| Abdomen 2 views (74019) |
$181.50 |
$242 |
1.9× |
| Ankle 2 views (73600) |
$73.50 |
$98 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$189.75 |
$253 |
2.4× |
| Chest 1 view (71045) |
$162 |
$216 |
2.1× |
| Chest 3 views (71047) |
$196.50 |
$262 |
2.5× |
| Clavicle complete (73000) |
$101.25 |
$135 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$776.25 |
$1,035 |
8.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,428.50 |
$3,238 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,563 |
$2,084 |
7.2× |
| CT abdomen w contrast (74160) |
$1,894.50 |
$2,526 |
11.9× |
| CT abdomen w wo contrast (74170) |
$2,400.75 |
$3,201 |
15.1× |
| CT abdomen w/o contrast (74150) |
$1,508.25 |
$2,011 |
15.9× |
| CT angiography upper extremity lt (73206) |
$2,278.50 |
$3,038 |
14.3× |
| CT c-spine w/o contrast (72125) |
$1,738.50 |
$2,318 |
18.4× |
| CT chest w/wo contrast (71270) |
$2,301.75 |
$3,069 |
14.5× |
| CT chest with contrast (71260) |
$2,104.50 |
$2,806 |
13.3× |
| CT head/brain without and with contrast (70470) |
$2,084.25 |
$2,779 |
13.1× |
| CT lower ext w/o (73700) |
$1,713.75 |
$2,285 |
18.1× |
| CT lower extremity with contrast (73701) |
$2,104.50 |
$2,806 |
13.3× |
| CT lumbar spine w/o contrast (72131) |
$1,713.75 |
$2,285 |
18.1× |
| CT maxillofacial w/o contrast (70486) |
$1,404 |
$1,872 |
14.8× |
| CT neck soft tissue w contrast (70491) |
$2,123.25 |
$2,831 |
13.4× |
| CT orbits w/o contrast (70480) |
$1,464.75 |
$1,953 |
15.5× |
| CT pelvis w & w/o contrast (72194) |
$2,084.25 |
$2,779 |
13.1× |
| CT pelvis w/o contrast (72192) |
$1,508.25 |
$2,011 |
15.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$342.75 |
$457 |
4.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,301.75 |
$3,069 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,713.75 |
$2,285 |
18.1× |
| CT thoracic spine w/o contrast (72128) |
$1,713.75 |
$2,285 |
18.1× |
| CT thorax w/o contrast (71250) |
$1,713.75 |
$2,285 |
18.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,713.75 |
$2,285 |
18.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,069.75 |
$4,093 |
19.3× |
| Cta Abdomen (74175) |
$2,445.75 |
$3,261 |
15.4× |
| CTA abdomen pelvis (74174) |
$2,455.50 |
$3,274 |
7.8× |
| CTA chest (71275) |
$2,496.75 |
$3,329 |
15.7× |
| Cta Head (70496) |
$2,240.25 |
$2,987 |
14.1× |
| CTA lwr ext w&w/o contrast (73706) |
$2,292 |
$3,056 |
14.4× |
| Cta Neck (70498) |
$2,240.25 |
$2,987 |
14.1× |
| Cta Pelvis (72191) |
$2,432.25 |
$3,243 |
15.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$342.75 |
$457 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$124.50 |
$166 |
1.6× |
| Dxa bone density study axial skeleton (77085) |
$141.75 |
$189 |
1.5× |
| Foot 2 views (73620) |
$73.50 |
$98 |
0.9× |
| Forearm 2 views (73090) |
$101.25 |
$135 |
1.3× |
| Hand 2 views (73120) |
$75 |
$100 |
0.8× |
| Hand 3 views (73130) |
$110.25 |
$147 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$98.25 |
$131 |
1.2× |
| Neck soft tissue (70360) |
$105.75 |
$141 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$124.50 |
$166 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$160.50 |
$214 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$144.75 |
$193 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$174.75 |
$233 |
2.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$273 |
$364 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$116.25 |
$155 |
1.5× |
| Ribs bilateral 3 views (71110) |
$196.50 |
$262 |
2.1× |
| Scapula complete (73010) |
$110.25 |
$147 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$66 |
$88 |
2.8× |
| Spine thoracic 3 views (72072) |
$91.50 |
$122 |
1.0× |
| Thoracolumbar 2 views (72080) |
$163.50 |
$218 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$256.12 |
$341.50 |
2.7× |
| Upper Extremity Infant (73092) |
$115.50 |
$154 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$666 |
$888 |
4.2× |
| Us abdl aorta screen aaa (76706) |
$259.50 |
$346 |
2.7× |
| Us breast unilateral complete (76641) |
$278.62 |
$371.50 |
2.9× |
| Us breast unilateral limited (76642) |
$246.38 |
$328.50 |
3.1× |
| Us chest (76604) |
$242.25 |
$323 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$215.25 |
$287 |
2.3× |
| Us pelvic non ob complete (76856) |
$192.75 |
$257 |
2.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$240.75 |
$321 |
2.5× |
| Us pregnancy ltd (76815) |
$273.75 |
$365 |
2.9× |
| Us retroperitoneal complete (76770) |
$192.75 |
$257 |
2.0× |
| Us retroperitoneal limited (76775) |
$204 |
$272 |
2.2× |
| Us scrotum and contents (76870) |
$242.25 |
$323 |
2.6× |
| Us soft tissue head/neck (76536) |
$242.25 |
$323 |
2.6× |
| Us xtr non-vasc lmtd (76882) |
$215.25 |
$287 |
2.3× |
| Wrist 2 views (73100) |
$73.50 |
$98 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$218.25 |
$291 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$144.75 |
$193 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$144.75 |
$193 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$73.50 |
$98 |
0.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$116.25 |
$155 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$124.50 |
$166 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$153 |
$204 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$216.75 |
$289 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$153 |
$204 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$144.75 |
$193 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$101.25 |
$135 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$175.50 |
$234 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$144.75 |
$193 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$116.25 |
$155 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$189.75 |
$253 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$261.75 |
$349 |
2.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$105.75 |
$141 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$168 |
$224 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$196.50 |
$262 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$246.75 |
$329 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$128.25 |
$171 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$105.75 |
$141 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$144.75 |
$193 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$174.75 |
$233 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$105.75 |
$141 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$189.75 |
$253 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$189.75 |
$253 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$141.75 |
$189 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$128.25 |
$171 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$131.25 |
$175 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$160.50 |
$214 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$101.25 |
$135 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$144.75 |
$193 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$254.25 |
$339 |
2.7× |
| Xr chest 4+ views (71048) |
$210.75 |
$281 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$101.25 |
$135 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$246.75 |
$329 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$101.25 |
$135 |
1.3× |
| Xr tmj bilateral (70330) |
$160.50 |
$214 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$101.25 |
$135 |
1.3× |