| Abdomen 2 views (74019) |
$270.75 |
$361 |
3.0× |
| Ankle 2 views (73600) |
$351.75 |
$469 |
4.6× |
| Bone age studies (77072) |
$368.25 |
$491 |
4.0× |
| Bone survey complete (77075) |
$390.75 |
$521 |
4.3× |
| Cervical spine 2 or 3 views (72040) |
$507.75 |
$677 |
6.7× |
| Chest 1 view (71045) |
$178.50 |
$238 |
2.3× |
| Clavicle complete (73000) |
$208.50 |
$278 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,065 |
$9,420 |
23.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,152.75 |
$5,537 |
19.9× |
| CT abdomen w contrast (74160) |
$3,319.50 |
$4,426 |
21.6× |
| CT abdomen w wo contrast (74170) |
$3,749.25 |
$4,999 |
24.4× |
| CT abdomen w/o contrast (74150) |
$1,005.75 |
$1,341 |
11.0× |
| CT c-spine w/o contrast (72125) |
$525.75 |
$701 |
5.7× |
| CT cervical spine with contrast (72126) |
$2,286 |
$3,048 |
7.5× |
| CT chest w/wo contrast (71270) |
$2,073.75 |
$2,765 |
13.5× |
| CT chest with contrast (71260) |
$1,848 |
$2,464 |
12.0× |
| CT head/brain without and with contrast (70470) |
$2,816.25 |
$3,755 |
18.3× |
| CT iac w contrast (70481) |
$1,570.50 |
$2,094 |
10.2× |
| CT limited/localized follow up study (76380) |
$693.75 |
$925 |
9.1× |
| CT lower ext w/o (73700) |
$1,022.25 |
$1,363 |
11.2× |
| CT lower extremity w wo contrast (73702) |
$1,321.50 |
$1,762 |
8.6× |
| CT lower extremity with contrast (73701) |
$401.25 |
$535 |
2.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,974.75 |
$2,633 |
12.8× |
| CT lumbar spine w/o contrast (72131) |
$506.25 |
$675 |
5.5× |
| CT lumbar spine with contrast (72132) |
$1,867.50 |
$2,490 |
6.1× |
| CT maxillofacial w contrast (70487) |
$1,845.75 |
$2,461 |
12.0× |
| CT maxillofacial w/o contrast (70486) |
$996 |
$1,328 |
10.9× |
| CT neck soft tissue w contrast (70491) |
$1,712.25 |
$2,283 |
11.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,157.25 |
$1,543 |
7.5× |
| CT orbits w/o contrast (70480) |
$1,232.25 |
$1,643 |
13.4× |
| CT pelvis w & w/o contrast (72194) |
$2,574.75 |
$3,433 |
16.8× |
| CT pelvis w/o contrast (72192) |
$597 |
$796 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,583.25 |
$2,111 |
17.3× |
| CT thoracic spine w/o contrast (72128) |
$610.50 |
$814 |
6.7× |
| CT thorax w/o contrast (71250) |
$429.75 |
$573 |
4.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,321.50 |
$1,762 |
8.6× |
| CT upper extremity w/o contrast rt (73200) |
$999.75 |
$1,333 |
10.9× |
| Cta Abdomen (74175) |
$2,299.50 |
$3,066 |
15.0× |
| CTA abdomen pelvis (74174) |
$606 |
$808 |
2.0× |
| CTA chest (71275) |
$4,387.50 |
$5,850 |
28.5× |
| Fetal biophysical profile non-stress testing (76818) |
$628.50 |
$838 |
6.9× |
| Foot 2 views (73620) |
$216 |
$288 |
2.8× |
| Forearm 2 views (73090) |
$240.75 |
$321 |
3.2× |
| Hand 2 views (73120) |
$351 |
$468 |
3.8× |
| Hand 3 views (73130) |
$374.25 |
$499 |
4.9× |
| Humerus Min 2 Views Left (73060) |
$162 |
$216 |
2.1× |
| Knee 3 views (73562) |
$275.25 |
$367 |
3.6× |
| Neck soft tissue (70360) |
$267 |
$356 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$81.75 |
$109 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$258 |
$344 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$402.75 |
$537 |
5.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$123 |
$164 |
1.6× |
| Radiological examination surgical specimen (76098) |
$837 |
$1,116 |
1.7× |
| Scapula complete (73010) |
$218.62 |
$291.50 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$846.75 |
$1,129 |
9.2× |
| Us compl joint r-t w/image documentation (76881) |
$494.25 |
$659 |
5.4× |
| Us ob transvaginal (76817) |
$831 |
$1,108 |
9.1× |
| Us pelvic non ob complete (76856) |
$973.50 |
$1,298 |
10.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$744 |
$992 |
8.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$853.50 |
$1,138 |
9.3× |
| Us retroperitoneal complete (76770) |
$516.75 |
$689 |
5.6× |
| Us scrotum and contents (76870) |
$976.50 |
$1,302 |
10.7× |
| Us soft tissue head/neck (76536) |
$970.50 |
$1,294 |
10.6× |
| Wrist 2 views (73100) |
$308.25 |
$411 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$532.50 |
$710 |
5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$242.25 |
$323 |
3.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$405 |
$540 |
5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$176.25 |
$235 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$405 |
$540 |
5.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$490.50 |
$654 |
5.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$507.75 |
$677 |
6.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$177 |
$236 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$229.88 |
$306.50 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$198 |
$264 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$288 |
$384 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$450 |
$600 |
4.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$366 |
$488 |
4.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$277.50 |
$370 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$103.50 |
$138 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$247.50 |
$330 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$320.25 |
$427 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$174 |
$232 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$404.25 |
$539 |
5.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$222 |
$296 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$326.25 |
$435 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$372.75 |
$497 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$210.75 |
$281 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$208.50 |
$278 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$372.75 |
$497 |
4.9× |
| Xr c-spine 6 or more views (72052) |
$732 |
$976 |
8.0× |
| Xr finger(s) 2+ views (73140) |
$302.25 |
$403 |
4.0× |
| Xr shoulder 1 view (73020) |
$104.25 |
$139 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$597 |
$796 |
6.5× |
| Xr tibia/fibula 2 views (73590) |
$194.25 |
$259 |
2.5× |
| Xr tmj bilateral (70330) |
$192 |
$256 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$197.25 |
$263 |
2.6× |