| Abdomen 2 views (74019) |
$197 |
$394 |
1.9× |
| Ankle 2 views (73600) |
$136 |
$272 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$177.50 |
$355 |
2.0× |
| Chest 1 view (71045) |
$134 |
$268 |
1.5× |
| Clavicle complete (73000) |
$161.50 |
$323 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$457.50 |
$915 |
4.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,303 |
$4,606 |
6.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,363.50 |
$2,727 |
5.7× |
| CT abdomen w contrast (74160) |
$1,528 |
$3,056 |
8.7× |
| CT abdomen w wo contrast (74170) |
$1,511 |
$3,022 |
8.6× |
| CT abdomen w/o contrast (74150) |
$929 |
$1,858 |
8.8× |
| CT angiography upper extremity lt (73206) |
$2,593.25 |
$5,186.50 |
14.7× |
| CT c-spine w/o contrast (72125) |
$958.50 |
$1,917 |
9.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,996 |
$3,992 |
11.3× |
| CT cervical spine with contrast (72126) |
$1,608.50 |
$3,217 |
4.6× |
| CT chest w/wo contrast (71270) |
$1,378 |
$2,756 |
7.8× |
| CT chest with contrast (71260) |
$1,189.50 |
$2,379 |
6.8× |
| CT head/brain with contrast (70460) |
$1,074 |
$2,148 |
6.1× |
| CT head/brain without and with contrast (70470) |
$1,208 |
$2,416 |
6.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,417.50 |
$2,835 |
16.2× |
| CT lower ext w/o (73700) |
$1,161.25 |
$2,322.50 |
11.1× |
| CT lower extremity w wo contrast (73702) |
$2,269.50 |
$4,539 |
12.9× |
| CT lower extremity with contrast (73701) |
$1,807 |
$3,614 |
10.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,622.50 |
$3,245 |
9.2× |
| CT lumbar spine w/o contrast (72131) |
$958.50 |
$1,917 |
9.1× |
| CT lumbar spine with contrast (72132) |
$1,490 |
$2,980 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,160.50 |
$2,321 |
6.6× |
| CT maxillofacial w/o contrast (70486) |
$761.50 |
$1,523 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,421.50 |
$2,843 |
8.1× |
| CT neck soft tissue w contrast (70491) |
$1,062.50 |
$2,125 |
6.0× |
| CT pelvis w & w/o contrast (72194) |
$1,722.50 |
$3,445 |
9.8× |
| CT pelvis w/o contrast (72192) |
$973 |
$1,946 |
9.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,367 |
$2,734 |
7.8× |
| CT soft tissue neck w/o contrast (70490) |
$815.50 |
$1,631 |
7.8× |
| CT thoracic spine w/contrast (72129) |
$1,673 |
$3,346 |
9.5× |
| CT thoracic spine w/o contrast (72128) |
$958.50 |
$1,917 |
9.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,975 |
$3,950 |
11.2× |
| CT thorax w/o contrast (71250) |
$979.50 |
$1,959 |
9.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,801.25 |
$3,602.50 |
10.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,175.75 |
$2,351.50 |
11.2× |
| CT upper extremity with contrast (73201) |
$1,569.25 |
$3,138.50 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,532.50 |
$5,065 |
14.4× |
| CTA chest (71275) |
$1,307.50 |
$2,615 |
7.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$325.50 |
$651 |
3.1× |
| Esophagus (74220) |
$315 |
$630 |
1.8× |
| Foot 2 views (73620) |
$150.50 |
$301 |
1.7× |
| Forearm 2 views (73090) |
$164 |
$328 |
1.9× |
| Hand 3 views (73130) |
$169 |
$338 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$167 |
$334 |
1.9× |
| Knee 3 views (73562) |
$224.50 |
$449 |
2.6× |
| MRA head w/o contrast (70544) |
$1,350.50 |
$2,701 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,695.50 |
$3,391 |
4.8× |
| MRI abdomen w contrast (74182) |
$1,726 |
$3,452 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,934.50 |
$3,869 |
5.5× |
| MRI abdomen w/o contrast (74181) |
$1,588 |
$3,176 |
6.6× |
| MRI c-spine with contrast (72142) |
$1,775 |
$3,550 |
5.1× |
| MRI cervical spine w/o contrast (72141) |
$1,401 |
$2,802 |
5.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,530 |
$5,060 |
7.2× |
| MRI chest w/o contrast (71550) |
$1,445 |
$2,890 |
6.0× |
| MRI chest with contrast (71551) |
$1,737.50 |
$3,475 |
2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,537 |
$3,074 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,515 |
$3,030 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,500 |
$3,000 |
4.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,000.50 |
$4,001 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,220 |
$2,440 |
5.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,934 |
$3,868 |
5.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,820 |
$3,640 |
5.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,175.50 |
$4,351 |
6.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,535.50 |
$3,071 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,111 |
$4,222 |
6.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,430 |
$2,860 |
4.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,428 |
$4,856 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,231.50 |
$2,463 |
5.1× |
| MRI tmj (70336) |
$1,114.50 |
$2,229 |
4.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,355.50 |
$2,711 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,764.50 |
$3,529 |
5.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,466 |
$2,932 |
6.1× |
| Neck soft tissue (70360) |
$160 |
$320 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$152 |
$304 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,925 |
$3,850 |
5.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$225.50 |
$451 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$218 |
$436 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$306 |
$612 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$152.50 |
$305 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$153 |
$306 |
1.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$134.50 |
$269 |
1.5× |
| Scapula complete (73010) |
$161.50 |
$323 |
1.5× |
| Spine thoracic 3 views (72072) |
$272 |
$544 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$388 |
$776 |
3.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$486.50 |
$973 |
2.8× |
| Us breast unilateral complete (76641) |
$436.25 |
$872.50 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$352.50 |
$705 |
3.4× |
| Us ob transvaginal (76817) |
$317 |
$634 |
3.0× |
| Us pelvic non ob complete (76856) |
$461 |
$922 |
4.4× |
| Us pregnancy ltd (76815) |
$270 |
$540 |
2.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$633.50 |
$1,267 |
6.0× |
| Us retroperitoneal complete (76770) |
$439 |
$878 |
4.2× |
| Us retroperitoneal limited (76775) |
$351 |
$702 |
3.3× |
| Us scrotum and contents (76870) |
$416 |
$832 |
4.0× |
| Us soft tissue head/neck (76536) |
$330.50 |
$661 |
3.1× |
| Venography extremity unilateral rs&i (75820) |
$800 |
$1,600 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$71.50 |
$143 |
0.8× |
| Wrist 2 views (73100) |
$158 |
$316 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$249 |
$498 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$160 |
$320 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$178 |
$356 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$161.50 |
$323 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$193 |
$386 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$121.50 |
$243 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$135.50 |
$271 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$183.50 |
$367 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$165.50 |
$331 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$169 |
$338 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$158 |
$316 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$259.50 |
$519 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$189.50 |
$379 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$379 |
$758 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$135.50 |
$271 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$200 |
$400 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$196 |
$392 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$233.50 |
$467 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$347 |
$694 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$166.50 |
$333 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$168 |
$336 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$162 |
$324 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$282.50 |
$565 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$158.50 |
$317 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$150 |
$300 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$200 |
$400 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$146.50 |
$293 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$167 |
$334 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$288 |
$576 |
2.7× |
| Xr chest 4+ views (71048) |
$192.50 |
$385 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$144 |
$288 |
1.6× |
| Xr shoulder 1 view (73020) |
$157.50 |
$315 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$158 |
$316 |
1.8× |
| Xr tmj bilateral (70330) |
$162 |
$324 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$150 |
$300 |
1.7× |