| Abdomen 2 views (74019) |
$396 |
$566 |
3.8× |
| Ankle 2 views (73600) |
$222 |
$317 |
2.5× |
| Bone age studies (77072) |
$225 |
$321 |
2.1× |
| Bone survey complete (77075) |
$1,198 |
$1,712 |
11.4× |
| Cervical spine 2 or 3 views (72040) |
$415 |
$593 |
4.7× |
| Chest 1 view (71045) |
$321 |
$458 |
3.7× |
| Clavicle complete (73000) |
$630 |
$900 |
7.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$840 |
$1,200 |
8.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,228 |
$6,040 |
12.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,188 |
$3,125 |
9.1× |
| CT abdomen w contrast (74160) |
$2,297.50 |
$3,282 |
13.0× |
| CT abdomen w wo contrast (74170) |
$2,625 |
$3,750 |
14.9× |
| CT abdomen w/o contrast (74150) |
$2,188 |
$3,125 |
20.8× |
| CT angiography upper extremity lt (73206) |
$1,268 |
$1,812 |
7.2× |
| CT c-spine w/o contrast (72125) |
$2,188 |
$3,126 |
20.8× |
| CT cervical spine with contrast (72126) |
$2,240 |
$3,200 |
6.4× |
| CT chest w/wo contrast (71270) |
$2,800 |
$4,000 |
15.9× |
| CT chest with contrast (71260) |
$2,538 |
$3,625 |
14.4× |
| CT head/brain without and with contrast (70470) |
$2,753 |
$3,933 |
15.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$53 |
$75 |
0.6× |
| CT lower ext w/o (73700) |
$1,750 |
$2,500 |
16.7× |
| CT lower extremity with contrast (73701) |
$2,188 |
$3,125 |
12.4× |
| CT lumbar spine w/o contrast (72131) |
$2,514 |
$3,592 |
23.9× |
| CT lumbar spine with contrast (72132) |
$2,660 |
$3,800 |
7.6× |
| CT maxillofacial w contrast (70487) |
$2,972 |
$4,245 |
16.9× |
| CT maxillofacial w/o contrast (70486) |
$2,302 |
$3,289 |
21.9× |
| CT neck soft tissue w contrast (70491) |
$2,240 |
$3,200 |
12.7× |
| CT pelvis w & w/o contrast (72194) |
$1,313 |
$1,875 |
7.5× |
| CT pelvis w/o contrast (72192) |
$2,188 |
$3,126 |
20.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$438 |
$625 |
5.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,188 |
$3,125 |
12.4× |
| CT soft tissue neck w/o contrast (70490) |
$2,209 |
$3,155 |
21.0× |
| CT thoracic spine w/contrast (72129) |
$2,940 |
$4,200 |
16.7× |
| CT thoracic spine w/o contrast (72128) |
$2,814 |
$4,020 |
26.8× |
| CT thorax w/o contrast (71250) |
$1,484.50 |
$2,121 |
14.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,750 |
$2,500 |
16.7× |
| CTA chest (71275) |
$2,800 |
$4,000 |
15.9× |
| Cta Head (70496) |
$1,750 |
$2,500 |
9.9× |
| CTA lwr ext w&w/o contrast (73706) |
$4,103 |
$5,861 |
23.3× |
| Cta Neck (70498) |
$1,750 |
$2,500 |
9.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$225 |
$321 |
2.1× |
| Foot 2 views (73620) |
$379 |
$542 |
4.3× |
| Forearm 2 views (73090) |
$433 |
$619 |
5.0× |
| Hand 2 views (73120) |
$417 |
$595 |
4.0× |
| Hand 3 views (73130) |
$431 |
$616 |
4.9× |
| Humerus Min 2 Views Left (73060) |
$435 |
$621 |
5.0× |
| Knee 3 views (73562) |
$431 |
$615 |
4.9× |
| MRA head w & w/o contrast (70546) |
$3,755 |
$5,365 |
10.7× |
| MRA head w/o contrast (70544) |
$3,111.50 |
$4,445 |
13.0× |
| MRA head with contrast (70545) |
$2,355 |
$3,364 |
6.7× |
| MRA neck w contrast (70548) |
$3,628 |
$5,183 |
10.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,507 |
$5,010 |
10.0× |
| MRA neck w/o contrast (70547) |
$2,790 |
$3,985 |
11.6× |
| MRI abdomen w contrast (74182) |
$2,800 |
$4,000 |
8.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,157 |
$5,939 |
11.9× |
| MRI abdomen w/o contrast (74181) |
$3,100 |
$4,429 |
12.9× |
| MRI any jnt lwr ext with con lt (73722) |
$3,091 |
$4,415 |
3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,319 |
$4,741 |
4.2× |
| MRI cervical spine w/o contrast (72141) |
$3,038 |
$4,340 |
12.7× |
| MRI chest w/o & w/contrast material (71552) |
$4,228 |
$6,040 |
12.1× |
| MRI chest w/o contrast (71550) |
$2,188 |
$3,126 |
9.1× |
| MRI chest with contrast (71551) |
$2,355 |
$3,364 |
3.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,944 |
$4,205 |
8.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,355 |
$3,364 |
6.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,843 |
$4,062 |
11.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,110 |
$3,014 |
8.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,176 |
$5,965 |
11.9× |
| MRI orbit/face/neck w/contrast (70542) |
$2,355 |
$3,364 |
6.7× |
| MRI pelvis w contrast (72196) |
$2,355 |
$3,364 |
6.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,192 |
$5,989 |
12.0× |
| MRI pelvis w/o contrast (72195) |
$2,878 |
$4,112 |
12.0× |
| MRI scan of arm joint before and after contrast (73223) |
$3,881 |
$5,544 |
11.1× |
| MRI scan of leg joint before and after contrast (73723) |
$4,228 |
$6,040 |
12.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,358 |
$6,226 |
12.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,536 |
$3,623 |
7.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,228 |
$6,040 |
12.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,536 |
$3,623 |
7.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,228 |
$6,040 |
12.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,904 |
$4,149 |
12.1× |
| MRI tmj (70336) |
$1,754 |
$2,505 |
7.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,406.50 |
$3,437.50 |
10.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,228 |
$6,040 |
12.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,800 |
$4,000 |
11.7× |
| Neck soft tissue (70360) |
$423 |
$604 |
4.8× |
| Pelvis 1 or 2 views (72170) |
$315 |
$450 |
3.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,929 |
$5,613 |
11.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$315 |
$450 |
3.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$438 |
$625 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$225 |
$321 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$240 |
$343 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$504 |
$720 |
4.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$377 |
$538 |
4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$428 |
$611 |
4.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$9 |
$13 |
0.0× |
| Sacroiliac Joints < 3 Views (72200) |
$225 |
$321 |
2.1× |
| Scapula complete (73010) |
$225 |
$321 |
2.1× |
| Sella turcica (70240) |
$183 |
$261 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$840 |
$1,200 |
8.0× |
| Us abdl aorta screen aaa (76706) |
$888 |
$1,268 |
8.5× |
| Us breast unilateral complete (76641) |
$225 |
$321 |
2.1× |
| Us breast unilateral limited (76642) |
$183 |
$261 |
2.1× |
| Us compl joint r-t w/image documentation (76881) |
$570 |
$814 |
5.4× |
| Us pelvic non ob complete (76856) |
$1,006 |
$1,437 |
9.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$518 |
$740 |
4.9× |
| Us pregnancy ltd (76815) |
$263 |
$375 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$410 |
$586 |
3.9× |
| Us retroperitoneal complete (76770) |
$888 |
$1,268 |
8.5× |
| Us retroperitoneal limited (76775) |
$792 |
$1,132 |
7.5× |
| Us scrotum and contents (76870) |
$886 |
$1,266 |
8.4× |
| Us soft tissue head/neck (76536) |
$754 |
$1,077 |
7.2× |
| Wrist 2 views (73100) |
$396 |
$566 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$183 |
$261 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$435 |
$621 |
5.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$470.50 |
$672 |
5.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$367 |
$524 |
4.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$420 |
$600 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$425 |
$607 |
4.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$206 |
$294 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$571 |
$815 |
5.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$438 |
$625 |
5.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$461 |
$659 |
4.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$778 |
$1,112 |
7.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$183 |
$261 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$438 |
$625 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$225 |
$321 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$406 |
$580 |
4.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$426 |
$608 |
4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$517 |
$738 |
5.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$263 |
$375 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$225 |
$321 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$438 |
$625 |
5.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$183 |
$261 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$451 |
$645 |
4.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$337 |
$481 |
3.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$426 |
$609 |
4.9× |
| Xr chest 4+ views (71048) |
$245 |
$350 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$344 |
$491 |
3.9× |
| Xr optic foramina (70190) |
$183 |
$261 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$685 |
$978 |
6.5× |
| Xr tibia/fibula 2 views (73590) |
$445 |
$635 |
5.1× |
| Xr tmj bilateral (70330) |
$183 |
$261 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$363 |
$518 |
4.2× |