| Abdomen 1 View (74018) |
— |
$253 |
— |
| Abdomen 2 views (74019) |
— |
$344 |
— |
| Ankle 2 views (73600) |
— |
$222 |
— |
| Chest 1 view (71045) |
— |
$281 |
— |
| Chest 2 views (71046) |
— |
$255 |
— |
| Clavicle complete (73000) |
— |
$240 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$563 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$1,815 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$1,271 |
— |
| CT abdomen w contrast (74160) |
— |
$1,053 |
— |
| CT abdomen w wo contrast (74170) |
— |
$1,263 |
— |
| CT abdomen w/o contrast (74150) |
— |
$944 |
— |
| CT Angio Chest (71275) |
— |
$1,362 |
— |
| CT bone density (77078) |
— |
$400 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$944 |
— |
| CT chest w contrast (71260) |
— |
$1,035 |
— |
| CT head/brain without and with contrast (70470) |
— |
$1,263 |
— |
| CT iac w contrast (70481) |
— |
$1,126 |
— |
| CT lower ext w/o (73700) |
— |
$854 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$990 |
— |
| CT lumbar spine w contrast (72132) |
— |
$1,089 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$944 |
— |
| CT maxillofacial w contrast (70487) |
— |
$944 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$854 |
— |
| CT orbits w/o contrast (70480) |
— |
$545 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$1,263 |
— |
| CT pelvis w/o contrast (72192) |
— |
$990 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$1,035 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,035 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$944 |
— |
| CT thorax w/o contrast (71250) |
— |
$491 |
— |
| CT upper ext wo (73200) |
— |
$944 |
— |
| CT upper extremity with contrast (73201) |
— |
$1,126 |
— |
| Foot 2 views (73620) |
— |
$225 |
— |
| Forearm 2 views (73090) |
— |
$208 |
— |
| Hand 2 views (73120) |
— |
$225 |
— |
| Knee 3 Views (73562) |
— |
$266 |
— |
| Neck soft tissue (70360) |
— |
$260 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$243 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$263 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$253 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$266 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$337 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$253 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$261 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$260 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$75 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$362 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$330 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$301 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$327 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$253 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$200 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$271 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$342 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$279 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$253 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$261 |
— |
| Ribs bilateral 3 views (71110) |
— |
$449 |
— |
| Scapula (73010) |
— |
$235 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$375 |
— |
| Skull less than 4 views (70250) |
— |
$359 |
— |
| Thoracic spine 2 views (72070) |
— |
$334 |
— |
| Thoracic spine 3 views (72072) |
— |
$363 |
— |
| Ultrasound Breast Limited (76642) |
— |
$375 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$495 |
— |
| Us breast unilateral complete (76641) |
— |
$438 |
— |
| Us chest (76604) |
— |
$438 |
— |
| Us complete joint (76881) |
— |
$248 |
— |
| Us ob detailed single fetus (76811) |
— |
$743 |
— |
| Us pelvic non ob complete (76856) |
— |
$454 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$660 |
— |
| Us retroperitoneal complete (76770) |
— |
$454 |
— |
| Us scrotum and contents (76870) |
— |
$273 |
— |
| Us thyroid (76536) |
— |
$273 |
— |
| Wrist 2 views (73100) |
— |
$182 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$738 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$319 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$375 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$486 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$370 |
— |
| X-ray humerus (73060) |
— |
$192 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$388 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$273 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$373 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$405 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$393 |
— |