| Abdomen 2 views (74019) |
$356.68 |
$356.68 |
3.4× |
| Arthrogram hip (73525) |
$538.04 |
$538.04 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$274.73 |
$274.73 |
3.1× |
| Chest 1 view (71045) |
$254.32 |
$254.32 |
2.9× |
| Clavicle complete (73000) |
$125.66 |
$125.66 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$11,256.80 |
$11,256.80 |
32.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,110.65 |
$2,110.65 |
8.8× |
| CT abdomen w contrast (74160) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT abdomen w wo contrast (74170) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT abdomen w/o contrast (74150) |
$2,110.65 |
$2,110.65 |
20.1× |
| CT c-spine w/o contrast (72125) |
$2,060.40 |
$2,060.40 |
19.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT cervical spine with contrast (72126) |
$2,110.65 |
$2,110.65 |
6.0× |
| CT chest w/wo contrast (71270) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT chest with contrast (71260) |
$1,684.94 |
$1,684.94 |
9.6× |
| CT head/brain with contrast (70460) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT head/brain without and with contrast (70470) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT iac w contrast (70481) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT lower ext w/o (73700) |
$2,110.65 |
$2,110.65 |
20.1× |
| CT lower extremity w wo contrast (73702) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT lower extremity with contrast (73701) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT lumbar spine w & w/o contrast (72133) |
$2,532.80 |
$2,532.80 |
14.4× |
| CT lumbar spine w/o contrast (72131) |
$5,909.83 |
$5,909.83 |
56.3× |
| CT lumbar spine with contrast (72132) |
$1,688.53 |
$1,688.53 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT orbits w/o contrast (70480) |
$2,110.65 |
$2,110.65 |
20.1× |
| CT pelvis w & w/o contrast (72194) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT pelvis w/o contrast (72192) |
$2,110.65 |
$2,110.65 |
20.1× |
| CT thoracic spine w/contrast (72129) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT thoracic spine w/o contrast (72128) |
$2,110.65 |
$2,110.65 |
20.1× |
| CT thoracic spine w/wo contrast (72130) |
$2,060.40 |
$2,060.40 |
11.7× |
| CT thorax w/o contrast (71250) |
$1,726.04 |
$1,726.04 |
16.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,110.65 |
$2,110.65 |
12.0× |
| CT upper extremity w/o contrast rt (73200) |
$2,110.65 |
$2,110.65 |
20.1× |
| CT upper extremity with contrast (73201) |
$2,110.65 |
$2,110.65 |
6.0× |
| Diskogram cervical (72285) |
$2,204.61 |
$2,204.61 |
1.1× |
| Diskography lumbar (72295) |
$703.55 |
$703.55 |
0.4× |
| Esophagus (74220) |
$593.20 |
$593.20 |
3.4× |
| Forearm 2 views (73090) |
$399.59 |
$399.59 |
4.6× |
| Hand 2 views (73120) |
$275.58 |
$275.58 |
2.6× |
| Hand 3 views (73130) |
$392.69 |
$392.69 |
4.5× |
| Humerus Min 2 Views Left (73060) |
$124.02 |
$124.02 |
1.4× |
| Knee 3 views (73562) |
$385.79 |
$385.79 |
4.4× |
| MRI abdomen w contrast (74182) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI abdomen w/o contrast (74181) |
$2,779.41 |
$2,779.41 |
11.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,814.20 |
$2,814.20 |
3.6× |
| MRI c-spine with contrast (72142) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI cervical spine w/o contrast (72141) |
$2,814.20 |
$2,814.20 |
11.7× |
| MRI chest w/o & w/contrast material (71552) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI chest w/o contrast (71550) |
$2,814.20 |
$2,814.20 |
11.7× |
| MRI chest with contrast (71551) |
$2,814.20 |
$2,814.20 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,920.12 |
$2,920.12 |
8.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,909.83 |
$5,909.83 |
16.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,814.20 |
$2,814.20 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,814.20 |
$2,814.20 |
11.7× |
| Myelogram Lumbar (72265) |
$1,653.47 |
$1,653.47 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$240.70 |
$240.70 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$306.47 |
$306.47 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$281.43 |
$281.43 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$551.16 |
$551.16 |
5.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$275.58 |
$275.58 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$254.10 |
$254.10 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$302.19 |
$302.19 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$294 |
$294 |
3.4× |
| Ribs bilateral 3 views (71110) |
$440.92 |
$440.92 |
4.2× |
| Scapula complete (73010) |
$344.47 |
$344.47 |
3.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$311.40 |
$311.40 |
3.0× |
| Spine thoracic 3 views (72072) |
$275.58 |
$275.58 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$338.33 |
$338.33 |
3.2× |
| Unlisted fluoroscopic procedure (76496) |
$413.35 |
$413.35 |
4.7× |
| Us chest (76604) |
$338.33 |
$338.33 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$1,587.56 |
$1,587.56 |
15.1× |
| Us pelvic non ob complete (76856) |
$338.33 |
$338.33 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$338.33 |
$338.33 |
3.2× |
| Us scrotum and contents (76870) |
$224.58 |
$224.58 |
2.1× |
| Us soft tissue head/neck (76536) |
$360.91 |
$360.91 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$2,066.81 |
$2,066.81 |
19.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$385.79 |
$385.79 |
4.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$389.90 |
$389.90 |
4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$365.13 |
$365.13 |
4.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$551.16 |
$551.16 |
5.2× |
| X-ray exam hip uni 1 view (73501) |
$376.60 |
$376.60 |
4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$439.55 |
$439.55 |
5.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$385.79 |
$385.79 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$399.59 |
$399.59 |
4.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$303.14 |
$303.14 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$261.81 |
$261.81 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$382.34 |
$382.34 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$422.12 |
$422.12 |
4.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$551.16 |
$551.16 |
5.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$316.91 |
$316.91 |
3.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$440.92 |
$440.92 |
4.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$394 |
$394 |
4.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$201.76 |
$201.76 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$440.92 |
$440.92 |
5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$128.13 |
$128.13 |
1.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$234.24 |
$234.24 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$385.79 |
$385.79 |
3.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$274.73 |
$274.73 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$275.58 |
$275.58 |
3.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$389.90 |
$389.90 |
4.5× |
| Xr c-spine 6 or more views (72052) |
$227.82 |
$227.82 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$303.14 |
$303.14 |
3.5× |
| Xr shoulder 1 view (73020) |
$394 |
$394 |
4.5× |
| Xr spine cervical 4 or 5 views (72050) |
$221.84 |
$221.84 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$275.58 |
$275.58 |
3.2× |
| Xray knee 1 or 2 views rt (73560) |
$274.73 |
$274.73 |
3.1× |