| Abdomen 2 views (74019) |
$201.72 |
$336.20 |
1.9× |
| Ankle 2 views (73600) |
$148.70 |
$247.83 |
1.7× |
| Bone age studies (77072) |
$201.72 |
$336.20 |
1.9× |
| Bone survey complete (77075) |
$201.72 |
$336.20 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$148.70 |
$247.83 |
1.7× |
| Chest 1 view (71045) |
$148.70 |
$247.83 |
1.7× |
| Chest 3 views (71047) |
$163.25 |
$272.08 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$328.37 |
$547.29 |
1.9× |
| Clavicle complete (73000) |
$155.84 |
$259.74 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$200.14 |
$333.57 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,737 |
$2,895 |
5.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,440 |
$2,400 |
6.0× |
| CT abdomen w contrast (74160) |
$1,246.80 |
$2,078 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,550.40 |
$2,584 |
8.8× |
| CT abdomen w/o contrast (74150) |
$1,098 |
$1,830 |
10.5× |
| CT angiography upper extremity lt (73206) |
$1,233 |
$2,055 |
7.0× |
| CT c-spine w/o contrast (72125) |
$966 |
$1,610 |
9.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,136.33 |
$1,893.88 |
6.4× |
| CT cervical spine with contrast (72126) |
$1,153.20 |
$1,922 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,342.80 |
$2,238 |
7.6× |
| CT chest with contrast (71260) |
$1,176 |
$1,960 |
6.7× |
| CT head/brain with contrast (70460) |
$1,035 |
$1,725 |
5.9× |
| CT head/brain without and with contrast (70470) |
$1,179 |
$1,965 |
6.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$102.85 |
$171.42 |
1.2× |
| CT iac w contrast (70481) |
$1,330.18 |
$2,216.96 |
7.5× |
| CT lower ext w/o (73700) |
$742.80 |
$1,238 |
7.1× |
| CT lower extremity w wo contrast (73702) |
$924 |
$1,540 |
5.2× |
| CT lower extremity with contrast (73701) |
$820.20 |
$1,367 |
4.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,172.99 |
$1,954.99 |
6.7× |
| CT lumbar spine w/o contrast (72131) |
$936 |
$1,560 |
8.9× |
| CT lumbar spine with contrast (72132) |
$1,153.20 |
$1,922 |
3.3× |
| CT maxillofacial w contrast (70487) |
$1,076.40 |
$1,794 |
6.1× |
| CT maxillofacial w/o contrast (70486) |
$841.80 |
$1,403 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,260 |
$2,100 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$838.80 |
$1,398 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,405.31 |
$2,342.18 |
8.0× |
| CT orbits w/o contrast (70480) |
$975 |
$1,625 |
9.3× |
| CT pelvis w & w/o contrast (72194) |
$1,444.11 |
$2,406.85 |
8.2× |
| CT pelvis w/o contrast (72192) |
$925.80 |
$1,543 |
8.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$953.60 |
$1,589.34 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$690 |
$1,150 |
6.6× |
| CT thoracic spine w/contrast (72129) |
$1,153.20 |
$1,922 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$886.20 |
$1,477 |
8.4× |
| CT thorax w/o contrast (71250) |
$930 |
$1,550 |
8.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,140 |
$1,900 |
6.5× |
| CT upper extremity w/o contrast rt (73200) |
$688.20 |
$1,147 |
6.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,539.60 |
$2,566 |
8.7× |
| Cta Abdomen (74175) |
$1,246.80 |
$2,078 |
7.1× |
| CTA abdomen pelvis (74174) |
$1,485 |
$2,475 |
4.2× |
| CTA chest (71275) |
$1,437 |
$2,395 |
8.2× |
| Cta Head (70496) |
$1,056 |
$1,760 |
6.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,233 |
$2,055 |
7.0× |
| Cta Neck (70498) |
$1,197 |
$1,995 |
6.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$242.40 |
$404 |
2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$148.70 |
$247.83 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$423 |
$705 |
1.8× |
| Foot 2 views (73620) |
$148.70 |
$247.83 |
1.7× |
| Forearm 2 views (73090) |
$155.84 |
$259.74 |
1.8× |
| Hand 2 views (73120) |
$200.14 |
$333.57 |
1.9× |
| Hand 3 views (73130) |
$155.84 |
$259.74 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$155.84 |
$259.74 |
1.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$201.72 |
$336.20 |
1.9× |
| Knee 3 views (73562) |
$156.68 |
$261.14 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,480.80 |
$2,468 |
4.2× |
| MRA head w/o contrast (70544) |
$1,120.80 |
$1,868 |
4.7× |
| MRA neck w contrast (70548) |
$1,341 |
$2,235 |
3.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,768.20 |
$2,947 |
5.0× |
| MRA neck w/o contrast (70547) |
$1,167 |
$1,945 |
4.9× |
| MRI abdomen w contrast (74182) |
$1,249.80 |
$2,083 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,344.60 |
$2,241 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$970.20 |
$1,617 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$1,172.40 |
$1,954 |
4.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,227 |
$2,045 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,129.20 |
$1,882 |
4.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,227.60 |
$2,046 |
5.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,370.24 |
$2,283.74 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,194 |
$1,990 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$1,127.40 |
$1,879 |
4.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,740 |
$2,900 |
5.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,201.20 |
$2,002 |
3.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,671 |
$2,785 |
4.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,217.99 |
$2,029.98 |
3.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,629 |
$2,715 |
4.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,590 |
$2,650 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,250.40 |
$2,084 |
5.2× |
| MRI tmj (70336) |
$926.74 |
$1,544.56 |
3.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,216.80 |
$2,028 |
5.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,431 |
$2,385 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,176 |
$1,960 |
4.9× |
| Neck soft tissue (70360) |
$148.70 |
$247.83 |
1.7× |
| Osseous survey infant (77076) |
$201.72 |
$336.20 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$200.14 |
$333.57 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,324.80 |
$2,208 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$201.72 |
$336.20 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$200.14 |
$333.57 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$201.72 |
$336.20 |
1.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$249.60 |
$416 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$201.72 |
$336.20 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$148.70 |
$247.83 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$150 |
$250 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$182.80 |
$304.66 |
2.1× |
| Ribs bilateral 3 views (71110) |
$201.72 |
$336.20 |
1.9× |
| Scanogram (77073) |
$201.72 |
$336.20 |
1.9× |
| Scapula complete (73010) |
$201.72 |
$336.20 |
1.9× |
| Spine thoracic 3 views (72072) |
$249.60 |
$416 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$253.20 |
$422 |
2.4× |
| Upper Extremity Infant (73092) |
$201.72 |
$336.20 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$328.37 |
$547.29 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$238.82 |
$398.04 |
2.3× |
| Us breast unilateral complete (76641) |
$201.72 |
$336.20 |
1.9× |
| Us breast unilateral limited (76642) |
$145.62 |
$242.70 |
1.7× |
| Us chest (76604) |
$204.16 |
$340.26 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$228.60 |
$381 |
2.2× |
| Us ob transvaginal (76817) |
$167.38 |
$278.96 |
1.6× |
| Us pelvic non ob complete (76856) |
$333 |
$555 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$253.20 |
$422 |
2.4× |
| Us pregnancy ltd (76815) |
$130.44 |
$217.40 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$257.90 |
$429.83 |
2.5× |
| Us retroperitoneal complete (76770) |
$219 |
$365 |
2.1× |
| Us scrotum and contents (76870) |
$297 |
$495 |
2.8× |
| Us soft tissue head/neck (76536) |
$219 |
$365 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$212.40 |
$354 |
2.0× |
| Vertebral fracture assessment via dxa (77086) |
$148.70 |
$247.83 |
1.7× |
| Wrist 2 views (73100) |
$155.84 |
$259.74 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$209.64 |
$349.40 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$156.68 |
$261.14 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$155.84 |
$259.74 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$155.84 |
$259.74 |
1.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$249.60 |
$416 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$156.68 |
$261.14 |
1.8× |
| X-ray exam of femur 1 (73551) |
$148.70 |
$247.83 |
1.7× |
| X-ray eye for foreign body (70030) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$201.72 |
$336.20 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$156.68 |
$261.14 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$202.69 |
$337.81 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$201.72 |
$336.20 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$297.48 |
$495.80 |
2.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$201.72 |
$336.20 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$200.14 |
$333.57 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$200.14 |
$333.57 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$201.72 |
$336.20 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$200.14 |
$333.57 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$176.40 |
$294 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$155.84 |
$259.74 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$201.72 |
$336.20 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$288 |
$480 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$201.72 |
$336.20 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$201.72 |
$336.20 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$148.70 |
$247.83 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$155.84 |
$259.74 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$201.72 |
$336.20 |
1.9× |
| Xr chest 4+ views (71048) |
$201.72 |
$336.20 |
1.9× |
| Xr Cholecystography Oral Contrast (74290) |
$328.37 |
$547.29 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$155.84 |
$259.74 |
1.8× |
| Xr shoulder 1 view (73020) |
$155.84 |
$259.74 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$201.72 |
$336.20 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$150.47 |
$250.79 |
1.7× |
| Xr tmj bilateral (70330) |
$148.70 |
$247.83 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$148.70 |
$247.83 |
1.7× |