 |
$3,120.96 |
7.6× |
| Cta Neck (70498) |
$1,191.63 |
$2,906.42 |
7.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$184.50 |
$450 |
1.8× |
| Foot 2 views (73620) |
$113.16 |
$276 |
1.4× |
| Forearm 2 views (73090) |
$185.32 |
$452 |
2.2× |
| Hand 2 views (73120) |
$113.16 |
$276 |
1.1× |
| Hand 3 views (73130) |
$155.80 |
$380 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$175.89 |
$429 |
2.1× |
| Knee 3 views (73562) |
$189.66 |
$462.58 |
2.3× |
| MRA head w & w/o contrast (70546) |
$1,483.79 |
$3,619 |
4.4× |
| MRA head w/o contrast (70544) |
$1,088.96 |
$2,656 |
4.7× |
| MRA head with contrast (70545) |
$1,483.79 |
$3,619 |
4.4× |
| MRA neck w contrast (70548) |
$1,483.79 |
$3,619 |
4.4× |
| MRA neck w/o contrast (70547) |
$1,068.46 |
$2,606 |
4.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,450.17 |
$3,537 |
4.3× |
| MRI abdomen w/o contrast (74181) |
$882.73 |
$2,153 |
3.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,096.75 |
$2,675 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,169.73 |
$2,853 |
1.6× |
| MRI c-spine with contrast (72142) |
$882.73 |
$2,153 |
2.6× |
| MRI cervical spine w/o contrast (72141) |
$740.46 |
$1,806 |
3.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,375.14 |
$3,354 |
4.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,137.75 |
$2,775 |
3.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$882.73 |
$2,153 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$682.24 |
$1,664 |
3.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$535.87 |
$1,307 |
2.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,450.17 |
$3,537 |
4.3× |
| MRI orbit/face/neck w/contrast (70542) |
$882.73 |
$2,153 |
2.6× |
| MRI pelvis w contrast (72196) |
$1,096.75 |
$2,675 |
3.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,450.17 |
$3,537 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$882.73 |
$2,153 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,335.37 |
$3,257 |
4.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,450.17 |
$3,537 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,450.17 |
$3,537 |
4.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,450.17 |
$3,537 |
4.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,743.32 |
$4,252 |
5.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,450.17 |
$3,537 |
4.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,159.07 |
$2,827 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$773.67 |
$1,887 |
3.4× |
| MRI tmj (70336) |
$1,449.97 |
$3,536.50 |
6.3× |
| MRI upper ext joint w/o contrast (73221) |
$953.25 |
$2,325 |
4.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,374.73 |
$3,353 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$882.73 |
$2,153 |
3.8× |
| Neck soft tissue (70360) |
$99.63 |
$243 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$101.27 |
$247 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,450.17 |
$3,537 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$221.40 |
$540 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$99.63 |
$243 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$134.07 |
$327 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$79.54 |
$194 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$88.15 |
$215 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$127.92 |
$312 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$141.45 |
$345 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$113.16 |
$276 |
1.4× |
| Ribs bilateral 3 views (71110) |
$227.96 |
$556 |
2.3× |
| Scapula complete (73010) |
$129.56 |
$316 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$290.69 |
$709 |
2.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$352.60 |
$860 |
2.1× |
| Us breast unilateral complete (76641) |
$180.81 |
$441 |
1.8× |
| Us compl joint r-t w/image documentation (76881) |
$245.18 |
$598 |
2.4× |
| Us ob detailed single fetus (76811) |
$180.81 |
$441 |
0.8× |
| Us pelvic non ob complete (76856) |
$407.95 |
$995 |
4.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$138.99 |
$339 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$243.54 |
$594 |
2.4× |
| Us retroperitoneal complete (76770) |
$348.91 |
$851 |
3.5× |
| Us retroperitoneal limited (76775) |
$279.21 |
$681 |
2.8× |
| Us scrotum and contents (76870) |
$225.91 |
$551 |
2.2× |
| Us soft tissue head/neck (76536) |
$342.76 |
$836 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$164.82 |
$402 |
1.6× |
| Wrist 2 views (73100) |
$90.61 |
$221 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$131.20 |
$320 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$77.08 |
$188 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$116.03 |
$283 |
1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$90.61 |
$221 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$113.16 |
$276 |
1.4× |
| X-ray exam hip uni 1 view (73501) |
$113.98 |
$278 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$113.16 |
$276 |
1.4× |
| X-ray exam of femur 1 (73551) |
$64.78 |
$158 |
0.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$113.16 |
$276 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$90.61 |
$221 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$135.71 |
$331 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$113.16 |
$276 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$88.15 |
$215 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$131.20 |
$320 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$68.06 |
$166 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$160.72 |
$392 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$158.26 |
$386 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$89.38 |
$218 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$241.90 |
$590 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$190.65 |
$465 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$121.36 |
$296 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$271.42 |
$662 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$90.61 |
$221 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$131.61 |
$321 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$203.36 |
$496 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$221.40 |
$540 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$161.95 |
$395 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$158.26 |
$386 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$145.96 |
$356 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$90.61 |
$221 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$171.38 |
$418 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$90.61 |
$221 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$115.21 |
$281 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$286.59 |
$699 |
2.9× |
| Xr finger(s) 2+ views (73140) |
$109.88 |
$268 |
1.3× |
| Xr shoulder 1 view (73020) |
$79.13 |
$193 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$229.60 |
$560 |
2.3× |
| Xr tibia/fibula 2 views (73590) |
$174.25 |
$425 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$182.86 |
$446 |
2.2× |