| Abdomen 2 views (74019) |
$150.60 |
$251 |
1.7× |
| Ankle 2 views (73600) |
$105 |
$175 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$156 |
$260 |
2.1× |
| Chest 1 view (71045) |
$126.60 |
$211 |
1.7× |
| Clavicle complete (73000) |
$99.60 |
$166 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$81 |
$135 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,938.60 |
$3,231 |
6.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,695 |
$2,825 |
8.2× |
| CT abdomen w contrast (74160) |
$970.20 |
$1,617 |
6.4× |
| CT abdomen w wo contrast (74170) |
$1,072.80 |
$1,788 |
7.1× |
| CT abdomen w/o contrast (74150) |
$799.20 |
$1,332 |
8.9× |
| CT c-spine w/o contrast (72125) |
$901.20 |
$1,502 |
10.0× |
| CT chest w/wo contrast (71270) |
$1,065.60 |
$1,776 |
7.0× |
| CT chest with contrast (71260) |
$932.40 |
$1,554 |
6.2× |
| CT head/brain without and with contrast (70470) |
$868.80 |
$1,448 |
5.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$103.80 |
$173 |
1.4× |
| CT lower ext w/o (73700) |
$606.60 |
$1,011 |
6.7× |
| CT lower extremity with contrast (73701) |
$849.60 |
$1,416 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$901.20 |
$1,502 |
10.0× |
| CT maxillofacial w contrast (70487) |
$717.60 |
$1,196 |
4.7× |
| CT maxillofacial w/o contrast (70486) |
$647.40 |
$1,079 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$740.40 |
$1,234 |
4.9× |
| CT orbits w/o contrast (70480) |
$694.80 |
$1,158 |
7.7× |
| CT pelvis w/o contrast (72192) |
$799.20 |
$1,332 |
8.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$805.80 |
$1,343 |
5.3× |
| CT soft tissue neck w/o contrast (70490) |
$604.80 |
$1,008 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$948 |
$1,580 |
10.5× |
| CT thorax w/o contrast (71250) |
$755.40 |
$1,259 |
8.4× |
| CT upper extremity w/o contrast rt (73200) |
$574.20 |
$957 |
6.4× |
| CTA abdomen pelvis (74174) |
$963.60 |
$1,606 |
3.2× |
| CTA chest (71275) |
$1,239 |
$2,065 |
8.2× |
| Cta Head (70496) |
$831 |
$1,385 |
5.5× |
| Cta Neck (70498) |
$831 |
$1,385 |
5.5× |
| Foot 2 views (73620) |
$109.20 |
$182 |
1.5× |
| Forearm 2 views (73090) |
$109.80 |
$183 |
1.5× |
| Hand 3 views (73130) |
$109.80 |
$183 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$507.60 |
$846 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$109.80 |
$183 |
1.5× |
| Knee 3 views (73562) |
$141.60 |
$236 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,611.20 |
$4,352 |
2.3× |
| Neck soft tissue (70360) |
$121.80 |
$203 |
1.6× |
| Nm gastric emptying study (78264) |
$1,088.40 |
$1,814 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$141 |
$235 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$131.40 |
$219 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$163.80 |
$273 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$82.80 |
$138 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$137.40 |
$229 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$193.20 |
$322 |
2.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$168 |
$280 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$100.20 |
$167 |
1.3× |
| Ribs bilateral 3 views (71110) |
$163.80 |
$273 |
1.8× |
| Sacroiliac Joints < 3 Views (72200) |
$91.20 |
$152 |
1.0× |
| Scapula complete (73010) |
$111 |
$185 |
1.2× |
| Spine thoracic 3 views (72072) |
$158.40 |
$264 |
1.8× |
| Thoracolumbar 2 views (72080) |
$131.40 |
$219 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$240.60 |
$401 |
2.7× |
| Upper Extremity Infant (73092) |
$67.80 |
$113 |
0.8× |
| Us abdl aorta screen aaa (76706) |
$81 |
$135 |
0.9× |
| Us chest (76604) |
$149.40 |
$249 |
1.7× |
| Us ob transvaginal (76817) |
$162 |
$270 |
1.8× |
| Us pelvic non ob complete (76856) |
$354.60 |
$591 |
3.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$151.20 |
$252 |
1.7× |
| Us pregnancy ltd (76815) |
$185.40 |
$309 |
2.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$175.20 |
$292 |
1.9× |
| Us retroperitoneal limited (76775) |
$310.20 |
$517 |
3.4× |
| Us scrotum and contents (76870) |
$208.20 |
$347 |
2.3× |
| Us soft tissue head/neck (76536) |
$289.20 |
$482 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$239.40 |
$399 |
2.7× |
| Wrist 2 views (73100) |
$106.20 |
$177 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$205.20 |
$342 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$130.80 |
$218 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$120 |
$200 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$127.20 |
$212 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$109.80 |
$183 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$130.80 |
$218 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$177.60 |
$296 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$127.20 |
$212 |
1.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$127.20 |
$212 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$67.20 |
$112 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$195.60 |
$326 |
2.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$101.40 |
$169 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$95.40 |
$159 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$123 |
$205 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$158.40 |
$264 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$209.40 |
$349 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$156.60 |
$261 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$130.80 |
$218 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$173.40 |
$289 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$119.40 |
$199 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$145.80 |
$243 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$119.40 |
$199 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$155.40 |
$259 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$96.60 |
$161 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$109.80 |
$183 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$90 |
$150 |
1.2× |
| Xr shoulder 1 view (73020) |
$95.40 |
$159 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$247.80 |
$413 |
2.8× |
| Xr tibia/fibula 2 views (73590) |
$114 |
$190 |
1.5× |
| Xr tmj bilateral (70330) |
$164.40 |
$274 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$123 |
$205 |
1.6× |