| Abdomen 2 views (74019) |
$234.64 |
$419 |
2.1× |
| Ankle 2 views (73600) |
$230.72 |
$412 |
2.5× |
| Bone age studies (77072) |
$176.96 |
$316 |
1.6× |
| Bone survey complete (77075) |
$790.72 |
$1,412 |
7.1× |
| Cervical spine 2 or 3 views (72040) |
$238.56 |
$426 |
2.6× |
| Chest 1 view (71045) |
$155.12 |
$277 |
1.7× |
| Clavicle complete (73000) |
$225.68 |
$403 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$636.16 |
$1,136 |
5.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,829.68 |
$5,053 |
7.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,484.72 |
$4,437 |
9.8× |
| CT abdomen w contrast (74160) |
$1,480.64 |
$2,644 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,698.48 |
$3,033 |
9.1× |
| CT abdomen w/o contrast (74150) |
$1,308.16 |
$2,336 |
11.7× |
| CT c-spine w/o contrast (72125) |
$1,308.16 |
$2,336 |
11.7× |
| CT chest w contrast (71260) |
$1,480.64 |
$2,644 |
7.9× |
| CT head/brain with contrast (70460) |
$1,480.64 |
$2,644 |
7.9× |
| CT head/brain without and with contrast (70470) |
$1,653.12 |
$2,952 |
8.8× |
| CT iac w contrast (70481) |
$1,629.04 |
$2,909 |
8.7× |
| CT lower ext w/o (73700) |
$1,308.16 |
$2,336 |
11.7× |
| CT lower extremity w wo contrast (73702) |
$1,687.84 |
$3,014 |
9.0× |
| CT lower extremity w/contrast material (73701) |
$1,480.64 |
$2,644 |
7.9× |
| CT lumbar spine w/contrast (72132) |
$1,480.64 |
$2,644 |
4.0× |
| CT lumbar spine w/o contrast (72131) |
$1,308.16 |
$2,336 |
11.7× |
| CT maxillofacial w contrast (70487) |
$1,480.64 |
$2,644 |
7.9× |
| CT maxillofacial wo contrast (70486) |
$1,308.16 |
$2,336 |
11.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,803.20 |
$3,220 |
9.6× |
| CT orbits w/o contrast (70480) |
$1,308.16 |
$2,336 |
11.7× |
| CT pelvis w/o contrast (72192) |
$1,308.16 |
$2,336 |
11.7× |
| CT pelvis w/wo contrast (72194) |
$1,653.12 |
$2,952 |
8.8× |
| CT soft tissue neck w contrast (70491) |
$1,480.64 |
$2,644 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,308.16 |
$2,336 |
11.7× |
| CT thoracic spine w/contrast (72129) |
$1,480.64 |
$2,644 |
7.9× |
| CT thoracic spine w/o contrast (72128) |
$1,116.64 |
$1,994 |
10.0× |
| CT thorax w/o contrast (71250) |
$1,308.16 |
$2,336 |
11.7× |
| CT upper ext wo (73200) |
$1,308.16 |
$2,336 |
11.7× |
| CT upper extremity with contrast (73201) |
$1,480.64 |
$2,644 |
4.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,310 |
$4,125 |
12.3× |
| Cta Abdomen (74175) |
$2,232.72 |
$3,987 |
11.9× |
| CTA abdomen pelvis (74174) |
$2,213.12 |
$3,952 |
5.9× |
| CTA chest (71275) |
$2,110.64 |
$3,769 |
11.3× |
| Cta Head (70496) |
$1,947.12 |
$3,477 |
10.4× |
| Cta Neck (70498) |
$1,947.12 |
$3,477 |
10.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$418.88 |
$748 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$416.36 |
$743.50 |
1.6× |
| Foot 2 views (73620) |
$199.92 |
$357 |
2.2× |
| Forearm 2 views (73090) |
$217.84 |
$389 |
2.3× |
| Hand 2 views (73120) |
$215.60 |
$385 |
1.9× |
| Knee 3 views (73562) |
$346.08 |
$618 |
3.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,914.52 |
$5,204.50 |
7.8× |
| MRA head w/o contrast (70544) |
$1,961.68 |
$3,503 |
7.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,736.72 |
$4,887 |
7.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,429.44 |
$6,124 |
9.2× |
| MRI abdomen w/o contrast (74181) |
$2,470.16 |
$4,411 |
9.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,478.16 |
$6,211 |
9.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,915.20 |
$3,420 |
7.5× |
| MRI cervical spine w/o contrast (72141) |
$2,447.76 |
$4,371 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$3,426.08 |
$6,118 |
9.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,431.12 |
$6,127 |
9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,083.20 |
$3,720 |
8.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,712.08 |
$4,843 |
7.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,081.68 |
$5,503 |
8.3× |
| MRI pelvis w/o contrast (72195) |
$2,494.24 |
$4,454 |
9.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,086.16 |
$5,511 |
8.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,292.24 |
$5,879 |
8.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,086.16 |
$5,511 |
8.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,447.76 |
$4,371 |
9.6× |
| MRI up ext w/o contrast (73218) |
$1,961.68 |
$3,503 |
7.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,961.68 |
$3,503 |
7.7× |
| MRI, joint upper extrem combo (73223) |
$2,859.92 |
$5,107 |
7.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,868.32 |
$5,122 |
2.1× |
| Neck soft tissue (70360) |
$215.60 |
$385 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$250.32 |
$447 |
2.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$246.96 |
$441 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$217.84 |
$389 |
2.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$246.96 |
$441 |
2.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$273.28 |
$488 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$207.20 |
$370 |
2.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$280 |
$500 |
3.0× |
| Radex Hand Minimum 3 Views (73130) |
$250.32 |
$447 |
2.7× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$223.44 |
$399 |
2.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$335.44 |
$599 |
3.0× |
| Radex Humerus Minimum 2 Views (73060) |
$223.44 |
$399 |
2.4× |
| Radex Kne 1/2 Views (73560) |
$246.96 |
$441 |
2.7× |
| Radex Kne Compl 4/More Views (73564) |
$308.56 |
$551 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$261.52 |
$467 |
2.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$292.32 |
$522 |
2.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$231.28 |
$413 |
2.5× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$171.36 |
$306 |
1.5× |
| Radex Toe Minimum 2 Views (73660) |
$234.64 |
$419 |
2.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$223.44 |
$399 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$196.56 |
$351 |
2.1× |
| Radiologic exam chest 2 views (71046) |
$211.68 |
$378 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$220.08 |
$393 |
2.4× |
| Ribs bilateral 3 views (71110) |
$247.52 |
$442 |
2.2× |
| Scapula (73010) |
$230.72 |
$412 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$43.12 |
$77 |
1.8× |
| Spine thoracic 3 views (72072) |
$258.16 |
$461 |
2.3× |
| Thoracolumbar 2 views (72080) |
$242.48 |
$433 |
2.6× |
| Ultrasound breast complete (76641) |
$454.16 |
$811 |
4.1× |
| Ultrasound Exam Aaa Screen (76706) |
$503.44 |
$899 |
4.5× |
| Ultrasound, abdomen limited (76705) |
$424.48 |
$758 |
3.8× |
| Us breast unilateral limited (76642) |
$323.68 |
$578 |
3.5× |
| Us chest (76604) |
$399.84 |
$714 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$527.52 |
$942 |
4.7× |
| Us elastography parenchyma (76981) |
$381.36 |
$681 |
3.4× |
| Us infant hips w manipulation (76885) |
$450.80 |
$805 |
4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$266 |
$475 |
2.4× |
| Us ob transvaginal (76817) |
$404.32 |
$722 |
3.6× |
| Us pelvic non ob complete (76856) |
$454.16 |
$811 |
4.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$318.64 |
$569 |
2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$441.84 |
$789 |
4.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$431.20 |
$770 |
3.9× |
| Us retroperitoneal complete (76770) |
$458.64 |
$819 |
4.1× |
| Us retroperitoneal limited (76775) |
$411.60 |
$735 |
3.7× |
| Us scrotum and contents (76870) |
$411.60 |
$735 |
3.7× |
| Us soft tissue head/neck (76536) |
$479.92 |
$857 |
4.3× |
| Wrist 2 views (73100) |
$226.24 |
$404 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$308.56 |
$551 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$273.28 |
$488 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$217.84 |
$389 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$327.04 |
$584 |
3.5× |
| X-ray exam of femur 2/> (73552) |
$253.68 |
$453 |
2.7× |
| X-ray eye for foreign body (70030) |
$211.68 |
$378 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$292.32 |
$522 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$258.16 |
$461 |
2.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$488.32 |
$872 |
4.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$303.52 |
$542 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$238.56 |
$426 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$347.20 |
$620 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$253.68 |
$453 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$211.68 |
$378 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$268.80 |
$480 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$284.48 |
$508 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$258.16 |
$461 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$268.80 |
$480 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$211.68 |
$378 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$246.96 |
$441 |
2.2× |
| Xr bone length studies (77073) |
$284.48 |
$508 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$319.20 |
$570 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$407.12 |
$727 |
3.6× |