| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST |
$8,980.12 |
$8,980.12 |
— |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST |
$8,980.12 |
$8,980.12 |
— |
| CT scan of the head or brain, no contrast dye
CPT 70450
HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST |
$3,646.52 |
$3,646.52 |
— |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST |
$3,646.52 |
$3,646.52 |
— |
| CT scan of the pelvis, with contrast dye
CPT 72193
HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST |
$4,219.80 |
$4,219.80 |
— |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST |
$4,219.80 |
$4,219.80 |
— |
| Diagnostic mammogram, both breasts both sides
CPT 77066
HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL |
$1,140.26 |
$1,140.26 |
— |
| Diagnostic mammogram, both breasts both sides
CPT 77066
HC DX MAMMO INCL CAD BI - MG BREAST BILATERAL POST BIOPSY CLIP |
$1,140.26 |
$1,140.26 |
— |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL |
$1,140.26 |
$1,140.26 |
— |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
HC DX MAMMO INCL CAD BI - MG BREAST BILATERAL POST BIOPSY CLIP |
$1,140.26 |
$1,140.26 |
— |
| Diagnostic mammogram, one breast
CPT 77065
HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC |
$493.15 |
$493.15 |
— |
| Diagnostic mammogram, one breast inpatient
CPT 77065
HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC |
$493.15 |
$493.15 |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CONT |
$4,316.78 |
$4,316.78 |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT |
$4,316.78 |
$4,316.78 |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT W IV CONT |
$4,316.78 |
$4,316.78 |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT W IV CONT |
$5,162.43 |
$5,162.43 |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CONT |
$5,162.43 |
$5,162.43 |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT |
$5,929.36 |
$5,929.36 |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT |
$4,316.78 |
$4,316.78 |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT W IV CONT |
$4,316.78 |
$4,316.78 |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CONT |
$4,316.78 |
$4,316.78 |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT W IV CONT |
$5,162.43 |
$5,162.43 |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CONT |
$5,162.43 |
$5,162.43 |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT |
$5,929.36 |
$5,929.36 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR KNEE W AND WO IV CONTRAST |
$4,305.63 |
$4,305.63 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR HIP WO IV CONTRAST |
$4,347.39 |
$4,347.39 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR HIP W AND WO IV CONTRAST |
$6,533.84 |
$6,533.84 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST |
$6,533.84 |
$6,533.84 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST |
$6,533.84 |
$6,533.84 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR KNEE W AND WO IV CONTRAST |
$4,305.63 |
$4,305.63 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR HIP WO IV CONTRAST |
$4,347.39 |
$4,347.39 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR HIP W AND WO IV CONTRAST |
$6,533.84 |
$6,533.84 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST |
$6,533.84 |
$6,533.84 |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST |
$6,533.84 |
$6,533.84 |
— |
| MRI of the brain, no contrast dye
CPT 70551
HC MRI BRAIN - MRI BRAIN WO CONTRAST |
$5,071.56 |
$5,071.56 |
— |
| MRI of the brain, no contrast dye inpatient
CPT 70551
HC MRI BRAIN - MRI BRAIN WO CONTRAST |
$5,071.56 |
$5,071.56 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST-PERFUSION |
$6,171.95 |
$6,171.95 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST-SELLA |
$6,171.95 |
$6,171.95 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST W ORBITS |
$6,233.42 |
$6,233.42 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST-W WO SELLA |
$6,264.74 |
$6,264.74 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST |
$6,326.22 |
$6,326.22 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST- IAC |
$6,357.53 |
$6,357.53 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST- W WO PF |
$6,419.01 |
$6,419.01 |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
HC MRI BRAIN PERFUSION - MRI BRAIN W WO CONTRAST |
$6,419.01 |
$6,419.01 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST-PERFUSION |
$6,171.95 |
$6,171.95 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST-SELLA |
$6,171.95 |
$6,171.95 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST W ORBITS |
$6,233.42 |
$6,233.42 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST-W WO SELLA |
$6,264.74 |
$6,264.74 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST |
$6,326.22 |
$6,326.22 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST- IAC |
$6,357.53 |
$6,357.53 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN PERFUSION - MRI BRAIN W WO CONTRAST |
$6,419.01 |
$6,419.01 |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST- W WO PF |
$6,419.01 |
$6,419.01 |
— |
| MRI of the lower back, no contrast dye
CPT 72148
HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST |
$4,716.16 |
$4,716.16 |
— |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST |
$4,716.16 |
$4,716.16 |
— |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST |
$1,390.31 |
$1,390.31 |
— |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST |
$1,390.31 |
$1,390.31 |
— |
| Screening mammogram, both breasts both sides
CPT 77067
HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING |
$427.16 |
$427.16 |
— |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING |
$427.16 |
$427.16 |
— |
| Sleep study in a lab (polysomnography)
CPT 95810
HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND |
$7,205.52 |
$7,205.52 |
— |
| Sleep study in a lab (polysomnography) inpatient
CPT 95810
HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND |
$7,205.52 |
$7,205.52 |
— |
| Transvaginal pelvic ultrasound
CPT 76830
HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL |
$1,163.41 |
$1,163.41 |
— |
| Transvaginal pelvic ultrasound
CPT 76830
HC ECHOGRAPHY,TRANSVAGINAL |
$1,163.41 |
$1,163.41 |
— |
| Transvaginal pelvic ultrasound
CPT 76830
HC US TRANSVAGINAL W/DOPPLER |
$1,169.20 |
$1,169.20 |
— |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL |
$1,163.41 |
$1,163.41 |
— |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
HC ECHOGRAPHY,TRANSVAGINAL |
$1,163.41 |
$1,163.41 |
— |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
HC US TRANSVAGINAL W/DOPPLER |
$1,169.20 |
$1,169.20 |
— |
| Ultrasound of the abdomen, complete
CPT 76700
HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE |
$3,098.96 |
$3,098.96 |
— |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE |
$3,098.96 |
$3,098.96 |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS |
$1,447.03 |
$1,447.03 |
— |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS |
$1,447.03 |
$1,447.03 |
— |