| Cervical spine 2 or 3 views (72040) |
$93.69 |
$443 |
1.2× |
| Chest 1 view (71045) |
$93.69 |
$357 |
1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$112.55 |
$2,723 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$399.72 |
$1,183 |
1.3× |
| CT abdomen and pelvis without contrast (74176) |
$256.89 |
$3,121 |
1.2× |
| CT abdomen w contrast (74160) |
$190.74 |
$3,121 |
1.2× |
| CT abdomen w wo contrast (74170) |
$190.74 |
$3,121 |
1.2× |
| CT abdomen w/o contrast (74150) |
$117.32 |
$2,853 |
1.2× |
| CT c-spine w/o contrast (72125) |
$117.32 |
$2,157 |
1.2× |
| CT cervical spine with contrast (72126) |
$399.72 |
$2,228 |
1.3× |
| CT chest w/wo contrast (71270) |
$190.74 |
$1,594 |
1.2× |
| CT chest with contrast (71260) |
$190.74 |
$1,594 |
1.2× |
| CT head/brain without and with contrast (70470) |
$190.74 |
$1,803 |
1.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$93.69 |
$3,715 |
1.2× |
| CT lower ext w/o (73700) |
$117.32 |
$2,196 |
1.2× |
| CT lower extremity with contrast (73701) |
$190.74 |
$2,853 |
1.2× |
| CT lumbar spine w & w/o contrast (72133) |
$190.74 |
$1,963 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$117.32 |
$2,200 |
1.2× |
| CT lumbar spine with contrast (72132) |
$399.72 |
$2,404 |
1.3× |
| CT maxillofacial w/o contrast (70486) |
$117.32 |
$2,012 |
1.2× |
| CT neck soft tissue w contrast (70491) |
$190.74 |
$2,481 |
1.2× |
| CT pelvis w/o contrast (72192) |
$117.32 |
$2,112.50 |
1.2× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$93.69 |
$6,531 |
1.2× |
| CT soft tissue neck w/o contrast (70490) |
$117.32 |
$2,012 |
1.2× |
| CT thoracic spine w/contrast (72129) |
$190.74 |
$2,200 |
1.2× |
| CT thoracic spine w/o contrast (72128) |
$117.32 |
$2,071 |
1.2× |
| CT thorax w/o contrast (71250) |
$117.32 |
$2,291 |
1.2× |
| CT upper extremity w/o contrast rt (73200) |
$117.32 |
$2,078.50 |
1.2× |
| CTA chest (71275) |
$190.74 |
$2,539.50 |
1.2× |
| Cta Head (70496) |
$190.74 |
$2,197.50 |
1.2× |
| Cta Neck (70498) |
$190.74 |
$1,962 |
1.2× |
| Diskography lumbar (72295) |
$1,635.62 |
$9,224.97 |
0.9× |
| Hand 2 views (73120) |
$117.32 |
$325 |
1.2× |
| MRA head w & w/o contrast (70546) |
$399.72 |
$2,632 |
1.3× |
| MRA head w/o contrast (70544) |
$256.89 |
$2,119.50 |
1.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$399.72 |
$1,749 |
1.3× |
| MRA neck w/o contrast (70547) |
$256.89 |
$1,749 |
1.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$399.72 |
$2,723 |
1.3× |
| MRI abdomen w/o contrast (74181) |
$256.89 |
$2,723 |
1.2× |
| MRI c-spine with contrast (72142) |
$399.72 |
$1,749 |
1.3× |
| MRI cervical spine w/o contrast (72141) |
$256.89 |
$1,749 |
1.2× |
| MRI chest w/o & w/contrast material (71552) |
$399.72 |
$1,749 |
1.3× |
| MRI chest w/o contrast (71550) |
$256.89 |
$1,749 |
1.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$256.89 |
$2,012.51 |
1.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$256.89 |
$2,711 |
1.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$399.72 |
$2,758 |
1.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$399.72 |
$1,719 |
1.3× |
| MRI pelvis w/o contrast (72195) |
$256.89 |
$2,723 |
1.2× |
| MRI scan of arm joint before and after contrast (73223) |
$399.72 |
$1,718 |
1.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$399.72 |
$2,746 |
1.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$399.72 |
$2,723 |
1.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$399.72 |
$1,749 |
1.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$399.72 |
$2,746 |
1.3× |
| MRI thoracic spine w/o contrast (72146) |
$256.89 |
$2,189 |
1.2× |
| MRI upper ext joint w/o contrast (73221) |
$256.89 |
$1,720 |
1.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$399.72 |
$1,720 |
1.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$256.89 |
$1,800 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$117.32 |
$313 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$399.72 |
$2,216 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$117.32 |
$383 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$93.69 |
$360 |
1.2× |
| Sacroiliac Joints < 3 Views (72200) |
$117.32 |
$340 |
1.2× |
| Spine thoracic 3 views (72072) |
$117.32 |
$395 |
1.2× |
| Thoracolumbar 2 views (72080) |
$93.69 |
$430 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$93.69 |
$362.70 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$93.69 |
$325 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$93.69 |
$242.10 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$117.32 |
$314 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$117.32 |
$466.50 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$117.32 |
$555 |
1.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$117.32 |
$281 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$117.32 |
$368 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$117.32 |
$368 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$117.32 |
$340 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$93.69 |
$329 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$117.32 |
$273 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$117.32 |
$472 |
1.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$117.32 |
$430 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$117.32 |
$437 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$93.69 |
$304 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$93.69 |
$269 |
1.2× |