| Abdominal CT scan without and with contrast
CPT 74170
CT Abdomen W/O & W/Contrast |
$6,136.80 |
$6,136.80 |
$4,602.60 |
148% above |
— |
| Abdominal CT scan without and with contrast inpatient
CPT 74170
CT Abdomen W/O & W/Contrast |
$6,136.80 |
$6,136.80 |
$4,602.60 |
— |
— |
| Abdominal X-ray, 2 views
CPT 74019
RAD Abdomen 2 Vws |
$537.98 |
$537.98 |
$403.49 |
35% above |
— |
| Abdominal X-ray, 2 views inpatient
CPT 74019
RAD Abdomen 2 Vws |
$537.98 |
$537.98 |
$403.49 |
— |
— |
| Ankle X-ray, complete, 3 or more views both sides
CPT 73610
RAD Ankle 3 Views Bilat |
$456.05 |
$456.05 |
$342.04 |
— |
— |
| Ankle X-ray, complete, 3 or more views one side
CPT 73610
RAD Ankle 3 Views Rt |
$203.50 |
$203.50 |
$152.63 |
35% below |
— |
| Ankle X-ray, complete, 3 or more views one side
CPT 73610
RAD Ankle 3 Views Lt |
$203.50 |
$203.50 |
$152.63 |
35% below |
— |
| Ankle X-ray, complete, 3 or more views inpatient both sides
CPT 73610
RAD Ankle 3 Views Bilat |
$456.05 |
$456.05 |
$342.04 |
— |
— |
| Ankle X-ray, complete, 3 or more views inpatient one side
CPT 73610
RAD Ankle 3 Views Rt |
$203.50 |
$203.50 |
$152.63 |
— |
— |
| Ankle X-ray, complete, 3 or more views inpatient one side
CPT 73610
RAD Ankle 3 Views Lt |
$203.50 |
$203.50 |
$152.63 |
— |
— |
| Ankle-brachial index (ABI), blood pressure test for leg arteries
CPT 93922
US Tcpo2 Multi Modfr 52 |
$554.95 |
$554.95 |
$416.21 |
1% below |
— |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient
CPT 93922
US Tcpo2 Multi Modfr 52 |
$554.95 |
$554.95 |
$416.21 |
— |
— |
| Arm CT scan without contrast (shoulder to hand, any part)
CPT 73200
CT Upper Extremities w/o dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
142% above |
— |
| Arm CT scan without contrast (shoulder to hand, any part) one side
CPT 73200
CT Upper Extrm W/O Dye Rt |
$8,200.00 |
$8,200.00 |
$6,150.00 |
457% above |
— |
| Arm CT scan without contrast (shoulder to hand, any part) one side
CPT 73200
CT Upper Extrm W/O Dye Lt |
$8,200.00 |
$8,200.00 |
$6,150.00 |
457% above |
— |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient
CPT 73200
CT Upper Extremities w/o dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side
CPT 73200
CT Upper Extrm W/O Dye Lt |
$8,200.00 |
$8,200.00 |
$6,150.00 |
— |
— |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side
CPT 73200
CT Upper Extrm W/O Dye Rt |
$8,200.00 |
$8,200.00 |
$6,150.00 |
— |
— |
| Barium swallow (esophagus X-ray with contrast)
CPT 74220
RAD Contrast Exam of Esophagus |
$613.85 |
$613.85 |
$460.39 |
2% below |
— |
| Barium swallow (esophagus X-ray with contrast) inpatient
CPT 74220
RAD Contrast Exam of Esophagus |
$613.85 |
$613.85 |
$460.39 |
— |
— |
| Bone scan, whole body (nuclear medicine)
CPT 78306
NM Bone Scan Whole B |
$2,015.55 |
$2,015.55 |
$1,511.66 |
21% above |
— |
| Bone scan, whole body (nuclear medicine) inpatient
CPT 78306
NM Bone Scan Whole B |
$2,015.55 |
$2,015.55 |
$1,511.66 |
— |
— |
| Breast ultrasound, complete, one breast
CPT 76641
US Ultrasound Breast Complete |
$1,479.08 |
$1,479.08 |
$1,109.31 |
355% above |
— |
| Breast ultrasound, complete, one breast inpatient
CPT 76641
US Ultrasound Breast Complete |
$1,479.08 |
$1,479.08 |
$1,109.31 |
— |
— |
| Breast ultrasound, limited (one breast or one area)
CPT 76642
US Breast Limited |
$1,733.94 |
$1,733.94 |
$1,300.46 |
594% above |
— |
| Breast ultrasound, limited (one breast or one area) inpatient
CPT 76642
US Breast Limited |
$1,733.94 |
$1,733.94 |
$1,300.46 |
— |
— |
| CT angiography (CTA) of the abdomen and pelvis
CPT 74174
CT Angio Abd&pelv W/O&w/Contra |
$4,909.45 |
$4,909.45 |
$3,682.09 |
42% above |
— |
| CT angiography (CTA) of the abdomen and pelvis inpatient
CPT 74174
CT Angio Abd&pelv W/O&w/Contra |
$4,909.45 |
$4,909.45 |
$3,682.09 |
— |
— |
| CT angiography (CTA) of the head
CPT 70496
CT Spiral Angiography Head |
$3,671.00 |
$3,671.00 |
$2,753.25 |
53% above |
— |
| CT angiography (CTA) of the head inpatient
CPT 70496
CT Spiral Angiography Head |
$3,671.00 |
$3,671.00 |
$2,753.25 |
— |
— |
| CT angiography (CTA) of the neck
CPT 70498
CT Angiography Neck |
$5,378.22 |
$5,378.22 |
$4,033.67 |
124% above |
— |
| CT angiography (CTA) of the neck inpatient
CPT 70498
CT Angiography Neck |
$5,378.22 |
$5,378.22 |
$4,033.67 |
— |
— |
| CT angiography of the chest (CTA), for blood clots in the lungs
CPT 71275
CT Angiography Chest w/Contras |
$6,213.35 |
$6,213.35 |
$4,660.01 |
251% above |
— |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient
CPT 71275
CT Angiography Chest w/Contras |
$6,213.35 |
$6,213.35 |
$4,660.01 |
— |
— |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score
CPT 75574
CT Angio Hrt W/3d Image |
$5,551.20 |
$5,551.20 |
$4,163.40 |
295% above |
— |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient
CPT 75574
CT Angio Hrt W/3d Image |
$5,551.20 |
$5,551.20 |
$4,163.40 |
— |
— |
| CT scan of abdomen and pelvis, no contrast dye
CPT 74176
CT Abd & Pelvis W/O Contrast |
$5,348.70 |
$5,348.70 |
$4,011.53 |
319% above |
— |
| CT scan of abdomen and pelvis, no contrast dye inpatient
CPT 74176
CT Abd & Pelvis W/O Contrast |
$5,348.70 |
$5,348.70 |
$4,011.53 |
— |
— |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT Abdomen & Pelvis w/Contrast |
$8,264.00 |
$8,264.00 |
$6,198.00 |
267% above |
— |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT Abdomen & Pelvis w/Contrast |
$8,264.00 |
$8,264.00 |
$6,198.00 |
— |
— |
| CT scan of abdomen and pelvis, without and then with contrast dye
CPT 74178
CT Abd & Pelv 1/> Regns w/wo c |
$9,205.20 |
$9,205.20 |
$6,903.90 |
193% above |
— |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient
CPT 74178
CT Abd & Pelv 1/> Regns w/wo c |
$9,205.20 |
$9,205.20 |
$6,903.90 |
— |
— |
| CT scan of the abdomen with contrast
CPT 74160
CT Abdomen W/Contrast |
$5,509.35 |
$5,509.35 |
$4,132.01 |
256% above |
— |
| CT scan of the abdomen with contrast inpatient
CPT 74160
CT Abdomen W/Contrast |
$5,509.35 |
$5,509.35 |
$4,132.01 |
— |
— |
| CT scan of the abdomen without contrast
CPT 74150
CT Abdomen W/O Contrast |
$3,565.80 |
$3,565.80 |
$2,674.35 |
249% above |
— |
| CT scan of the abdomen without contrast inpatient
CPT 74150
CT Abdomen W/O Contrast |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| CT scan of the face and sinuses, no contrast dye
CPT 70486
CT Maxillofacial w/o contrast |
$3,565.80 |
$3,565.80 |
$2,674.35 |
224% above |
— |
| CT scan of the face and sinuses, no contrast dye inpatient
CPT 70486
CT Maxillofacial w/o contrast |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT Head/Brain W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
331% above |
— |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT Head/Brain W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| CT scan of the head with contrast
CPT 70460
CT Head/Brain W/Contrast |
$5,509.35 |
$5,509.35 |
$4,132.01 |
359% above |
— |
| CT scan of the head with contrast inpatient
CPT 70460
CT Head/Brain W/Contrast |
$5,509.35 |
$5,509.35 |
$4,132.01 |
— |
— |
| CT scan of the head without and with contrast
CPT 70470
CT Head/Brain W/O & W/Dye |
$6,136.80 |
$6,136.80 |
$4,602.60 |
340% above |
— |
| CT scan of the head without and with contrast inpatient
CPT 70470
CT Head/Brain W/O & W/Dye |
$6,136.80 |
$6,136.80 |
$4,602.60 |
— |
— |
| CT scan of the lower back (lumbar spine) without contrast
CPT 72131
CT Lumbar Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
244% above |
— |
| CT scan of the lower back (lumbar spine) without contrast inpatient
CPT 72131
CT Lumbar Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| CT scan of the neck (cervical spine), no contrast dye
CPT 72125
CT C-Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
241% above |
— |
| CT scan of the neck (cervical spine), no contrast dye inpatient
CPT 72125
CT C-Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT Pelvis W/Dye |
$5,509.35 |
$5,509.35 |
$4,132.01 |
165% above |
— |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT Pelvis W/Dye |
$5,509.35 |
$5,509.35 |
$4,132.01 |
— |
— |
| Carotid artery ultrasound (duplex), both sides of the neck
CPT 93880
Duplex Scan/Carotid |
$1,794.00 |
$1,794.00 |
$1,345.50 |
7% above |
— |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient
CPT 93880
Duplex Scan/Carotid |
$1,794.00 |
$1,794.00 |
$1,345.50 |
— |
— |
| Chest CT scan without and with contrast
CPT 71270
CT Chest W/O & W/Dye |
$6,136.80 |
$6,136.80 |
$4,602.60 |
249% above |
— |
| Chest CT scan without and with contrast inpatient
CPT 71270
CT Chest W/O & W/Dye |
$6,136.80 |
$6,136.80 |
$4,602.60 |
— |
— |
| Chest X-ray, 2 views
CPT 71046
RAD Chest 2 Views |
$549.75 |
$549.75 |
$412.31 |
59% above |
— |
| Chest X-ray, 2 views inpatient
CPT 71046
RAD Chest 2 Views |
$549.75 |
$549.75 |
$412.31 |
— |
— |
| Chest X-ray, single view
CPT 71045
RAD Chest 1 View |
$308.50 |
$308.50 |
$231.38 |
8% above |
— |
| Chest X-ray, single view inpatient
CPT 71045
RAD Chest 1 View |
$308.50 |
$308.50 |
$231.38 |
— |
— |
| Collarbone (clavicle) X-ray, complete both sides
CPT 73000
RAD Clavicle Comp Bilat |
$380.00 |
$380.00 |
$285.00 |
— |
— |
| Collarbone (clavicle) X-ray, complete
CPT 73000
RAD Clavicle 2 Views |
$308.80 |
$308.80 |
$231.60 |
4% above |
— |
| Collarbone (clavicle) X-ray, complete inpatient both sides
CPT 73000
RAD Clavicle Comp Bilat |
$380.00 |
$380.00 |
$285.00 |
— |
— |
| Collarbone (clavicle) X-ray, complete inpatient
CPT 73000
RAD Clavicle 2 Views |
$308.80 |
$308.80 |
$231.60 |
— |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys
CPT 76770
US Exam Abdo Back Wall Comp |
$1,020.85 |
$1,020.85 |
$765.64 |
156% above |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys
CPT 76770
Renal Ultrasound Complete |
$1,415.51 |
$1,415.51 |
$1,061.63 |
255% above |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient
CPT 76770
US Exam Abdo Back Wall Comp |
$1,020.85 |
$1,020.85 |
$765.64 |
— |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient
CPT 76770
Renal Ultrasound Complete |
$1,415.51 |
$1,415.51 |
$1,061.63 |
— |
— |
| DEXA bone density scan of the hip, pelvis or spine
CPT 77080
DXA Bone Density Axial |
$501.26 |
$501.26 |
$375.95 |
94% above |
— |
| DEXA bone density scan of the hip, pelvis or spine inpatient
CPT 77080
DXA Bone Density Axial |
$501.26 |
$501.26 |
$375.95 |
— |
— |
| Diagnostic CT scan of the chest, no contrast dye
CPT 71250
CT Chest w/o Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
111% above |
— |
| Diagnostic CT scan of the chest, no contrast dye inpatient
CPT 71250
CT Chest w/o Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| Diagnostic CT scan of the chest, with contrast dye
CPT 71260
CT Chest W/ Dye |
$5,509.35 |
$5,509.35 |
$4,132.01 |
289% above |
— |
| Diagnostic CT scan of the chest, with contrast dye inpatient
CPT 71260
CT Chest W/ Dye |
$5,509.35 |
$5,509.35 |
$4,132.01 |
— |
— |
| Duplex ultrasound of the leg arteries, both legs
CPT 93925
Noninv Extreme Art L |
$1,713.20 |
$1,713.20 |
$1,284.90 |
— |
— |
| Duplex ultrasound of the leg arteries, both legs inpatient
CPT 93925
Noninv Extreme Art L |
$1,713.20 |
$1,713.20 |
$1,284.90 |
— |
— |
| Duplex ultrasound of the leg veins, both legs both sides
CPT 93970
Doppler Upper Extrem bilat |
$714.65 |
$714.65 |
$535.99 |
— |
— |
| Duplex ultrasound of the leg veins, both legs inpatient both sides
CPT 93970
Doppler Upper Extrem bilat |
$714.65 |
$714.65 |
$535.99 |
— |
— |
| Echocardiogram through the chest wall, complete, with Doppler
CPT 93306
Echo Transthoracic 2d |
$1,063.70 |
$1,063.70 |
$797.78 |
45% below |
— |
| Echocardiogram through the chest wall, complete, with Doppler inpatient
CPT 93306
Echo Transthoracic 2d |
$1,063.70 |
$1,063.70 |
$797.78 |
— |
— |
| Elbow X-ray, 2 views one side
CPT 73070
RAD Elbow 2 Views Rt |
$211.75 |
$211.75 |
$158.81 |
15% below |
— |
| Elbow X-ray, 2 views one side
CPT 73070
RAD Elbow 2 Views Lt |
$211.75 |
$211.75 |
$158.81 |
15% below |
— |
| Elbow X-ray, 2 views inpatient one side
CPT 73070
RAD Elbow 2 Views Lt |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Elbow X-ray, 2 views inpatient one side
CPT 73070
RAD Elbow 2 Views Rt |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Elbow X-ray, complete, 3 or more views one side
CPT 73080
RAD Elbow 3 Views Rt |
$211.75 |
$211.75 |
$158.81 |
32% below |
— |
| Elbow X-ray, complete, 3 or more views one side
CPT 73080
RAD Elbow 3 Views Lt |
$211.75 |
$211.75 |
$158.81 |
32% below |
— |
| Elbow X-ray, complete, 3 or more views inpatient one side
CPT 73080
RAD Elbow 3 Views Lt |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Elbow X-ray, complete, 3 or more views inpatient one side
CPT 73080
RAD Elbow 3 Views Rt |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Eye socket (orbit) CT scan without contrast
CPT 70480
CT Orbit/Ear/Fossa W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
188% above |
— |
| Eye socket (orbit) CT scan without contrast inpatient
CPT 70480
CT Orbit/Ear/Fossa W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| Facial bones X-ray, complete, 3 or more views
CPT 70150
RAD Facial Bones 3 Views |
$523.50 |
$523.50 |
$392.63 |
24% above |
— |
| Facial bones X-ray, complete, 3 or more views inpatient
CPT 70150
RAD Facial Bones 3 Views |
$523.50 |
$523.50 |
$392.63 |
— |
— |
| Forearm X-ray (radius and ulna), 2 views one side
CPT 73090
RAD Forearm 2 Views Lt |
$354.75 |
$354.75 |
$266.06 |
14% above |
— |
| Forearm X-ray (radius and ulna), 2 views one side
CPT 73090
RAD Forearm 2 Views Rt |
$354.75 |
$354.75 |
$266.06 |
14% above |
— |
| Forearm X-ray (radius and ulna), 2 views inpatient one side
CPT 73090
RAD Forearm 2 Views Lt |
$354.75 |
$354.75 |
$266.06 |
— |
— |
| Forearm X-ray (radius and ulna), 2 views inpatient one side
CPT 73090
RAD Forearm 2 Views Rt |
$354.75 |
$354.75 |
$266.06 |
— |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder
CPT 78226
NM Hepatobiliary |
$1,864.50 |
$1,864.50 |
$1,398.38 |
42% above |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient
CPT 78226
NM Hepatobiliary |
$1,864.50 |
$1,864.50 |
$1,398.38 |
— |
— |
| Hand X-ray, 2 views both sides
CPT 73120
RAD Hand 2+ Views Bilat |
$462.00 |
$462.00 |
$346.50 |
— |
— |
| Hand X-ray, 2 views one side
CPT 73120
RAD Hand 2+ Views Rt |
$335.50 |
$335.50 |
$251.63 |
at median |
— |
| Hand X-ray, 2 views one side
CPT 73120
RAD Hand 2+ Views Lt |
$335.50 |
$335.50 |
$251.63 |
at median |
— |
| Hand X-ray, 2 views inpatient both sides
CPT 73120
RAD Hand 2+ Views Bilat |
$462.00 |
$462.00 |
$346.50 |
— |
— |
| Hand X-ray, 2 views inpatient one side
CPT 73120
RAD Hand 2+ Views Lt |
$335.50 |
$335.50 |
$251.63 |
— |
— |
| Hand X-ray, 2 views inpatient one side
CPT 73120
RAD Hand 2+ Views Rt |
$335.50 |
$335.50 |
$251.63 |
— |
— |
| Heel bone (calcaneus) X-ray, 2 or more views both sides
CPT 73650
RAD CalcaneUS 2+ View Bilat |
$545.70 |
$545.70 |
$409.28 |
— |
— |
| Heel bone (calcaneus) X-ray, 2 or more views one side
CPT 73650
RAD CalcaneUS 2+ View Rt |
$193.85 |
$193.85 |
$145.39 |
34% below |
— |
| Heel bone (calcaneus) X-ray, 2 or more views one side
CPT 73650
RAD CalcaneUS 2+ View Lt |
$193.85 |
$193.85 |
$145.39 |
34% below |
— |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides
CPT 73650
RAD CalcaneUS 2+ View Bilat |
$545.70 |
$545.70 |
$409.28 |
— |
— |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side
CPT 73650
RAD CalcaneUS 2+ View Rt |
$193.85 |
$193.85 |
$145.39 |
— |
— |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side
CPT 73650
RAD CalcaneUS 2+ View Lt |
$193.85 |
$193.85 |
$145.39 |
— |
— |
| Knee X-ray, 3 views both sides
CPT 73562
RAD Knee 3 Views Bilat |
$679.70 |
$679.70 |
$509.78 |
— |
— |
| Knee X-ray, 3 views one side
CPT 73562
RAD Knee 3 Views Lt |
$402.85 |
$402.85 |
$302.14 |
30% above |
— |
| Knee X-ray, 3 views one side
CPT 73562
RAD Knee 3 Views Rt |
$402.85 |
$402.85 |
$302.14 |
30% above |
— |
| Knee X-ray, 3 views inpatient both sides
CPT 73562
RAD Knee 3 Views Bilat |
$679.70 |
$679.70 |
$509.78 |
— |
— |
| Knee X-ray, 3 views inpatient one side
CPT 73562
RAD Knee 3 Views Lt |
$402.85 |
$402.85 |
$302.14 |
— |
— |
| Knee X-ray, 3 views inpatient one side
CPT 73562
RAD Knee 3 Views Rt |
$402.85 |
$402.85 |
$302.14 |
— |
— |
| Knee X-ray, complete, 4 or more views one side
CPT 73564
RAD Knee 4+ Views-Left |
$672.00 |
$672.00 |
$504.00 |
73% above |
— |
| Knee X-ray, complete, 4 or more views one side
CPT 73564
RAD Knee 4+ Views-Right |
$672.00 |
$672.00 |
$504.00 |
73% above |
— |
| Knee X-ray, complete, 4 or more views inpatient one side
CPT 73564
RAD Knee 4+ Views-Left |
$672.00 |
$672.00 |
$504.00 |
— |
— |
| Knee X-ray, complete, 4 or more views inpatient one side
CPT 73564
RAD Knee 4+ Views-Right |
$672.00 |
$672.00 |
$504.00 |
— |
— |
| Leg CT scan without contrast (hip to foot, any part) one side
CPT 73700
CT Lower Extremity W/O Dye Lt |
$2,941.10 |
$2,941.10 |
$2,205.83 |
184% above |
— |
| Leg CT scan without contrast (hip to foot, any part) one side
CPT 73700
CT Lower Extremity W/O Dye Rt |
$2,941.10 |
$2,941.10 |
$2,205.83 |
184% above |
— |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side
CPT 73700
CT Lower Extremity W/O Dye Lt |
$2,941.10 |
$2,941.10 |
$2,205.83 |
— |
— |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side
CPT 73700
CT Lower Extremity W/O Dye Rt |
$2,941.10 |
$2,941.10 |
$2,205.83 |
— |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder
CPT 76705
US Exam Abdomen Limited |
$978.85 |
$978.85 |
$734.14 |
182% above |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient
CPT 76705
US Exam Abdomen Limited |
$978.85 |
$978.85 |
$734.14 |
— |
— |
| Limited ultrasound of an arm or leg (non-vascular) one side
CPT 76882
US Extrem LimitED Lt |
$702.60 |
$702.60 |
$526.95 |
282% above |
— |
| Limited ultrasound of an arm or leg (non-vascular) one side
CPT 76882
US Extrem LimitED Rt |
$702.60 |
$702.60 |
$526.95 |
282% above |
— |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side
CPT 76882
US Extrem LimitED Rt |
$702.60 |
$702.60 |
$526.95 |
— |
— |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side
CPT 76882
US Extrem LimitED Lt |
$702.60 |
$702.60 |
$526.95 |
— |
— |
| Lower leg X-ray (tibia and fibula), 2 views
CPT 73590
RAD Tib Fib Ap&lat |
$523.50 |
$523.50 |
$392.63 |
86% above |
— |
| Lower leg X-ray (tibia and fibula), 2 views one side
CPT 73590
RAD Tibia/Fibula Rt |
$203.50 |
$203.50 |
$152.63 |
28% below |
— |
| Lower leg X-ray (tibia and fibula), 2 views one side
CPT 73590
RAD Tibia/Fibula Lt |
$236.40 |
$236.40 |
$177.30 |
16% below |
— |
| Lower leg X-ray (tibia and fibula), 2 views inpatient
CPT 73590
RAD Tib Fib Ap&lat |
$523.50 |
$523.50 |
$392.63 |
— |
— |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side
CPT 73590
RAD Tibia/Fibula Rt |
$203.50 |
$203.50 |
$152.63 |
— |
— |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side
CPT 73590
RAD Tibia/Fibula Lt |
$236.40 |
$236.40 |
$177.30 |
— |
— |
| MR angiography (MRA) of the head without contrast
CPT 70544
MRA Angiography Head w/o Contr |
$3,785.04 |
$3,785.04 |
$2,838.78 |
104% above |
— |
| MR angiography (MRA) of the head without contrast inpatient
CPT 70544
MRA Angiography Head w/o Contr |
$3,785.04 |
$3,785.04 |
$2,838.78 |
— |
— |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MRI Jnt of Lwr Extre W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
289% above |
— |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MRI Jnt of Lwr Extre W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MRI Joint Lwr Extr W/O&w/Dye R |
$6,305.10 |
$6,305.10 |
$4,728.83 |
87% above |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MRI Joint Lwr Extr W/O&w/Dye R |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the abdomen without contrast
CPT 74181
MRI Abdomen W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
331% above |
— |
| MRI of the abdomen without contrast inpatient
CPT 74181
MRI Abdomen W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the abdomen, without and then with contrast dye
CPT 74183
MRI Angio Abdom W Orw/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
123% above |
— |
| MRI of the abdomen, without and then with contrast dye inpatient
CPT 74183
MRI Angio Abdom W Orw/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the brain, no contrast dye
CPT 70551
MRI Brain Stem W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
324% above |
— |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI Brain Stem W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI Brain Stem W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
291% above |
— |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI Brain Stem W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
— |
— |
| MRI of the lower back, no contrast dye
CPT 72148
MRI Lumbar Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
328% above |
— |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MRI Lumbar Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the lower back, without and then with contrast dye
CPT 72158
MRI Lumbar Spine W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
287% above |
— |
| MRI of the lower back, without and then with contrast dye inpatient
CPT 72158
MRI Lumbar Spine W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
— |
— |
| MRI of the mid back (thoracic spine), no contrast dye
CPT 72146
MRI Thoracic Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
329% above |
— |
| MRI of the mid back (thoracic spine), no contrast dye inpatient
CPT 72146
MRI Thoracic Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the neck (cervical spine) without and with contrast
CPT 72156
MRI Neck Spine W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
286% above |
— |
| MRI of the neck (cervical spine) without and with contrast inpatient
CPT 72156
MRI Neck Spine W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
— |
— |
| MRI of the neck (cervical spine), no contrast dye
CPT 72141
MRI Neck Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
329% above |
— |
| MRI of the neck (cervical spine), no contrast dye inpatient
CPT 72141
MRI Neck Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the pelvis without and with contrast
CPT 72197
MRI Pelvis W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
247% above |
— |
| MRI of the pelvis without and with contrast inpatient
CPT 72197
MRI Pelvis W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$7,345.76 |
— |
— |
| MRI of the pelvis, no contrast dye
CPT 72195
MRI Pelvis W/O Dye |
$5,262.62 |
$5,262.62 |
$3,946.97 |
228% above |
— |
| MRI of the pelvis, no contrast dye inpatient
CPT 72195
MRI Pelvis W/O Dye |
$5,262.62 |
$5,262.62 |
$3,946.97 |
— |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye
CPT 73221
MRI Uppr Ext Jnt W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
289% above |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye
CPT 73221
MRI Upper Ext Jnt |
$6,305.10 |
$6,305.10 |
$4,728.83 |
289% above |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient
CPT 73221
MRI Upper Ext Jnt |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient
CPT 73221
MRI Uppr Ext Jnt W/O Dye |
$6,305.10 |
$6,305.10 |
$4,728.83 |
— |
— |
| Neck (cervical spine) X-ray, 4 or 5 views
CPT 72050
RAD Exam Neck Spine 4/5vws |
$2,133.60 |
$2,133.60 |
$1,600.20 |
401% above |
— |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient
CPT 72050
RAD Exam Neck Spine 4/5vws |
$2,133.60 |
$2,133.60 |
$1,600.20 |
— |
— |
| Neck soft tissue CT scan with contrast
CPT 70491
CT Neck Soft Tiss W/ |
$5,509.35 |
$5,509.35 |
$4,132.01 |
262% above |
— |
| Neck soft tissue CT scan with contrast inpatient
CPT 70491
CT Neck Soft Tiss W/ |
$5,509.35 |
$5,509.35 |
$4,132.01 |
— |
— |
| Neck soft tissue CT scan without contrast
CPT 70490
CT Soft Tissue Neck W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
213% above |
— |
| Neck soft tissue CT scan without contrast inpatient
CPT 70490
CT Soft Tissue Neck W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| Neck soft tissue X-ray
CPT 70360
RAD Neck Soft Tissue |
$209.00 |
$209.00 |
$156.75 |
12% below |
— |
| Neck soft tissue X-ray inpatient
CPT 70360
RAD Neck Soft Tissue |
$209.00 |
$209.00 |
$156.75 |
— |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies
CPT 78452
NM Hrt Muscle Image Spect |
$5,052.27 |
$5,052.27 |
$3,789.20 |
39% above |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient
CPT 78452
NM Hrt Muscle Image Spect |
$5,052.27 |
$5,052.27 |
$3,789.20 |
— |
— |
| PET/CT scan from the base of the skull to mid-thigh
CPT 78815
NM Tumor Image Pet/CT Skul-T |
$28,516.32 |
$28,516.32 |
$21,387.24 |
292% above |
— |
| PET/CT scan from the base of the skull to mid-thigh inpatient
CPT 78815
NM Tumor Image Pet/CT Skul-T |
$28,516.32 |
$28,516.32 |
$21,387.24 |
— |
— |
| Pelvic CT scan without contrast
CPT 72192
CT Pelvis W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
245% above |
— |
| Pelvic CT scan without contrast inpatient
CPT 72192
CT Pelvis W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up
CPT 76857
US Exam Pelvic Limited |
$907.30 |
$907.30 |
$680.48 |
262% above |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient
CPT 76857
US Exam Pelvic Limited |
$907.30 |
$907.30 |
$680.48 |
— |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy)
CPT 76856
US Exam Pelvic Complete |
$1,130.75 |
$1,130.75 |
$848.06 |
225% above |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient
CPT 76856
US Exam Pelvic Complete |
$1,130.75 |
$1,130.75 |
$848.06 |
— |
— |
| Rib X-ray, one side, 2 views one side
CPT 71100
RAD Ribs Unilat 2 Vws Lt |
$453.75 |
$453.75 |
$340.31 |
23% above |
— |
| Rib X-ray, one side, 2 views one side
CPT 71100
RAD Ribs Unilat 2 Vws Rt |
$453.75 |
$453.75 |
$340.31 |
23% above |
— |
| Rib X-ray, one side, 2 views inpatient one side
CPT 71100
RAD Ribs Unilat 2 Vws Lt |
$453.75 |
$453.75 |
$340.31 |
— |
— |
| Rib X-ray, one side, 2 views inpatient one side
CPT 71100
RAD Ribs Unilat 2 Vws Rt |
$453.75 |
$453.75 |
$340.31 |
— |
— |
| Rib X-ray, one side, with a chest view, 3 or more views one side
CPT 71101
RAD Ribs Uni W/Pa Cht Rt |
$453.75 |
$453.75 |
$340.31 |
14% above |
— |
| Rib X-ray, one side, with a chest view, 3 or more views one side
CPT 71101
RAD Ribs Uni W/Pa Cht Lt |
$453.75 |
$453.75 |
$340.31 |
14% above |
— |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side
CPT 71101
RAD Ribs Uni W/Pa Cht Rt |
$453.75 |
$453.75 |
$340.31 |
— |
— |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side
CPT 71101
RAD Ribs Uni W/Pa Cht Lt |
$453.75 |
$453.75 |
$340.31 |
— |
— |
| Screening mammogram, both breasts both sides
CPT 77067
Screening Mammo Bilat |
$1,628.79 |
$1,628.79 |
$1,221.59 |
— |
— |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
Screening Mammo Bilat |
$1,628.79 |
$1,628.79 |
$1,221.59 |
— |
— |
| Shoulder X-ray, complete, 2 or more views
CPT 73030
RAD Shoulder Complete |
$733.45 |
$733.45 |
$550.09 |
147% above |
— |
| Shoulder X-ray, complete, 2 or more views one side
CPT 73030
RAD Shoulder 2 Views Lt |
$407.00 |
$407.00 |
$305.25 |
37% above |
— |
| Shoulder X-ray, complete, 2 or more views one side
CPT 73030
RAD Shoulder 2 Views Rt |
$407.00 |
$407.00 |
$305.25 |
37% above |
— |
| Shoulder X-ray, complete, 2 or more views inpatient
CPT 73030
RAD Shoulder Complete |
$733.45 |
$733.45 |
$550.09 |
— |
— |
| Shoulder X-ray, complete, 2 or more views inpatient one side
CPT 73030
RAD Shoulder 2 Views Rt |
$407.00 |
$407.00 |
$305.25 |
— |
— |
| Shoulder X-ray, complete, 2 or more views inpatient one side
CPT 73030
RAD Shoulder 2 Views Lt |
$407.00 |
$407.00 |
$305.25 |
— |
— |
| Sinus X-ray, complete, 3 or more views
CPT 70220
RAD Sinuses Paranasal |
$523.05 |
$523.05 |
$392.29 |
25% above |
— |
| Sinus X-ray, complete, 3 or more views inpatient
CPT 70220
RAD Sinuses Paranasal |
$523.05 |
$523.05 |
$392.29 |
— |
— |
| Skull X-ray, fewer than 4 views
CPT 70250
RAD Exam of Skull <4 views |
$301.00 |
$301.00 |
$225.75 |
8% below |
— |
| Skull X-ray, fewer than 4 views inpatient
CPT 70250
RAD Exam of Skull <4 views |
$301.00 |
$301.00 |
$225.75 |
— |
— |
| Swallow study (modified barium swallow, video X-ray)
CPT 74230
RAD Cine/Vid Throat/Esoph MBSS |
$854.45 |
$854.45 |
$640.84 |
29% above |
— |
| Swallow study (modified barium swallow, video X-ray) inpatient
CPT 74230
RAD Cine/Vid Throat/Esoph MBSS |
$854.45 |
$854.45 |
$640.84 |
— |
— |
| Thigh bone (femur) X-ray, 2 or more views
CPT 73552
RAD Exam Femur 2 View Bil |
$211.75 |
$211.75 |
$158.81 |
32% below |
— |
| Thigh bone (femur) X-ray, 2 or more views
CPT 73552
RAD Femur Ap&lat |
$408.45 |
$408.45 |
$306.34 |
32% above |
— |
| Thigh bone (femur) X-ray, 2 or more views one side
CPT 73552
RAD Exam Femur 2 View Lt |
$398.75 |
$398.75 |
$299.06 |
28% above |
— |
| Thigh bone (femur) X-ray, 2 or more views one side
CPT 73552
RAD Exam Femur 2 View Rt |
$398.75 |
$398.75 |
$299.06 |
28% above |
— |
| Thigh bone (femur) X-ray, 2 or more views inpatient
CPT 73552
RAD Exam Femur 2 View Bil |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Thigh bone (femur) X-ray, 2 or more views inpatient
CPT 73552
RAD Femur Ap&lat |
$408.45 |
$408.45 |
$306.34 |
— |
— |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side
CPT 73552
RAD Exam Femur 2 View Lt |
$398.75 |
$398.75 |
$299.06 |
— |
— |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side
CPT 73552
RAD Exam Femur 2 View Rt |
$398.75 |
$398.75 |
$299.06 |
— |
— |
| Thoracic spine (mid back) CT scan without contrast
CPT 72128
CT Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
243% above |
— |
| Thoracic spine (mid back) CT scan without contrast inpatient
CPT 72128
CT Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$2,674.35 |
— |
— |
| Toe X-ray, 2 or more views
CPT 73660
RAD Toes 2+ Views |
$500.00 |
$500.00 |
$375.00 |
77% above |
— |
| Toe X-ray, 2 or more views inpatient
CPT 73660
RAD Toes 2+ Views |
$500.00 |
$500.00 |
$375.00 |
— |
— |
| Transvaginal pelvic ultrasound
CPT 76830
US Transvaginal Non-Ob |
$662.20 |
$662.20 |
$496.65 |
60% above |
— |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US Transvaginal Non-Ob |
$662.20 |
$662.20 |
$496.65 |
— |
— |
| Ultrasound of the abdomen, complete
CPT 76700
US Exam Abdom Complete |
$1,130.75 |
$1,130.75 |
$848.06 |
183% above |
— |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US Exam Abdom Complete |
$1,130.75 |
$1,130.75 |
$848.06 |
— |
— |
| Ultrasound of the scrotum and testicles
CPT 76870
US Exam Scrotum |
$446.80 |
$446.80 |
$335.10 |
15% above |
— |
| Ultrasound of the scrotum and testicles inpatient
CPT 76870
US Exam Scrotum |
$446.80 |
$446.80 |
$335.10 |
— |
— |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid
CPT 76536
US Exam of Head and Neck |
$968.55 |
$968.55 |
$726.41 |
139% above |
— |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient
CPT 76536
US Exam of Head and Neck |
$968.55 |
$968.55 |
$726.41 |
— |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast)
CPT 74240
RAD Upper Gi Delay W/O Kub |
$709.25 |
$709.25 |
$531.94 |
1% below |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast)
CPT 74240
RAD Upper Gi Delay Single Cont |
$2,136.45 |
$2,136.45 |
$1,602.34 |
199% above |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient
CPT 74240
RAD Upper Gi Delay W/O Kub |
$709.25 |
$709.25 |
$531.94 |
— |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient
CPT 74240
RAD Upper Gi Delay Single Cont |
$2,136.45 |
$2,136.45 |
$1,602.34 |
— |
— |
| Upper arm X-ray (humerus), 2 views one side
CPT 73060
RAD HumerUS 2+ Views Lt |
$369.85 |
$369.85 |
$277.39 |
13% above |
— |
| Upper arm X-ray (humerus), 2 views one side
CPT 73060
RAD HumerUS 2+ Views Rt |
$369.85 |
$369.85 |
$277.39 |
13% above |
— |
| Upper arm X-ray (humerus), 2 views inpatient one side
CPT 73060
RAD HumerUS 2+ Views Lt |
$369.85 |
$369.85 |
$277.39 |
— |
— |
| Upper arm X-ray (humerus), 2 views inpatient one side
CPT 73060
RAD HumerUS 2+ Views Rt |
$369.85 |
$369.85 |
$277.39 |
— |
— |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side
CPT 93971
Doppler Extremity Vein Ltd RT |
$1,167.35 |
$1,167.35 |
$875.51 |
54% above |
— |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side
CPT 93971
Doppler Extremity Vein Ltd Lt |
$1,167.35 |
$1,167.35 |
$875.51 |
54% above |
— |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side
CPT 93971
Doppler Extremity Vein Ltd RT |
$1,167.35 |
$1,167.35 |
$875.51 |
— |
— |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side
CPT 93971
Doppler Extremity Vein Ltd Lt |
$1,167.35 |
$1,167.35 |
$875.51 |
— |
— |
| Wrist X-ray, 2 views one side
CPT 73100
RAD Wrist 2 Views Lt |
$211.75 |
$211.75 |
$158.81 |
18% below |
— |
| Wrist X-ray, 2 views one side
CPT 73100
RAD Wrist 2 Views Rt |
$211.75 |
$211.75 |
$158.81 |
18% below |
— |
| Wrist X-ray, 2 views inpatient one side
CPT 73100
RAD Wrist 2 Views Rt |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Wrist X-ray, 2 views inpatient one side
CPT 73100
RAD Wrist 2 Views Lt |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| Wrist X-ray, complete, 3 or more views one side
CPT 73110
RAD Wrist 3+ Views Lt |
$408.35 |
$408.35 |
$306.26 |
25% above |
— |
| Wrist X-ray, complete, 3 or more views one side
CPT 73110
RAD Wrist 3+ Views Rt |
$408.35 |
$408.35 |
$306.26 |
25% above |
— |
| Wrist X-ray, complete, 3 or more views inpatient one side
CPT 73110
RAD Wrist 3+ Views Lt |
$408.35 |
$408.35 |
$306.26 |
— |
— |
| Wrist X-ray, complete, 3 or more views inpatient one side
CPT 73110
RAD Wrist 3+ Views Rt |
$408.35 |
$408.35 |
$306.26 |
— |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side
CPT 73502
RAD Hip 2-3 Views Unil Rt |
$467.50 |
$467.50 |
$350.63 |
25% above |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side
CPT 73502
RAD Hip 2-3 Views Unil Lt |
$467.50 |
$467.50 |
$350.63 |
25% above |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side
CPT 73502
RAD Hip 2-3 Views Unil Lt |
$467.50 |
$467.50 |
$350.63 |
— |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side
CPT 73502
RAD Hip 2-3 Views Unil Rt |
$467.50 |
$467.50 |
$350.63 |
— |
— |
| X-ray of the abdomen, 1 view
CPT 74018
MRI Joint Lwr Extr W/O&w/Dye |
$370.55 |
$370.55 |
$277.91 |
19% above |
— |
| X-ray of the abdomen, 1 view
CPT 74018
RAD Abdomen 1 Vw |
$403.10 |
$403.10 |
$302.33 |
30% above |
— |
| X-ray of the abdomen, 1 view inpatient
CPT 74018
MRI Joint Lwr Extr W/O&w/Dye |
$370.55 |
$370.55 |
$277.91 |
— |
— |
| X-ray of the abdomen, 1 view inpatient
CPT 74018
RAD Abdomen 1 Vw |
$403.10 |
$403.10 |
$302.33 |
— |
— |
| X-ray of the ankle, 2 views both sides
CPT 73600
RAD Ankle 2 Views Bilat |
$379.50 |
$379.50 |
$284.63 |
— |
— |
| X-ray of the ankle, 2 views one side
CPT 73600
RAD Ankle 2 Views Lt |
$202.10 |
$202.10 |
$151.58 |
22% below |
— |
| X-ray of the ankle, 2 views one side
CPT 73600
RAD Ankle 2 Views Rt |
$202.10 |
$202.10 |
$151.58 |
22% below |
— |
| X-ray of the ankle, 2 views inpatient both sides
CPT 73600
RAD Ankle 2 Views Bilat |
$379.50 |
$379.50 |
$284.63 |
— |
— |
| X-ray of the ankle, 2 views inpatient one side
CPT 73600
RAD Ankle 2 Views Lt |
$202.10 |
$202.10 |
$151.58 |
— |
— |
| X-ray of the ankle, 2 views inpatient one side
CPT 73600
RAD Ankle 2 Views Rt |
$202.10 |
$202.10 |
$151.58 |
— |
— |
| X-ray of the finger(s), 2 or more views one side
CPT 73140
RAD Finger(S) 2+ View Rt |
$332.75 |
$332.75 |
$249.56 |
7% above |
— |
| X-ray of the finger(s), 2 or more views one side
CPT 73140
RAD Finger(S) 2+ View Lt |
$332.75 |
$332.75 |
$249.56 |
7% above |
— |
| X-ray of the finger(s), 2 or more views inpatient one side
CPT 73140
RAD Finger(S) 2+ View Rt |
$332.75 |
$332.75 |
$249.56 |
— |
— |
| X-ray of the finger(s), 2 or more views inpatient one side
CPT 73140
RAD Finger(S) 2+ View Lt |
$332.75 |
$332.75 |
$249.56 |
— |
— |
| X-ray of the foot, 2 views
CPT 73620
RAD Foot 2 Views Bilater |
$599.50 |
$599.50 |
$449.63 |
136% above |
— |
| X-ray of the foot, 2 views one side
CPT 73620
RAD Foot 2 Views Lt |
$203.50 |
$203.50 |
$152.63 |
20% below |
— |
| X-ray of the foot, 2 views one side
CPT 73620
RAD Foot 2 Views Rt |
$203.50 |
$203.50 |
$152.63 |
20% below |
— |
| X-ray of the foot, 2 views inpatient
CPT 73620
RAD Foot 2 Views Bilater |
$599.50 |
$599.50 |
$449.63 |
— |
— |
| X-ray of the foot, 2 views inpatient one side
CPT 73620
RAD Foot 2 Views Lt |
$203.50 |
$203.50 |
$152.63 |
— |
— |
| X-ray of the foot, 2 views inpatient one side
CPT 73620
RAD Foot 2 Views Rt |
$203.50 |
$203.50 |
$152.63 |
— |
— |
| X-ray of the foot, complete, 3 or more views
CPT 73630
RAD Foot 3 Views Bilater |
$306.60 |
$306.60 |
$229.95 |
at median |
— |
| X-ray of the foot, complete, 3 or more views one side
CPT 73630
RAD Foot 3 Views Lt |
$397.35 |
$397.35 |
$298.01 |
30% above |
— |
| X-ray of the foot, complete, 3 or more views one side
CPT 73630
RAD Foot 3 Views Rt |
$397.35 |
$397.35 |
$298.01 |
30% above |
— |
| X-ray of the foot, complete, 3 or more views inpatient
CPT 73630
RAD Foot 3 Views Bilater |
$306.60 |
$306.60 |
$229.95 |
— |
— |
| X-ray of the foot, complete, 3 or more views inpatient one side
CPT 73630
RAD Foot 3 Views Rt |
$397.35 |
$397.35 |
$298.01 |
— |
— |
| X-ray of the foot, complete, 3 or more views inpatient one side
CPT 73630
RAD Foot 3 Views Lt |
$397.35 |
$397.35 |
$298.01 |
— |
— |
| X-ray of the hand, 3 or more views one side
CPT 73130
RAD Hand 3 Views Lt |
$347.85 |
$347.85 |
$260.89 |
6% above |
— |
| X-ray of the hand, 3 or more views one side
CPT 73130
RAD Hand 3 Views Rt |
$347.85 |
$347.85 |
$260.89 |
6% above |
— |
| X-ray of the hand, 3 or more views inpatient one side
CPT 73130
RAD Hand 3 Views Rt |
$347.85 |
$347.85 |
$260.89 |
— |
— |
| X-ray of the hand, 3 or more views inpatient one side
CPT 73130
RAD Hand 3 Views Lt |
$347.85 |
$347.85 |
$260.89 |
— |
— |
| X-ray of the knee, 1 or 2 views both sides
CPT 73560
RAD Knee 1-2 Views Bilat |
$427.60 |
$427.60 |
$320.70 |
— |
— |
| X-ray of the knee, 1 or 2 views
CPT 73560
RAD Knee/Patella 2 View |
$316.55 |
$316.55 |
$237.41 |
6% above |
— |
| X-ray of the knee, 1 or 2 views one side
CPT 73560
RAD Knee 1-2 Views Rt |
$365.75 |
$365.75 |
$274.31 |
22% above |
— |
| X-ray of the knee, 1 or 2 views one side
CPT 73560
RAD Knee 1-2 Views Lt |
$365.75 |
$365.75 |
$274.31 |
22% above |
— |
| X-ray of the knee, 1 or 2 views inpatient both sides
CPT 73560
RAD Knee 1-2 Views Bilat |
$427.60 |
$427.60 |
$320.70 |
— |
— |
| X-ray of the knee, 1 or 2 views inpatient
CPT 73560
RAD Knee/Patella 2 View |
$316.55 |
$316.55 |
$237.41 |
— |
— |
| X-ray of the knee, 1 or 2 views inpatient one side
CPT 73560
RAD Knee 1-2 Views Lt |
$365.75 |
$365.75 |
$274.31 |
— |
— |
| X-ray of the knee, 1 or 2 views inpatient one side
CPT 73560
RAD Knee 1-2 Views Rt |
$365.75 |
$365.75 |
$274.31 |
— |
— |
| X-ray of the lower back (lumbar spine), 2 or 3 views
CPT 72100
RAD Exam L-S Spine 2/3 Vws |
$497.55 |
$497.55 |
$373.16 |
29% above |
— |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient
CPT 72100
RAD Exam L-S Spine 2/3 Vws |
$497.55 |
$497.55 |
$373.16 |
— |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
RAD Exam L-2 Spine 4/>vws |
$260.35 |
$260.35 |
$195.26 |
36% below |
— |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
RAD Exam L-2 Spine 4/>vws |
$260.35 |
$260.35 |
$195.26 |
— |
— |
| X-ray of the mid back (thoracic spine), 2 views
CPT 72070
RAD Exam Thorac Spine 2vws |
$211.75 |
$211.75 |
$158.81 |
35% below |
— |
| X-ray of the mid back (thoracic spine), 2 views inpatient
CPT 72070
RAD Exam Thorac Spine 2vws |
$211.75 |
$211.75 |
$158.81 |
— |
— |
| X-ray of the nasal bones, 3 or more views
CPT 70160
RAD Nasal Bones 3 Views |
$418.55 |
$418.55 |
$313.91 |
45% above |
— |
| X-ray of the nasal bones, 3 or more views inpatient
CPT 70160
RAD Nasal Bones 3 Views |
$418.55 |
$418.55 |
$313.91 |
— |
— |
| X-ray of the neck (cervical spine), 2 or 3 views
CPT 72040
RAD Exam Neck Spine 2-3 Vw |
$404.00 |
$404.00 |
$303.00 |
21% above |
— |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient
CPT 72040
RAD Exam Neck Spine 2-3 Vw |
$404.00 |
$404.00 |
$303.00 |
— |
— |
| X-ray of the pelvis, 1 or 2 views
CPT 72170
RAD Exam of Pelvis |
$558.30 |
$558.30 |
$418.73 |
81% above |
— |
| X-ray of the pelvis, 1 or 2 views inpatient
CPT 72170
RAD Exam of Pelvis |
$558.30 |
$558.30 |
$418.73 |
— |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views
CPT 72220
RAD Exam Sacrum Tailbone |
$334.25 |
$334.25 |
$250.69 |
4% above |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient
CPT 72220
RAD Exam Sacrum Tailbone |
$334.25 |
$334.25 |
$250.69 |
— |
— |