| Abdomen 2 views (74019) |
$105 |
$105 |
1.1× |
| Ankle 2 views (73600) |
$130 |
$130 |
1.6× |
| Bone survey complete (77075) |
$918 |
$918 |
9.7× |
| Cervical spine 2 or 3 views (72040) |
$110 |
$110 |
1.4× |
| Chest 1 view (71045) |
$95 |
$95 |
1.2× |
| Clavicle complete (73000) |
$170 |
$170 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$100 |
$100 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,550 |
$3,550 |
11.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,800 |
$1,800 |
8.3× |
| CT abdomen w contrast (74160) |
$1,750 |
$1,750 |
11.0× |
| CT abdomen w wo contrast (74170) |
$2,050 |
$2,050 |
12.9× |
| CT c-spine w/o contrast (72125) |
$1,000 |
$1,000 |
10.6× |
| CT chest with contrast (71260) |
$1,790 |
$1,790 |
11.3× |
| CT head/brain with contrast (70460) |
$1,590 |
$1,590 |
10.0× |
| CT head/brain without and with contrast (70470) |
$1,790 |
$1,790 |
11.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$100 |
$100 |
1.3× |
| CT lower ext w/o (73700) |
$790 |
$790 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$1,790 |
$1,790 |
11.3× |
| CT lower extremity with contrast (73701) |
$1,480 |
$1,480 |
9.3× |
| CT lumbar spine w/o contrast (72131) |
$1,300 |
$1,300 |
13.7× |
| CT maxillofacial w contrast (70487) |
$1,590 |
$1,590 |
10.0× |
| CT maxillofacial w/o contrast (70486) |
$920 |
$920 |
9.7× |
| CT neck soft tissue w contrast (70491) |
$1,670 |
$1,670 |
10.5× |
| CT pelvis w/o contrast (72192) |
$1,000 |
$1,000 |
10.6× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$200 |
$200 |
2.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,040 |
$1,040 |
11.0× |
| CT thoracic spine w/o contrast (72128) |
$1,400 |
$1,400 |
14.8× |
| CT thorax w/o contrast (71250) |
$1,120 |
$1,120 |
11.8× |
| CT upper extremity w/o contrast rt (73200) |
$790 |
$790 |
8.3× |
| CTA chest (71275) |
$2,450 |
$2,450 |
15.4× |
| Foot 2 views (73620) |
$130 |
$130 |
1.6× |
| Forearm 2 views (73090) |
$160 |
$160 |
2.0× |
| Hand 2 views (73120) |
$130 |
$130 |
1.4× |
| Hand 3 views (73130) |
$170 |
$170 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$170 |
$170 |
2.2× |
| Neck soft tissue (70360) |
$120 |
$120 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$85 |
$85 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$120 |
$120 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$135 |
$135 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$105 |
$105 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$90 |
$90 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$105 |
$105 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$95 |
$95 |
1.2× |
| Ribs bilateral 3 views (71110) |
$155 |
$155 |
1.6× |
| Scapula complete (73010) |
$170 |
$170 |
1.8× |
| Spine thoracic 3 views (72072) |
$110 |
$110 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$170 |
$170 |
1.8× |
| Us breast unilateral complete (76641) |
$200 |
$200 |
2.1× |
| Us chest (76604) |
$125 |
$125 |
1.3× |
| Us pelvic non ob complete (76856) |
$180 |
$180 |
1.9× |
| Us retroperitoneal complete (76770) |
$190 |
$190 |
2.0× |
| Us retroperitoneal limited (76775) |
$125 |
$125 |
1.3× |
| Us soft tissue head/neck (76536) |
$165 |
$165 |
1.7× |
| Us xtr non-vasc lmtd (76882) |
$137.50 |
$137.50 |
1.5× |
| Wrist 2 views (73100) |
$130 |
$130 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$120 |
$120 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$170 |
$170 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$130 |
$130 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$95 |
$95 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$90 |
$90 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$105 |
$105 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$170 |
$170 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$140 |
$140 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$110 |
$110 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$110 |
$110 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$185 |
$185 |
2.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$95 |
$95 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$95 |
$95 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$140 |
$140 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$160 |
$160 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$125 |
$125 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$120 |
$120 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$85 |
$85 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$105 |
$105 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$125 |
$125 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$105 |
$105 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$125 |
$125 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$110 |
$110 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$150 |
$150 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$170 |
$170 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$150 |
$150 |
1.9× |
| Xr shoulder 1 view (73020) |
$140 |
$140 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$155 |
$155 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$95 |
$95 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$170 |
$170 |
2.2× |