| Abdomen 1 View (74018) |
$234 |
$234 |
2.6× |
| Abdomen 2 views (74019) |
$250 |
$250 |
2.3× |
| Ankle 2 views (73600) |
$220 |
$220 |
2.5× |
| Bone age studies (77072) |
$93 |
$93 |
0.9× |
| Bone survey infant (77076) |
$406 |
$406 |
3.8× |
| Chest 1 view (71045) |
$212 |
$212 |
2.4× |
| Chest 2 views (71046) |
$266 |
$266 |
3.0× |
| Clavicle complete (73000) |
$234 |
$234 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$975 |
$975 |
9.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,763 |
$3,763 |
10.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,039 |
$2,039 |
8.4× |
| CT abdomen w contrast (74160) |
$2,360 |
$2,360 |
13.2× |
| CT abdomen w wo contrast (74170) |
$2,922 |
$2,922 |
16.3× |
| CT abdomen w/o contrast (74150) |
$1,952 |
$1,952 |
18.3× |
| CT Angio Abdomen and Pelvis (74174) |
$3,231 |
$3,231 |
9.1× |
| CT Angio Chest (71275) |
$3,426 |
$3,426 |
19.1× |
| CT Angio Head (70496) |
$2,246 |
$2,246 |
12.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,816 |
$2,816 |
15.7× |
| CT Angio Neck (70498) |
$2,757 |
$2,757 |
15.4× |
| CT cervical spine w/ contrast (72126) |
$2,434 |
$2,434 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$2,039 |
$2,039 |
19.1× |
| CT cervical spine w/wo cont (72127) |
$3,046 |
$3,046 |
17.0× |
| CT chest w contrast (71260) |
$2,434 |
$2,434 |
13.6× |
| CT chest w/wo contrast (71270) |
$3,046 |
$3,046 |
17.0× |
| CT head/brain with contrast (70460) |
$1,952 |
$1,952 |
10.9× |
| CT head/brain without and with contrast (70470) |
$2,434 |
$2,434 |
13.6× |
| CT iac w contrast (70481) |
$2,223 |
$2,223 |
12.4× |
| CT l-spine w&w/o contrast (72133) |
$3,046 |
$3,046 |
17.0× |
| CT lower ext w/o (73700) |
$1,711 |
$1,711 |
16.0× |
| CT lower extremity w/contrast material (73701) |
$2,039 |
$2,039 |
11.4× |
| CT lumbar spine w contrast (72132) |
$2,434 |
$2,434 |
6.8× |
| CT lumbar spine w/o contrast (72131) |
$2,039 |
$2,039 |
19.1× |
| CT maxillofacial w contrast (70487) |
$1,952 |
$1,952 |
10.9× |
| CT maxillofacial wo contrast (70486) |
$1,632 |
$1,632 |
15.3× |
| CT neck tissue combo (70492) |
$2,434 |
$2,434 |
13.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,454 |
$2,454 |
13.7× |
| CT orbits w/o contrast (70480) |
$1,815 |
$1,815 |
17.0× |
| CT pelvis w&w/o contrast (72194) |
$2,922 |
$2,922 |
16.3× |
| CT pelvis w/o contrast (72192) |
$2,039 |
$2,039 |
19.1× |
| CT scan of leg combo (73702) |
$2,559 |
$2,559 |
14.3× |
| CT scans face/jaw combo (70488) |
$2,434 |
$2,434 |
13.6× |
| CT soft tissue neck w contrast (70491) |
$1,952 |
$1,952 |
10.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,632 |
$1,632 |
15.3× |
| CT thoracic spine w contrast (72129) |
$2,434 |
$2,434 |
13.6× |
| CT thoracic spine w/o contrast (72128) |
$2,039 |
$2,039 |
19.1× |
| CT thoracic spine w/wo cont (72130) |
$3,046 |
$3,046 |
17.0× |
| CT thorax w/o contrast (71250) |
$2,039 |
$2,039 |
19.1× |
| CT upper ext wo (73200) |
$1,711 |
$1,711 |
16.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,559 |
$2,559 |
14.3× |
| CT upper extremity with contrast (73201) |
$2,039 |
$2,039 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,491 |
$3,491 |
19.5× |
| Cta Abdomen (74175) |
$2,747 |
$2,747 |
15.3× |
| CTA pelvis (72191) |
$2,747 |
$2,747 |
15.3× |
| Dxa Bone Density Axial (77080) |
$575 |
$575 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$154 |
$154 |
1.7× |
| Fetal Biophys Profile W/Nst (76818) |
$604 |
$604 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$303 |
$303 |
2.8× |
| Foot 2 views (73620) |
$225 |
$225 |
2.5× |
| Forearm 2 views (73090) |
$234 |
$234 |
2.6× |
| Hand 2 views (73120) |
$129 |
$129 |
1.2× |
| Knee 3 Views (73562) |
$266 |
$266 |
3.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$2,426 |
$2,426 |
13.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$6,937 |
$6,937 |
38.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$5,070 |
$5,070 |
14.2× |
| MRA head w/o contrast (70544) |
$3,307 |
$3,307 |
13.6× |
| MRA head with contrast (70545) |
$3,260 |
$3,260 |
9.1× |
| MRA neck w contrast (70548) |
$3,516 |
$3,516 |
9.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,103 |
$5,103 |
14.3× |
| MRA neck w/o contrast (70547) |
$3,321 |
$3,321 |
13.6× |
| MRI abdomen w contrast (74182) |
$3,660 |
$3,660 |
10.3× |
| MRI abdomen w/o contrast (74181) |
$2,592 |
$2,592 |
10.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,150 |
$3,150 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,814 |
$4,814 |
13.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,129 |
$3,129 |
3.9× |
| MRI cervical spine w contrast (72142) |
$3,112 |
$3,112 |
8.7× |
| MRI cervical spine w/o cont (72141) |
$2,514 |
$2,514 |
10.3× |
| MRI chest wo w contrast (71552) |
$5,217 |
$5,217 |
14.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,219 |
$3,219 |
9.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,075 |
$5,075 |
14.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,957 |
$2,957 |
12.1× |
| MRI lumbar spine w contrast (72149) |
$3,111 |
$3,111 |
8.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,938 |
$4,938 |
13.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,907 |
$2,907 |
11.9× |
| MRI orbit face neck w contrast (70542) |
$3,196 |
$3,196 |
9.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,024 |
$5,024 |
14.1× |
| MRI pelvis w contrast (72196) |
$3,233 |
$3,233 |
9.1× |
| MRI pelvis w/o & w contrast (72197) |
$5,077 |
$5,077 |
14.2× |
| MRI pelvis w/o contrast (72195) |
$3,004 |
$3,004 |
12.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,673 |
$2,673 |
11.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,379 |
$3,379 |
9.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,146 |
$3,146 |
12.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,077 |
$5,077 |
14.2× |
| MRI, abdomen, combo (74183) |
$5,080 |
$5,080 |
14.3× |
| MRI, dorsal spine combo (72157) |
$4,654 |
$4,654 |
13.1× |
| MRI, dorsal spine contrast (72147) |
$2,893 |
$2,893 |
8.1× |
| MRI, joint upper extrem (73221) |
$2,646 |
$2,646 |
10.9× |
| MRI, joint upper extrem combo (73223) |
$4,825 |
$4,825 |
13.5× |
| MRI, lumbar spine combo (72158) |
$4,934 |
$4,934 |
13.8× |
| Neck soft tissue (70360) |
$188 |
$188 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$223 |
$223 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$331 |
$331 |
3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$234 |
$234 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$223 |
$223 |
2.5× |
| Radex elbow complete minimum 3 views (73080) |
$261 |
$261 |
2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$308 |
$308 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$201 |
$201 |
2.3× |
| Radex foot complete minimum 3 views (73630) |
$236 |
$236 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$236 |
$236 |
2.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$131 |
$131 |
1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$258 |
$258 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$234 |
$234 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$212 |
$212 |
2.4× |
| Radex shoulder complete minimum 2 views (73030) |
$250 |
$250 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$223 |
$223 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$93 |
$93 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$135 |
$135 |
1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$325 |
$325 |
3.7× |
| Radex Toe Minimum 2 Views (73660) |
$165 |
$165 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$131 |
$131 |
1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$236 |
$236 |
2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$266 |
$266 |
2.5× |
| Radiologic exam knee complete 4/more views (73564) |
$288 |
$288 |
2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$308 |
$308 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$266 |
$266 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$266 |
$266 |
3.0× |
| Radiologic examination knee 1/2 views (73560) |
$223 |
$223 |
2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$174 |
$174 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$234 |
$234 |
2.6× |
| Ribs bilateral 3 views (71110) |
$325 |
$325 |
3.0× |
| Scapula (73010) |
$234 |
$234 |
2.2× |
| Shoulder 1 view (73020) |
$201 |
$201 |
2.3× |
| Skull less than 4 views (70250) |
$266 |
$266 |
2.5× |
| Speech evaluation, complex (70371) |
$730 |
$730 |
3.0× |
| Sternoclavicular joints (71130) |
$301 |
$301 |
3.4× |
| Thoracic spine 2 views (72070) |
$289 |
$289 |
2.7× |
| Thoracic spine 3 views (72072) |
$301 |
$301 |
2.8× |
| Thoracolumbar 2 views (72080) |
$136 |
$136 |
1.5× |
| Ultrasound Breast Limited (76642) |
$353 |
$353 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$644 |
$644 |
6.0× |
| Umbilical-artery Doppler (OB) (76820) |
$132 |
$132 |
1.2× |
| Us breast unilateral complete (76641) |
$462 |
$462 |
4.3× |
| Us chest (76604) |
$498 |
$498 |
4.7× |
| Us complete joint (76881) |
$587 |
$587 |
5.5× |
| Us exam, pelvic, limited (76857) |
$456 |
$456 |
4.3× |
| Us head (76506) |
$564 |
$564 |
5.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$190 |
$190 |
1.8× |
| Us ob limited 1 or more fetuses (76815) |
$536 |
$536 |
5.0× |
| Us ob transvaginal (76817) |
$338 |
$338 |
3.2× |
| Us pelvic non ob complete (76856) |
$574 |
$574 |
5.4× |
| Us retroperitoneal complete (76770) |
$733 |
$733 |
6.9× |
| Us retroperitoneal limited (76775) |
$536 |
$536 |
5.0× |
| Us scrotum and contents (76870) |
$574 |
$574 |
5.4× |
| Us thyroid (76536) |
$574 |
$574 |
5.4× |
| Wrist 2 views (73100) |
$225 |
$225 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$160 |
$160 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$234 |
$234 |
2.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$306 |
$306 |
2.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$344 |
$344 |
3.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$336 |
$336 |
3.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$374 |
$374 |
4.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$671 |
$671 |
6.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$747 |
$747 |
7.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$289 |
$289 |
3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$508 |
$508 |
4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$301 |
$301 |
2.8× |
| X-ray eye for foreign body (70030) |
$177 |
$177 |
2.0× |
| X-ray humerus (73060) |
$266 |
$266 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$289 |
$289 |
2.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$234 |
$234 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$250 |
$250 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$325 |
$325 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$349 |
$349 |
3.3× |
| X-Rays Bone Survey Complete (77075) |
$402 |
$402 |
3.8× |
| Xr c-spine 4 or 5 views (72050) |
$359 |
$359 |
3.4× |
| Xr facial bones less than 3 views (70140) |
$123 |
$123 |
1.4× |