| Abdomen 2 views (74019) |
$214 |
$214 |
2.2× |
| Ankle 2 views (73600) |
$178.50 |
$178.50 |
2.2× |
| Bone survey complete (77075) |
$846 |
$846 |
8.8× |
| Cervical spine 2 or 3 views (72040) |
$268 |
$268 |
3.3× |
| Chest 1 view (71045) |
$207 |
$207 |
2.6× |
| Chest 3 views (71047) |
$220 |
$220 |
2.7× |
| Clavicle complete (73000) |
$198.90 |
$198.90 |
2.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$120 |
$120 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$795 |
$795 |
2.5× |
| CT abdomen and pelvis without contrast (74176) |
$766 |
$766 |
3.5× |
| CT abdomen w contrast (74160) |
$775 |
$775 |
4.8× |
| CT abdomen w wo contrast (74170) |
$795 |
$795 |
4.9× |
| CT abdomen w/o contrast (74150) |
$766 |
$766 |
8.0× |
| CT c-spine w/o contrast (72125) |
$766 |
$766 |
8.0× |
| CT chest w/wo contrast (71270) |
$795 |
$795 |
4.9× |
| CT chest with contrast (71260) |
$775 |
$775 |
4.8× |
| CT head/brain with contrast (70460) |
$775 |
$775 |
4.8× |
| CT head/brain without and with contrast (70470) |
$795 |
$795 |
4.9× |
| CT lower ext w/o (73700) |
$781.32 |
$781.32 |
8.1× |
| CT lower extremity w wo contrast (73702) |
$810.90 |
$810.90 |
5.0× |
| CT lower extremity with contrast (73701) |
$790.50 |
$790.50 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$766 |
$766 |
8.0× |
| CT lumbar spine with contrast (72132) |
$775 |
$775 |
2.4× |
| CT maxillofacial w contrast (70487) |
$754.90 |
$754.90 |
4.7× |
| CT maxillofacial w/o contrast (70486) |
$766 |
$766 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$795 |
$795 |
4.9× |
| CT neck soft tissue w contrast (70491) |
$775 |
$775 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$795 |
$795 |
4.9× |
| CT orbits w/o contrast (70480) |
$766 |
$766 |
8.0× |
| CT pelvis w & w/o contrast (72194) |
$795 |
$795 |
4.9× |
| CT pelvis w/o contrast (72192) |
$766 |
$766 |
8.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$795 |
$795 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$766 |
$766 |
8.0× |
| CT thoracic spine w/o contrast (72128) |
$766 |
$766 |
8.0× |
| CT thorax w/o contrast (71250) |
$766 |
$766 |
8.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$810.90 |
$810.90 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$781.32 |
$781.32 |
8.1× |
| CT upper extremity with contrast (73201) |
$790.50 |
$790.50 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,092 |
$2,092 |
13.0× |
| Cta Abdomen (74175) |
$1,990 |
$1,990 |
12.3× |
| CTA abdomen pelvis (74174) |
$2,025 |
$2,025 |
6.3× |
| CTA chest (71275) |
$1,600 |
$1,600 |
9.9× |
| Cta Head (70496) |
$1,600 |
$1,600 |
9.9× |
| Cta Neck (70498) |
$1,600 |
$1,600 |
9.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$332 |
$332 |
3.5× |
| Esophagus (74220) |
$453 |
$453 |
2.8× |
| Foot 2 views (73620) |
$162.18 |
$162.18 |
2.0× |
| Forearm 2 views (73090) |
$213.18 |
$213.18 |
2.7× |
| Hand 2 views (73120) |
$178.50 |
$178.50 |
1.9× |
| Hand 3 views (73130) |
$233.58 |
$233.58 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$234.60 |
$234.60 |
2.9× |
| Knee 3 views (73562) |
$259.08 |
$259.08 |
3.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$995 |
$995 |
3.1× |
| MRI abdomen w/o contrast (74181) |
$950 |
$950 |
4.3× |
| MRI cervical spine w/o contrast (72141) |
$950 |
$950 |
4.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$969 |
$969 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$950 |
$950 |
4.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$995 |
$995 |
3.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$995 |
$995 |
3.1× |
| MRI pelvis w/o contrast (72195) |
$950 |
$950 |
4.3× |
| MRI scan of arm joint before and after contrast (73223) |
$995 |
$995 |
3.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,014.90 |
$1,014.90 |
3.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$995 |
$995 |
3.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$975 |
$975 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$995 |
$995 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$995 |
$995 |
3.1× |
| MRI thoracic spine w/o contrast (72146) |
$950 |
$950 |
4.3× |
| MRI upper ext joint w/o contrast (73221) |
$950 |
$950 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$625 |
$625 |
1.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$969 |
$969 |
4.4× |
| Neck soft tissue (70360) |
$217 |
$217 |
2.7× |
| Osseous survey limited (77074) |
$240 |
$240 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$218 |
$218 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,014.90 |
$1,014.90 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$125 |
$125 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$195 |
$195 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$180 |
$180 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$353 |
$353 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$226 |
$226 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$210 |
$210 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$1,685 |
$1,685 |
10.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$714 |
$714 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$170 |
$170 |
2.1× |
| Ribs bilateral 3 views (71110) |
$226 |
$226 |
2.4× |
| Scapula complete (73010) |
$196 |
$196 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$135.20 |
$135.20 |
5.8× |
| Spine thoracic 3 views (72072) |
$338 |
$338 |
3.5× |
| Thoracolumbar 2 views (72080) |
$322 |
$322 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$197 |
$197 |
2.0× |
| Upper Extremity Infant (73092) |
$176.46 |
$176.46 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$806 |
$806 |
5.0× |
| Us abdl aorta screen aaa (76706) |
$250 |
$250 |
2.6× |
| Us breast unilateral complete (76641) |
$159 |
$159 |
1.7× |
| Us breast unilateral limited (76642) |
$162.18 |
$162.18 |
2.0× |
| Us chest (76604) |
$186 |
$186 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$197 |
$197 |
2.0× |
| Us ob transvaginal (76817) |
$165 |
$165 |
1.7× |
| Us pelvic non ob complete (76856) |
$207 |
$207 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$173 |
$173 |
1.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$191 |
$191 |
2.0× |
| Us retroperitoneal complete (76770) |
$254 |
$254 |
2.6× |
| Us retroperitoneal limited (76775) |
$197 |
$197 |
2.0× |
| Us scrotum and contents (76870) |
$206 |
$206 |
2.1× |
| Us soft tissue head/neck (76536) |
$805 |
$805 |
8.4× |
| Us transrectal (76872) |
$178 |
$178 |
1.9× |
| Us xtr non-vasc lmtd (76882) |
$197 |
$197 |
2.0× |
| Wrist 2 views (73100) |
$175.44 |
$175.44 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$442 |
$442 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$384 |
$384 |
4.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$238.68 |
$238.68 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$193.80 |
$193.80 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$258.06 |
$258.06 |
3.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$150 |
$150 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$175 |
$175 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$252.50 |
$252.50 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$195 |
$195 |
2.0× |
| X-ray exam of femur 1 (73551) |
$110 |
$110 |
1.4× |
| X-ray eye for foreign body (70030) |
$109.62 |
$109.62 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$317 |
$317 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$300 |
$300 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$230.52 |
$230.52 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$195.84 |
$195.84 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$369.24 |
$369.24 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$184 |
$184 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$236.64 |
$236.64 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$293 |
$293 |
3.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$391 |
$391 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$248 |
$248 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$227 |
$227 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$224 |
$224 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$243 |
$243 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$240 |
$240 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$205.02 |
$205.02 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$325 |
$325 |
4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$352 |
$352 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$239 |
$239 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$287 |
$287 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$243 |
$243 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$224 |
$224 |
2.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$181 |
$181 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$244.80 |
$244.80 |
3.1× |
| Xr c-spine 6 or more views (72052) |
$454 |
$454 |
4.7× |
| Xr finger(s) 2+ views (73140) |
$154 |
$154 |
1.9× |
| Xr shoulder 1 view (73020) |
$181.56 |
$181.56 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$386 |
$386 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$242.76 |
$242.76 |
3.0× |
| Xr tmj bilateral (70330) |
$305 |
$305 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$183.60 |
$183.60 |
2.3× |