| Abdomen 2 views (74019) |
$286.50 |
$286.50 |
3.1× |
| Ankle 2 views (73600) |
$109 |
$109 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$404 |
$404 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$606 |
$606 |
1.7× |
| Bone age studies (77072) |
$286.50 |
$286.50 |
3.1× |
| Bone Imaging 3 Phase (78315) |
$1,016.50 |
$1,016.50 |
2.9× |
| Bone survey complete (77075) |
$833.50 |
$833.50 |
9.1× |
| Cervical spine 2 or 3 views (72040) |
$146 |
$146 |
1.9× |
| Chest 1 view (71045) |
$336 |
$336 |
4.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$250 |
$250 |
1.6× |
| Clavicle complete (73000) |
$203.50 |
$203.50 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,150 |
$1,150 |
12.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,300 |
$1,300 |
4.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,468 |
$2,468 |
11.8× |
| CT abdomen w contrast (74160) |
$1,150 |
$1,150 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,300 |
$1,300 |
8.5× |
| CT abdomen w/o contrast (74150) |
$1,150 |
$1,150 |
12.6× |
| CT c-spine w/o contrast (72125) |
$1,150 |
$1,150 |
12.6× |
| CT cervical spine with contrast (72126) |
$1,152 |
$1,152 |
3.8× |
| CT chest w/wo contrast (71270) |
$1,382.50 |
$1,382.50 |
9.0× |
| CT chest with contrast (71260) |
$1,728 |
$1,728 |
11.2× |
| CT head/brain with contrast (70460) |
$1,152 |
$1,152 |
7.5× |
| CT head/brain without and with contrast (70470) |
$1,382.50 |
$1,382.50 |
9.0× |
| CT lower ext w/o (73700) |
$1,150 |
$1,150 |
12.6× |
| CT lower extremity w wo contrast (73702) |
$1,382.50 |
$1,382.50 |
9.0× |
| CT lower extremity with contrast (73701) |
$1,152 |
$1,152 |
7.5× |
| CT lumbar spine w/o contrast (72131) |
$1,150 |
$1,150 |
12.6× |
| CT lumbar spine with contrast (72132) |
$1,152 |
$1,152 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,152 |
$1,152 |
7.5× |
| CT maxillofacial w/o contrast (70486) |
$1,728 |
$1,728 |
18.9× |
| CT neck soft tissue w contrast (70491) |
$1,150 |
$1,150 |
7.5× |
| CT orbits w/o contrast (70480) |
$1,152 |
$1,152 |
12.6× |
| CT pelvis w & w/o contrast (72194) |
$1,382.50 |
$1,382.50 |
9.0× |
| CT pelvis w/o contrast (72192) |
$1,150 |
$1,150 |
12.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,382.50 |
$1,382.50 |
9.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,150 |
$1,150 |
12.6× |
| CT thoracic spine w/o contrast (72128) |
$1,150 |
$1,150 |
12.6× |
| CT thorax w/o contrast (71250) |
$1,186.56 |
$1,186.56 |
13.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,382.50 |
$1,382.50 |
9.0× |
| CT upper extremity w/o contrast rt (73200) |
$2,304 |
$2,304 |
25.1× |
| CT upper extremity with contrast (73201) |
$1,152 |
$1,152 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,256.64 |
$1,256.64 |
8.2× |
| CTA abdomen pelvis (74174) |
$1,382.50 |
$1,382.50 |
4.5× |
| CTA chest (71275) |
$2,074 |
$2,074 |
13.5× |
| Cta Head (70496) |
$1,382.50 |
$1,382.50 |
9.0× |
| Cta Neck (70498) |
$1,382.50 |
$1,382.50 |
9.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$205 |
$205 |
2.2× |
| Esophagus (74220) |
$250 |
$250 |
1.6× |
| Foot 2 views (73620) |
$203.50 |
$203.50 |
2.7× |
| Forearm 2 views (73090) |
$236.50 |
$236.50 |
3.1× |
| Hand 2 views (73120) |
$286.50 |
$286.50 |
3.1× |
| Hand 3 views (73130) |
$228 |
$228 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$666 |
$666 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$813 |
$813 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$237 |
$237 |
3.1× |
| Knee 3 views (73562) |
$231 |
$231 |
3.0× |
| MRA head w/o contrast (70544) |
$2,000 |
$2,000 |
9.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,463 |
$5,463 |
17.9× |
| MRI c-spine with contrast (72142) |
$2,895 |
$2,895 |
9.5× |
| MRI cervical spine w/o contrast (72141) |
$4,193 |
$4,193 |
20.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,795 |
$2,795 |
13.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,795 |
$2,795 |
13.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,842 |
$3,842 |
12.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,642 |
$3,642 |
11.9× |
| MRI pelvis w/o contrast (72195) |
$2,795 |
$2,795 |
13.4× |
| MRI scan of arm joint before and after contrast (73223) |
$3,642 |
$3,642 |
11.9× |
| MRI scan of leg joint before and after contrast (73723) |
$3,642 |
$3,642 |
11.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,642 |
$3,642 |
11.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,642 |
$3,642 |
11.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,642 |
$3,642 |
11.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,998 |
$1,998 |
9.6× |
| MRI upper ext joint w/o contrast (73221) |
$4,114 |
$4,114 |
19.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,114 |
$4,114 |
19.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,135 |
$3,135 |
2.8× |
| Neck soft tissue (70360) |
$553 |
$553 |
7.3× |
| Nm gastric emptying study (78264) |
$727 |
$727 |
2.1× |
| Parathyroid imaging (78070) |
$1,230 |
$1,230 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$430 |
$430 |
4.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,642 |
$3,642 |
11.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,232 |
$1,232 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$146 |
$146 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$205 |
$205 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$109 |
$109 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$354 |
$354 |
4.6× |
| Radiologic exam colon single contrast study (74270) |
$432 |
$432 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$355.50 |
$355.50 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$178.55 |
$178.55 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$146 |
$146 |
1.9× |
| Radiological examination surgical specimen (76098) |
$482.89 |
$482.89 |
1.0× |
| Ribs bilateral 3 views (71110) |
$286.50 |
$286.50 |
3.1× |
| Sacroiliac Joints < 3 Views (72200) |
$374.08 |
$374.08 |
4.1× |
| Scapula complete (73010) |
$237 |
$237 |
2.6× |
| Screening digital breast tomosynthesis (77063) |
$101 |
$101 |
4.3× |
| Spine thoracic 3 views (72072) |
$205 |
$205 |
2.2× |
| Thoracolumbar 2 views (72080) |
$146 |
$146 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,309 |
$1,309 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$610 |
$610 |
6.7× |
| Us abdl aorta screen aaa (76706) |
$291 |
$291 |
3.2× |
| Us breast unilateral complete (76641) |
$254 |
$254 |
2.8× |
| Us breast unilateral limited (76642) |
$381 |
$381 |
5.0× |
| Us chest (76604) |
$351.51 |
$351.51 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$286.50 |
$286.50 |
3.1× |
| Us ob transvaginal (76817) |
$291 |
$291 |
3.2× |
| Us pelvic non ob complete (76856) |
$610 |
$610 |
6.7× |
| Us pregnancy ltd (76815) |
$242 |
$242 |
2.6× |
| Us retroperitoneal complete (76770) |
$291 |
$291 |
3.2× |
| Us retroperitoneal limited (76775) |
$242 |
$242 |
2.6× |
| Us scrotum and contents (76870) |
$291 |
$291 |
3.2× |
| Us soft tissue head/neck (76536) |
$610 |
$610 |
6.7× |
| Us xtr non-vasc lmtd (76882) |
$254 |
$254 |
2.8× |
| Wrist 2 views (73100) |
$203.50 |
$203.50 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$316.23 |
$316.23 |
3.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$228 |
$228 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$601.50 |
$601.50 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$203.50 |
$203.50 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$304.08 |
$304.08 |
4.0× |
| X-ray exam hip uni 1 view (73501) |
$203 |
$203 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$297 |
$297 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$205 |
$205 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$286.50 |
$286.50 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$154 |
$154 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$169 |
$169 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$152 |
$152 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$186.50 |
$186.50 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$312 |
$312 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$228 |
$228 |
3.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$237 |
$237 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$430 |
$430 |
4.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$218 |
$218 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$209 |
$209 |
2.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$152 |
$152 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$286.50 |
$286.50 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$286.50 |
$286.50 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$109 |
$109 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$205 |
$205 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$205 |
$205 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$146 |
$146 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$392 |
$392 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$203.50 |
$203.50 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$286.50 |
$286.50 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$205 |
$205 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$152 |
$152 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$203.50 |
$203.50 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$205 |
$205 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$305.50 |
$305.50 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$152 |
$152 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$237 |
$237 |
3.1× |
| Xr c-spine 6 or more views (72052) |
$222 |
$222 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$203.50 |
$203.50 |
2.7× |
| Xr shoulder 1 view (73020) |
$203.50 |
$203.50 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$436 |
$436 |
4.8× |
| Xr tibia/fibula 2 views (73590) |
$110 |
$110 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$169 |
$169 |
2.2× |