| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT Abdomen and Pelvis W/ Contrast |
$5,409.60 |
$9,660.00 |
44% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT Abdomen and Pelvis W/ Contrast |
$5,409.60 |
$9,660.00 |
44% |
| CT scan of the head or brain, no contrast dye
CPT 70450
Head W/O Contrast |
$817.04 |
$1,459.00 |
44% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
Head W/O Contrast |
$817.04 |
$1,459.00 |
44% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT Pelvis W/ Contrast |
$2,123.52 |
$3,792.00 |
44% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT Pelvis W/ Contrast |
$2,123.52 |
$3,792.00 |
44% |
| Diagnostic mammogram, both breasts
CPT 77066
Mammography Dx-Bil |
$663.60 |
$1,185.00 |
44% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
Mammography Dx-Bil |
$663.60 |
$1,185.00 |
44% |
| Diagnostic mammogram, one breast one side
CPT 77065
Mammography Dx-Rt |
$442.40 |
$790.00 |
44% |
| Diagnostic mammogram, one breast one side
CPT 77065
Mammography Dx-Lt |
$442.40 |
$790.00 |
44% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
Mammography Dx-Rt |
$442.40 |
$790.00 |
44% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
Mammography Dx-Lt |
$442.40 |
$790.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
Hip Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
Ankle Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MRI Knee Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MRI Toe Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Hip Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Ankle Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Knee Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Knee Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Toe Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Hip Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Ankle Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Toe Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MRI Knee Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
Hip Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
Ankle Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MRI Toe Joint W/O Contrast-Bil |
$4,687.20 |
$8,370.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Knee Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Hip Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Toe Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Knee Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Ankle Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Hip Joint W/O Contrast-Rt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Ankle Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Toe Joint W/O Contrast-Lt |
$3,039.68 |
$5,428.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
Hip Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
Ankle Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Hip Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Hip Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
Hip Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
Ankle Joint W/O and W/ Contrast-Bil |
$6,537.44 |
$11,674.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Hip Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Hip Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Lt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Rt |
$6,199.20 |
$11,070.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
Iac W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
Pituitary W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
MRI Posterior Fossa W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
Brain W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
Brain W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
Iac W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
Pituitary W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI Posterior Fossa W/O Contrast |
$2,670.64 |
$4,769.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
Pituitary W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI Posterior Fossa W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
Brain W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
Iac W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
Iac W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI Posterior Fossa W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
Brain W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
Pituitary W/O and W/ Contrast |
$3,477.60 |
$6,210.00 |
44% |
| MRI of the lower back, no contrast dye
CPT 72148
MRI L-Spine W/O Contrast |
$2,327.36 |
$4,156.00 |
44% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MRI L-Spine W/O Contrast |
$2,327.36 |
$4,156.00 |
44% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB Ultra > 14 Weeks 1st Fetus, Complete |
$709.52 |
$1,267.00 |
44% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB Ultra > 14 Weeks 1st Fetus, Complete |
$709.52 |
$1,267.00 |
44% |
| Screening mammogram, both breasts
CPT 77067
Mammography Screening-Bil |
$441.84 |
$789.00 |
44% |
| Screening mammogram, both breasts one side
CPT 77067
Mammography Screening-Lt |
$294.56 |
$526.00 |
44% |
| Screening mammogram, both breasts one side
CPT 77067
Mammography Screening-Rt |
$294.56 |
$526.00 |
44% |
| Screening mammogram, both breasts inpatient
CPT 77067
Mammography Screening-Bil |
$441.84 |
$789.00 |
44% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
Mammography Screening-Rt |
$294.56 |
$526.00 |
44% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
Mammography Screening-Lt |
$294.56 |
$526.00 |
44% |
| Transvaginal pelvic ultrasound
CPT 76830
Transvaginal US Non OB |
$832.16 |
$1,486.00 |
44% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
Transvaginal US Non OB |
$832.16 |
$1,486.00 |
44% |
| Ultrasound of the abdomen, complete
CPT 76700
US Abdomen Complete |
$1,374.80 |
$2,455.00 |
44% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US Abdomen Complete |
$1,374.80 |
$2,455.00 |
44% |
| X-ray of the lower back, 4 or more views
CPT 72110
Spine Lumbosacral Min 4 Views |
$742.00 |
$1,325.00 |
44% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
Spine Lumbosacral Min 4 Views |
$742.00 |
$1,325.00 |
44% |