| Abdomen 2 views (74019) |
$450 |
$450 |
4.3× |
| Ankle 2 views (73600) |
$390 |
$390 |
4.5× |
| Cervical spine 2 or 3 views (72040) |
$204 |
$204 |
2.3× |
| Chest 1 view (71045) |
$156 |
$156 |
1.8× |
| Clavicle complete (73000) |
$151 |
$151 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,927 |
$1,927 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,565 |
$1,565 |
6.5× |
| CT abdomen w wo contrast (74170) |
$1,475 |
$1,475 |
8.4× |
| CT abdomen w/o contrast (74150) |
$1,054 |
$1,054 |
10.0× |
| CT angiography upper extremity lt (73206) |
$662 |
$662 |
3.8× |
| CT c-spine w/o contrast (72125) |
$1,199 |
$1,199 |
11.4× |
| CT chest w/wo contrast (71270) |
$1,800 |
$1,800 |
10.2× |
| CT chest with contrast (71260) |
$1,563 |
$1,563 |
8.9× |
| CT lower ext w/o (73700) |
$2,448 |
$2,448 |
23.3× |
| CT lumbar spine w/o contrast (72131) |
$935 |
$935 |
8.9× |
| CT maxillofacial w/o contrast (70486) |
$873 |
$873 |
8.3× |
| CT neck soft tissue w contrast (70491) |
$522 |
$522 |
3.0× |
| CT pelvis w & w/o contrast (72194) |
$2,828 |
$2,828 |
16.0× |
| CT pelvis w/o contrast (72192) |
$1,098 |
$1,098 |
10.5× |
| CT thoracic spine w/o contrast (72128) |
$357 |
$357 |
3.4× |
| CT thorax w/o contrast (71250) |
$1,000 |
$1,000 |
9.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,060 |
$1,060 |
10.1× |
| Cta Abdomen (74175) |
$3,971 |
$3,971 |
22.5× |
| CTA chest (71275) |
$1,310 |
$1,310 |
7.4× |
| Cta Head (70496) |
$3,636 |
$3,636 |
20.6× |
| CTA lwr ext w&w/o contrast (73706) |
$4,401 |
$4,401 |
25.0× |
| Cta Neck (70498) |
$1,100 |
$1,100 |
6.2× |
| Cta Pelvis (72191) |
$3,184 |
$3,184 |
18.1× |
| Foot 2 views (73620) |
$227 |
$227 |
2.6× |
| Forearm 2 views (73090) |
$453 |
$453 |
5.2× |
| Hand 2 views (73120) |
$166 |
$166 |
1.6× |
| Hand 3 views (73130) |
$163 |
$163 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$152 |
$152 |
1.7× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$10 |
$10 |
0.0× |
| MRA head w & w/o contrast (70546) |
$3,402 |
$3,402 |
9.7× |
| MRA head w/o contrast (70544) |
$3,306 |
$3,306 |
13.8× |
| MRA head with contrast (70545) |
$3,044 |
$3,044 |
8.7× |
| MRA neck w contrast (70548) |
$3,829 |
$3,829 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,011 |
$4,011 |
11.4× |
| MRA neck w/o contrast (70547) |
$3,152 |
$3,152 |
13.2× |
| MRI abdomen w contrast (74182) |
$2,325 |
$2,325 |
6.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,988 |
$4,988 |
14.2× |
| MRI abdomen w/o contrast (74181) |
$3,580 |
$3,580 |
14.9× |
| MRI any jnt lwr ext with con lt (73722) |
$3,915 |
$3,915 |
5.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,912 |
$3,912 |
5.0× |
| MRI c-spine with contrast (72142) |
$3,362 |
$3,362 |
9.6× |
| MRI cervical spine w/o contrast (72141) |
$1,670 |
$1,670 |
7.0× |
| MRI chest w/o & w/contrast material (71552) |
$4,168 |
$4,168 |
11.9× |
| MRI chest w/o contrast (71550) |
$1,780 |
$1,780 |
7.4× |
| MRI chest with contrast (71551) |
$1,642 |
$1,642 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,066 |
$1,066 |
3.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$662 |
$662 |
1.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,430 |
$3,430 |
14.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,477 |
$3,477 |
14.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,527 |
$4,527 |
12.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,066 |
$1,066 |
3.0× |
| MRI pelvis w contrast (72196) |
$2,093 |
$2,093 |
6.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,445 |
$4,445 |
12.7× |
| MRI pelvis w/o contrast (72195) |
$3,245 |
$3,245 |
13.5× |
| MRI scan of arm joint before and after contrast (73223) |
$4,964 |
$4,964 |
14.2× |
| MRI scan of leg joint before and after contrast (73723) |
$5,139 |
$5,139 |
14.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,301 |
$5,301 |
15.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,965 |
$2,965 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,204 |
$5,204 |
14.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,193 |
$3,193 |
9.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,023 |
$5,023 |
14.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,381 |
$1,381 |
5.8× |
| MRI upper ext joint w/o contrast (73221) |
$907 |
$907 |
3.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,232 |
$5,232 |
14.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,607 |
$3,607 |
15.0× |
| Neck soft tissue (70360) |
$393 |
$393 |
4.5× |
| Pelvis 1 or 2 views (72170) |
$165 |
$165 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,384 |
$4,384 |
12.5× |
| Pr red cell survival study (78130) |
$11 |
$11 |
0.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$661 |
$661 |
6.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$572 |
$572 |
5.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$170 |
$170 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$210 |
$210 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$180 |
$180 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$365 |
$365 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$104 |
$104 |
1.2× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$6 |
$6 |
0.0× |
| Sacroiliac Joints < 3 Views (72200) |
$367 |
$367 |
3.5× |
| Scapula complete (73010) |
$389 |
$389 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$310 |
$310 |
3.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$518 |
$518 |
1.3× |
| Unlisted Ultrasound Procedure (76999) |
$471 |
$471 |
5.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$11,990 |
$11,990 |
68.0× |
| Us breast unilateral complete (76641) |
$525 |
$525 |
5.0× |
| Us chest (76604) |
$716 |
$716 |
6.8× |
| Us compl joint r-t w/image documentation (76881) |
$345 |
$345 |
3.3× |
| Us ob detailed single fetus (76811) |
$1,048 |
$1,048 |
4.4× |
| Us ob transvaginal (76817) |
$690 |
$690 |
6.6× |
| Us pelvic non ob complete (76856) |
$333 |
$333 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$207 |
$207 |
2.0× |
| Us retroperitoneal complete (76770) |
$461 |
$461 |
4.4× |
| Us retroperitoneal limited (76775) |
$240 |
$240 |
2.3× |
| Us scrotum and contents (76870) |
$942 |
$942 |
9.0× |
| Us soft tissue head/neck (76536) |
$293 |
$293 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$630 |
$630 |
6.0× |
| Wrist 2 views (73100) |
$415 |
$415 |
4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$150 |
$150 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$184 |
$184 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$132 |
$132 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$140 |
$140 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$349 |
$349 |
4.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$249 |
$249 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$200 |
$200 |
1.9× |
| X-ray exam of femur 1 (73551) |
$162 |
$162 |
1.9× |
| X-ray eye for foreign body (70030) |
$348 |
$348 |
4.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$150 |
$150 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$164 |
$164 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$330 |
$330 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$190 |
$190 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$482 |
$482 |
5.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$159 |
$159 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$153 |
$153 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$395 |
$395 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$464 |
$464 |
5.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$187 |
$187 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$609 |
$609 |
7.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$386 |
$386 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$747 |
$747 |
7.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$138 |
$138 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$460 |
$460 |
5.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$151 |
$151 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$394 |
$394 |
4.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$174 |
$174 |
2.0× |
| Xr chest 4+ views (71048) |
$353 |
$353 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$124 |
$124 |
1.4× |
| Xr shoulder 1 view (73020) |
$431 |
$431 |
4.9× |
| Xr spine cervical 4 or 5 views (72050) |
$271 |
$271 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$145 |
$145 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$168 |
$168 |
1.9× |