| Ankle X-ray, complete, 3 or more views both sides
CPT 73610
RAD Ankle 3 Views Bilat |
$456.05 |
$456.05 |
$37.09–$410.45 |
— |
— |
| Ankle X-ray, complete, 3 or more views one side
CPT 73610
RAD Ankle 3 Views Rt |
$203.50 |
$203.50 |
$37.09–$183.15 |
38% below |
— |
| Ankle X-ray, complete, 3 or more views one side
CPT 73610
RAD Ankle 3 Views Lt |
$203.50 |
$203.50 |
$37.09–$183.15 |
38% below |
— |
| Ankle X-ray, complete, 3 or more views inpatient both sides
CPT 73610
RAD Ankle 3 Views Bilat |
$456.05 |
$456.05 |
$319.24–$410.45 |
— |
— |
| Ankle X-ray, complete, 3 or more views inpatient one side
CPT 73610
RAD Ankle 3 Views Lt |
$203.50 |
$203.50 |
$142.45–$183.15 |
— |
— |
| Ankle X-ray, complete, 3 or more views inpatient one side
CPT 73610
RAD Ankle 3 Views Rt |
$203.50 |
$203.50 |
$142.45–$183.15 |
— |
— |
| Ankle-brachial index (ABI), blood pressure test for leg arteries
CPT 93922
US Tcpo2 Multi Modfr 52 |
$554.95 |
$554.95 |
$101.21–$499.46 |
9% below |
— |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient
CPT 93922
US Tcpo2 Multi Modfr 52 |
$554.95 |
$554.95 |
$388.47–$499.46 |
— |
— |
| Barium swallow (esophagus X-ray with contrast)
CPT 74220
RAD Contrast Exam of Esophagus |
$613.85 |
$613.85 |
$99.90–$552.47 |
22% above |
— |
| Barium swallow (esophagus X-ray with contrast) inpatient
CPT 74220
RAD Contrast Exam of Esophagus |
$613.85 |
$613.85 |
$429.70–$552.47 |
— |
— |
| Bone scan, whole body (nuclear medicine)
CPT 78306
NM Bone Scan Whole B |
$2,015.55 |
$2,015.55 |
$275.66–$1,814.00 |
16% above |
— |
| Bone scan, whole body (nuclear medicine) inpatient
CPT 78306
NM Bone Scan Whole B |
$2,015.55 |
$2,015.55 |
$1,410.89–$1,814.00 |
— |
— |
| Breast ultrasound, complete, one breast
CPT 76641
US Ultrasound Breast Complete |
$1,479.08 |
$1,479.08 |
$79.53–$1,331.17 |
234% above |
— |
| Breast ultrasound, complete, one breast inpatient
CPT 76641
US Ultrasound Breast Complete |
$1,479.08 |
$1,479.08 |
$1,035.36–$1,331.17 |
— |
— |
| Breast ultrasound, limited (one breast or one area)
CPT 76642
US Breast Limited |
$1,733.94 |
$1,733.94 |
$66.20–$1,560.55 |
401% above |
— |
| Breast ultrasound, limited (one breast or one area) inpatient
CPT 76642
US Breast Limited |
$1,733.94 |
$1,733.94 |
$1,213.76–$1,560.55 |
— |
— |
| 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 |
$133.43–$5,592.02 |
119% 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 |
$4,349.35–$5,592.02 |
— |
— |
| 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 |
$180.34–$4,996.08 |
233% 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 |
$3,885.84–$4,996.08 |
— |
— |
| CT scan of abdomen and pelvis, no contrast dye
CPT 74176
CT Abd & Pelvis W/O Contrast |
$5,348.70 |
$5,348.70 |
$181.51–$4,813.83 |
59% 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 |
$3,744.09–$4,813.83 |
— |
— |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT Abdomen & Pelvis w/Contrast |
$8,264.00 |
$8,264.00 |
$265.40–$7,437.60 |
112% above |
— |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT Abdomen & Pelvis w/Contrast |
$8,264.00 |
$8,264.00 |
$5,784.80–$7,437.60 |
— |
— |
| 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 |
$265.40–$8,284.68 |
121% 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 |
$6,443.64–$8,284.68 |
— |
— |
| CT scan of the abdomen with contrast
CPT 74160
CT Abdomen W/Contrast |
$5,509.35 |
$5,509.35 |
$133.43–$4,958.42 |
111% above |
— |
| CT scan of the abdomen with contrast inpatient
CPT 74160
CT Abdomen W/Contrast |
$5,509.35 |
$5,509.35 |
$3,856.55–$4,958.42 |
— |
— |
| CT scan of the abdomen without contrast
CPT 74150
CT Abdomen W/O Contrast |
$3,565.80 |
$3,565.80 |
$79.53–$3,209.22 |
70% above |
— |
| CT scan of the abdomen without contrast inpatient
CPT 74150
CT Abdomen W/O Contrast |
$3,565.80 |
$3,565.80 |
$2,496.06–$3,209.22 |
— |
— |
| CT scan of the face and sinuses, no contrast dye
CPT 70486
CT Maxillofacial w/o contrast |
$3,565.80 |
$3,565.80 |
$79.53–$3,209.22 |
110% 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 |
$2,496.06–$3,209.22 |
— |
— |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT Head/Brain W/O Dye |
$3,565.80 |
$3,565.80 |
$79.53–$3,209.22 |
87% 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 |
$2,496.06–$3,209.22 |
— |
— |
| CT scan of the head with contrast
CPT 70460
CT Head/Brain W/Contrast |
$5,509.35 |
$5,509.35 |
$133.43–$4,958.42 |
213% above |
— |
| CT scan of the head with contrast inpatient
CPT 70460
CT Head/Brain W/Contrast |
$5,509.35 |
$5,509.35 |
$3,856.55–$4,958.42 |
— |
— |
| CT scan of the head without and with contrast
CPT 70470
CT Head/Brain W/O & W/Dye |
$6,136.80 |
$6,136.80 |
$133.43–$5,523.12 |
164% 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 |
$4,295.76–$5,523.12 |
— |
— |
| CT scan of the lower back (lumbar spine) without contrast
CPT 72131
CT Lumbar Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$79.53–$3,209.22 |
74% 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 |
$2,496.06–$3,209.22 |
— |
— |
| CT scan of the neck (cervical spine), no contrast dye
CPT 72125
CT C-Spine W/O Dye |
$3,565.80 |
$3,565.80 |
$79.53–$3,209.22 |
69% 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 |
$2,496.06–$3,209.22 |
— |
— |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT Pelvis W/Dye |
$5,509.35 |
$5,509.35 |
$133.43–$4,958.42 |
150% above |
— |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT Pelvis W/Dye |
$5,509.35 |
$5,509.35 |
$3,856.55–$4,958.42 |
— |
— |
| Carotid artery ultrasound (duplex), both sides of the neck
CPT 93880
Duplex Scan/Carotid |
$1,794.00 |
$1,794.00 |
$181.51–$1,614.60 |
30% above |
— |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient
CPT 93880
Duplex Scan/Carotid |
$1,794.00 |
$1,794.00 |
$1,255.80–$1,614.60 |
— |
— |
| Chest X-ray, 2 views
CPT 71046
RAD Chest 2 Views |
$549.75 |
$549.75 |
$33.75–$494.78 |
40% above |
— |
| Chest X-ray, 2 views inpatient
CPT 71046
RAD Chest 2 Views |
$549.75 |
$549.75 |
$384.83–$494.78 |
— |
— |
| Chest X-ray, single view
CPT 71045
RAD Chest 1 View |
$308.50 |
$308.50 |
$26.06–$277.65 |
5% below |
— |
| Chest X-ray, single view inpatient
CPT 71045
RAD Chest 1 View |
$308.50 |
$308.50 |
$215.95–$277.65 |
— |
— |
| 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 |
$79.53–$918.77 |
38% above |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys
CPT 76770
Renal Ultrasound Complete |
$1,415.51 |
$1,415.51 |
$79.53–$1,273.96 |
92% 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 |
$714.60–$918.77 |
— |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient
CPT 76770
Renal Ultrasound Complete |
$1,415.51 |
$1,415.51 |
$990.86–$1,273.96 |
— |
— |
| DEXA bone density scan of the hip, pelvis or spine
CPT 77080
DXA Bone Density Axial |
$501.26 |
$501.26 |
$38.09–$451.13 |
21% above |
— |
| DEXA bone density scan of the hip, pelvis or spine inpatient
CPT 77080
DXA Bone Density Axial |
$501.26 |
$501.26 |
$350.88–$451.13 |
— |
— |
| Diagnostic CT scan of the chest, no contrast dye
CPT 71250
CT Chest w/o Dye |
$3,565.80 |
$3,565.80 |
$79.53–$3,209.22 |
93% above |
— |
| Diagnostic CT scan of the chest, no contrast dye inpatient
CPT 71250
CT Chest w/o Dye |
$3,565.80 |
$3,565.80 |
$2,496.06–$3,209.22 |
— |
— |
| Diagnostic CT scan of the chest, with contrast dye
CPT 71260
CT Chest W/ Dye |
$5,509.35 |
$5,509.35 |
$133.43–$4,958.42 |
145% above |
— |
| Diagnostic CT scan of the chest, with contrast dye inpatient
CPT 71260
CT Chest W/ Dye |
$5,509.35 |
$5,509.35 |
$3,856.55–$4,958.42 |
— |
— |
| Duplex ultrasound of the leg arteries, both legs
CPT 93925
Noninv Extreme Art L |
$1,713.20 |
$1,713.20 |
$181.51–$1,541.88 |
5% below |
— |
| Duplex ultrasound of the leg arteries, both legs inpatient
CPT 93925
Noninv Extreme Art L |
$1,713.20 |
$1,713.20 |
$1,199.24–$1,541.88 |
— |
— |
| Duplex ultrasound of the leg veins, both legs both sides
CPT 93970
Doppler Upper Extrem bilat |
$714.65 |
$714.65 |
$164.37–$643.19 |
— |
— |
| Duplex ultrasound of the leg veins, both legs inpatient both sides
CPT 93970
Doppler Upper Extrem bilat |
$714.65 |
$714.65 |
$500.26–$643.19 |
— |
— |
| Echocardiogram through the chest wall, complete, with Doppler
CPT 93306
Echo Transthoracic 2d |
$1,063.70 |
$1,063.70 |
$244.65–$1,097.38 |
55% below |
— |
| Echocardiogram through the chest wall, complete, with Doppler inpatient
CPT 93306
Echo Transthoracic 2d |
$1,063.70 |
$1,063.70 |
$744.59–$957.33 |
— |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder
CPT 78226
NM Hepatobiliary |
$1,864.50 |
$1,864.50 |
$303.06–$1,678.05 |
16% above |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient
CPT 78226
NM Hepatobiliary |
$1,864.50 |
$1,864.50 |
$1,305.15–$1,678.05 |
— |
— |
| Knee X-ray, 3 views both sides
CPT 73562
RAD Knee 3 Views Bilat |
$679.70 |
$679.70 |
$40.76–$611.73 |
— |
— |
| Knee X-ray, 3 views one side
CPT 73562
RAD Knee 3 Views Lt |
$402.85 |
$402.85 |
$40.76–$362.57 |
16% above |
— |
| Knee X-ray, 3 views one side
CPT 73562
RAD Knee 3 Views Rt |
$402.85 |
$402.85 |
$40.76–$362.57 |
16% above |
— |
| Knee X-ray, 3 views inpatient both sides
CPT 73562
RAD Knee 3 Views Bilat |
$679.70 |
$679.70 |
$475.79–$611.73 |
— |
— |
| Knee X-ray, 3 views inpatient one side
CPT 73562
RAD Knee 3 Views Rt |
$402.85 |
$402.85 |
$282.00–$362.57 |
— |
— |
| Knee X-ray, 3 views inpatient one side
CPT 73562
RAD Knee 3 Views Lt |
$402.85 |
$402.85 |
$282.00–$362.57 |
— |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder
CPT 76705
US Exam Abdomen Limited |
$978.85 |
$978.85 |
$79.53–$880.97 |
56% above |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient
CPT 76705
US Exam Abdomen Limited |
$978.85 |
$978.85 |
$685.20–$880.97 |
— |
— |
| 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 |
$181.51–$5,674.59 |
209% 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 |
$4,413.57–$5,674.59 |
— |
— |
| 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 |
$265.40–$5,674.59 |
123% 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 |
$4,413.57–$5,674.59 |
— |
— |
| MRI of the abdomen without contrast
CPT 74181
MRI Abdomen W/O Dye |
$6,305.10 |
$6,305.10 |
$181.51–$5,674.59 |
185% above |
— |
| MRI of the abdomen without contrast inpatient
CPT 74181
MRI Abdomen W/O Dye |
$6,305.10 |
$6,305.10 |
$4,413.57–$5,674.59 |
— |
— |
| 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 |
$265.40–$5,674.59 |
94% 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 |
$4,413.57–$5,674.59 |
— |
— |
| MRI of the brain, no contrast dye
CPT 70551
MRI Brain Stem W/O Dye |
$6,305.10 |
$6,305.10 |
$181.51–$5,674.59 |
188% above |
— |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI Brain Stem W/O Dye |
$6,305.10 |
$6,305.10 |
$4,413.57–$5,674.59 |
— |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI Brain Stem W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$265.40–$8,814.92 |
224% 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 |
$6,856.05–$8,814.92 |
— |
— |
| MRI of the lower back, no contrast dye
CPT 72148
MRI Lumbar Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$181.51–$5,674.59 |
176% above |
— |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MRI Lumbar Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$4,413.57–$5,674.59 |
— |
— |
| 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 |
$265.40–$8,814.92 |
206% 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 |
$6,856.05–$8,814.92 |
— |
— |
| MRI of the mid back (thoracic spine), no contrast dye
CPT 72146
MRI Thoracic Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$181.51–$5,674.59 |
194% 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 |
$4,413.57–$5,674.59 |
— |
— |
| 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 |
$265.40–$8,814.92 |
200% 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 |
$6,856.05–$8,814.92 |
— |
— |
| MRI of the neck (cervical spine), no contrast dye
CPT 72141
MRI Neck Spine W/O Dye |
$6,305.10 |
$6,305.10 |
$181.51–$5,674.59 |
172% 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 |
$4,413.57–$5,674.59 |
— |
— |
| MRI of the pelvis without and with contrast
CPT 72197
MRI Pelvis W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$265.40–$8,814.92 |
190% above |
— |
| MRI of the pelvis without and with contrast inpatient
CPT 72197
MRI Pelvis W/O & W/Dye |
$9,794.35 |
$9,794.35 |
$6,856.05–$8,814.92 |
— |
— |
| MRI of the pelvis, no contrast dye
CPT 72195
MRI Pelvis W/O Dye |
$5,262.62 |
$5,262.62 |
$181.51–$4,736.36 |
114% above |
— |
| MRI of the pelvis, no contrast dye inpatient
CPT 72195
MRI Pelvis W/O Dye |
$5,262.62 |
$5,262.62 |
$3,683.83–$4,736.36 |
— |
— |
| 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 |
$181.51–$5,674.59 |
253% above |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye
CPT 73221
MRI Upper Ext Jnt |
$6,305.10 |
$6,305.10 |
$181.51–$5,674.59 |
253% above |
— |
| 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 |
$4,413.57–$5,674.59 |
— |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient
CPT 73221
MRI Upper Ext Jnt |
$6,305.10 |
$6,305.10 |
$4,413.57–$5,674.59 |
— |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies
CPT 78452
NM Hrt Muscle Image Spect |
$5,052.27 |
$5,052.27 |
$438.05–$4,547.04 |
16% above |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient
CPT 78452
NM Hrt Muscle Image Spect |
$5,052.27 |
$5,052.27 |
$3,536.59–$4,547.04 |
— |
— |
| 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 |
$1,087.80–$25,664.69 |
506% 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 |
$19,961.42–$25,664.69 |
— |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up
CPT 76857
US Exam Pelvic Limited |
$907.30 |
$907.30 |
$50.79–$816.57 |
85% above |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient
CPT 76857
US Exam Pelvic Limited |
$907.30 |
$907.30 |
$635.11–$816.57 |
— |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy)
CPT 76856
US Exam Pelvic Complete |
$1,130.75 |
$1,130.75 |
$79.53–$1,017.68 |
31% above |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient
CPT 76856
US Exam Pelvic Complete |
$1,130.75 |
$1,130.75 |
$791.53–$1,017.68 |
— |
— |
| Screening mammogram, both breasts both sides
CPT 77067
Screening Mammo Bilat |
$1,628.79 |
$1,628.79 |
$90.75–$1,465.91 |
— |
— |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
Screening Mammo Bilat |
$1,628.79 |
$1,628.79 |
$1,140.15–$1,465.91 |
— |
— |
| Shoulder X-ray, complete, 2 or more views
CPT 73030
RAD Shoulder Complete |
$733.45 |
$733.45 |
$34.75–$660.11 |
138% above |
— |
| Shoulder X-ray, complete, 2 or more views one side
CPT 73030
RAD Shoulder 2 Views Rt |
$407.00 |
$407.00 |
$34.75–$366.30 |
32% above |
— |
| Shoulder X-ray, complete, 2 or more views one side
CPT 73030
RAD Shoulder 2 Views Lt |
$407.00 |
$407.00 |
$34.75–$366.30 |
32% above |
— |
| Shoulder X-ray, complete, 2 or more views inpatient
CPT 73030
RAD Shoulder Complete |
$733.45 |
$733.45 |
$513.42–$660.11 |
— |
— |
| Shoulder X-ray, complete, 2 or more views inpatient one side
CPT 73030
RAD Shoulder 2 Views Lt |
$407.00 |
$407.00 |
$284.90–$366.30 |
— |
— |
| Shoulder X-ray, complete, 2 or more views inpatient one side
CPT 73030
RAD Shoulder 2 Views Rt |
$407.00 |
$407.00 |
$284.90–$366.30 |
— |
— |
| Swallow study (modified barium swallow, video X-ray)
CPT 74230
RAD Cine/Vid Throat/Esoph MBSS |
$854.45 |
$854.45 |
$127.64–$769.01 |
42% above |
— |
| Swallow study (modified barium swallow, video X-ray) inpatient
CPT 74230
RAD Cine/Vid Throat/Esoph MBSS |
$854.45 |
$854.45 |
$598.12–$769.01 |
— |
— |
| Transvaginal pelvic ultrasound
CPT 76830
US Transvaginal Non-Ob |
$662.20 |
$662.20 |
$79.53–$595.98 |
3% above |
— |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US Transvaginal Non-Ob |
$662.20 |
$662.20 |
$463.54–$595.98 |
— |
— |
| Ultrasound of the abdomen, complete
CPT 76700
US Exam Abdom Complete |
$1,130.75 |
$1,130.75 |
$79.53–$1,017.68 |
31% above |
— |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US Exam Abdom Complete |
$1,130.75 |
$1,130.75 |
$791.53–$1,017.68 |
— |
— |
| Ultrasound of the scrotum and testicles
CPT 76870
US Exam Scrotum |
$446.80 |
$446.80 |
$79.53–$402.12 |
27% below |
— |
| Ultrasound of the scrotum and testicles inpatient
CPT 76870
US Exam Scrotum |
$446.80 |
$446.80 |
$312.76–$402.12 |
— |
— |
| 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 |
$79.53–$871.70 |
54% 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 |
$677.99–$871.70 |
— |
— |
| 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 |
$124.96–$638.33 |
4% 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 |
$124.96–$1,922.81 |
190% 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 |
$496.48–$638.33 |
— |
— |
| 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 |
$1,495.52–$1,922.81 |
— |
— |
| 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 |
$79.53–$1,050.62 |
45% above |
— |
| 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 |
$79.53–$1,050.62 |
45% 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 |
$817.15–$1,050.62 |
— |
— |
| 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 |
$817.15–$1,050.62 |
— |
— |
| Wrist X-ray, complete, 3 or more views one side
CPT 73110
RAD Wrist 3+ Views Lt |
$408.35 |
$408.35 |
$41.10–$367.52 |
31% above |
— |
| Wrist X-ray, complete, 3 or more views one side
CPT 73110
RAD Wrist 3+ Views Rt |
$408.35 |
$408.35 |
$41.10–$367.52 |
31% above |
— |
| Wrist X-ray, complete, 3 or more views inpatient one side
CPT 73110
RAD Wrist 3+ Views Rt |
$408.35 |
$408.35 |
$285.85–$367.52 |
— |
— |
| Wrist X-ray, complete, 3 or more views inpatient one side
CPT 73110
RAD Wrist 3+ Views Lt |
$408.35 |
$408.35 |
$285.85–$367.52 |
— |
— |
| 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 |
$47.11–$420.75 |
17% 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 Rt |
$467.50 |
$467.50 |
$47.11–$420.75 |
17% 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 |
$327.25–$420.75 |
— |
— |
| 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 |
$327.25–$420.75 |
— |
— |
| X-ray of the abdomen, 1 view
CPT 74018
MRI Joint Lwr Extr W/O&w/Dye |
$370.55 |
$370.55 |
$30.08–$333.50 |
9% above |
— |
| X-ray of the abdomen, 1 view
CPT 74018
RAD Abdomen 1 Vw |
$403.10 |
$403.10 |
$30.08–$362.79 |
19% above |
— |
| X-ray of the abdomen, 1 view inpatient
CPT 74018
MRI Joint Lwr Extr W/O&w/Dye |
$370.55 |
$370.55 |
$259.39–$333.50 |
— |
— |
| X-ray of the abdomen, 1 view inpatient
CPT 74018
RAD Abdomen 1 Vw |
$403.10 |
$403.10 |
$282.17–$362.79 |
— |
— |
| X-ray of the ankle, 2 views both sides
CPT 73600
RAD Ankle 2 Views Bilat |
$379.50 |
$379.50 |
$32.75–$341.55 |
— |
— |
| X-ray of the ankle, 2 views one side
CPT 73600
RAD Ankle 2 Views Rt |
$202.10 |
$202.10 |
$32.75–$181.89 |
28% below |
— |
| X-ray of the ankle, 2 views one side
CPT 73600
RAD Ankle 2 Views Lt |
$202.10 |
$202.10 |
$32.75–$181.89 |
28% below |
— |
| X-ray of the ankle, 2 views inpatient both sides
CPT 73600
RAD Ankle 2 Views Bilat |
$379.50 |
$379.50 |
$265.65–$341.55 |
— |
— |
| X-ray of the ankle, 2 views inpatient one side
CPT 73600
RAD Ankle 2 Views Lt |
$202.10 |
$202.10 |
$141.47–$181.89 |
— |
— |
| X-ray of the ankle, 2 views inpatient one side
CPT 73600
RAD Ankle 2 Views Rt |
$202.10 |
$202.10 |
$141.47–$181.89 |
— |
— |
| X-ray of the finger(s), 2 or more views one side
CPT 73140
RAD Finger(S) 2+ View Lt |
$332.75 |
$332.75 |
$38.09–$299.48 |
38% above |
— |
| X-ray of the finger(s), 2 or more views one side
CPT 73140
RAD Finger(S) 2+ View Rt |
$332.75 |
$332.75 |
$38.09–$299.48 |
38% above |
— |
| 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 |
$232.93–$299.48 |
— |
— |
| 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 |
$232.93–$299.48 |
— |
— |
| X-ray of the foot, 2 views
CPT 73620
RAD Foot 2 Views Bilater |
$599.50 |
$599.50 |
$28.40–$539.55 |
108% above |
— |
| X-ray of the foot, 2 views one side
CPT 73620
RAD Foot 2 Views Lt |
$203.50 |
$203.50 |
$28.40–$183.15 |
29% below |
— |
| X-ray of the foot, 2 views one side
CPT 73620
RAD Foot 2 Views Rt |
$203.50 |
$203.50 |
$28.40–$183.15 |
29% below |
— |
| X-ray of the foot, 2 views inpatient
CPT 73620
RAD Foot 2 Views Bilater |
$599.50 |
$599.50 |
$419.65–$539.55 |
— |
— |
| X-ray of the foot, 2 views inpatient one side
CPT 73620
RAD Foot 2 Views Lt |
$203.50 |
$203.50 |
$142.45–$183.15 |
— |
— |
| X-ray of the foot, 2 views inpatient one side
CPT 73620
RAD Foot 2 Views Rt |
$203.50 |
$203.50 |
$142.45–$183.15 |
— |
— |
| X-ray of the foot, complete, 3 or more views
CPT 73630
RAD Foot 3 Views Bilater |
$306.60 |
$306.60 |
$34.41–$275.94 |
16% below |
— |
| X-ray of the foot, complete, 3 or more views one side
CPT 73630
RAD Foot 3 Views Rt |
$397.35 |
$397.35 |
$34.41–$357.62 |
9% above |
— |
| X-ray of the foot, complete, 3 or more views one side
CPT 73630
RAD Foot 3 Views Lt |
$397.35 |
$397.35 |
$34.41–$357.62 |
9% above |
— |
| X-ray of the foot, complete, 3 or more views inpatient
CPT 73630
RAD Foot 3 Views Bilater |
$306.60 |
$306.60 |
$214.62–$275.94 |
— |
— |
| X-ray of the foot, complete, 3 or more views inpatient one side
CPT 73630
RAD Foot 3 Views Lt |
$397.35 |
$397.35 |
$278.15–$357.62 |
— |
— |
| X-ray of the foot, complete, 3 or more views inpatient one side
CPT 73630
RAD Foot 3 Views Rt |
$397.35 |
$397.35 |
$278.15–$357.62 |
— |
— |
| X-ray of the hand, 3 or more views one side
CPT 73130
RAD Hand 3 Views Lt |
$347.85 |
$347.85 |
$37.09–$313.07 |
8% above |
— |
| X-ray of the hand, 3 or more views one side
CPT 73130
RAD Hand 3 Views Rt |
$347.85 |
$347.85 |
$37.09–$313.07 |
8% above |
— |
| X-ray of the hand, 3 or more views inpatient one side
CPT 73130
RAD Hand 3 Views Rt |
$347.85 |
$347.85 |
$243.50–$313.07 |
— |
— |
| X-ray of the hand, 3 or more views inpatient one side
CPT 73130
RAD Hand 3 Views Lt |
$347.85 |
$347.85 |
$243.50–$313.07 |
— |
— |
| X-ray of the knee, 1 or 2 views both sides
CPT 73560
RAD Knee 1-2 Views Bilat |
$427.60 |
$427.60 |
$34.41–$384.84 |
— |
— |
| X-ray of the knee, 1 or 2 views
CPT 73560
RAD Knee/Patella 2 View |
$316.55 |
$316.55 |
$34.41–$284.90 |
14% above |
— |
| X-ray of the knee, 1 or 2 views one side
CPT 73560
RAD Knee 1-2 Views Lt |
$365.75 |
$365.75 |
$34.41–$329.18 |
32% above |
— |
| X-ray of the knee, 1 or 2 views one side
CPT 73560
RAD Knee 1-2 Views Rt |
$365.75 |
$365.75 |
$34.41–$329.18 |
32% 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 |
$299.32–$384.84 |
— |
— |
| X-ray of the knee, 1 or 2 views inpatient
CPT 73560
RAD Knee/Patella 2 View |
$316.55 |
$316.55 |
$221.59–$284.90 |
— |
— |
| X-ray of the knee, 1 or 2 views inpatient one side
CPT 73560
RAD Knee 1-2 Views Rt |
$365.75 |
$365.75 |
$256.03–$329.18 |
— |
— |
| X-ray of the knee, 1 or 2 views inpatient one side
CPT 73560
RAD Knee 1-2 Views Lt |
$365.75 |
$365.75 |
$256.03–$329.18 |
— |
— |
| 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 |
$40.10–$447.80 |
7% 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 |
$348.29–$447.80 |
— |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
RAD Exam L-2 Spine 4/>vws |
$260.35 |
$260.35 |
$51.45–$234.32 |
58% 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 |
$182.25–$234.32 |
— |
— |
| X-ray of the mid back (thoracic spine), 2 views
CPT 72070
RAD Exam Thorac Spine 2vws |
$211.75 |
$211.75 |
$33.08–$209.96 |
47% below |
— |
| X-ray of the mid back (thoracic spine), 2 views inpatient
CPT 72070
RAD Exam Thorac Spine 2vws |
$211.75 |
$211.75 |
$148.23–$190.58 |
— |
— |
| X-ray of the nasal bones, 3 or more views
CPT 70160
RAD Nasal Bones 3 Views |
$418.55 |
$418.55 |
$38.43–$376.70 |
44% above |
— |
| X-ray of the nasal bones, 3 or more views inpatient
CPT 70160
RAD Nasal Bones 3 Views |
$418.55 |
$418.55 |
$292.99–$376.70 |
— |
— |
| X-ray of the neck (cervical spine), 2 or 3 views
CPT 72040
RAD Exam Neck Spine 2-3 Vw |
$404.00 |
$404.00 |
$39.76–$363.60 |
8% 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 |
$282.80–$363.60 |
— |
— |
| X-ray of the pelvis, 1 or 2 views
CPT 72170
RAD Exam of Pelvis |
$558.30 |
$558.30 |
$28.06–$502.47 |
50% above |
— |
| X-ray of the pelvis, 1 or 2 views inpatient
CPT 72170
RAD Exam of Pelvis |
$558.30 |
$558.30 |
$390.81–$502.47 |
— |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views
CPT 72220
RAD Exam Sacrum Tailbone |
$334.25 |
$334.25 |
$32.75–$300.83 |
2% above |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient
CPT 72220
RAD Exam Sacrum Tailbone |
$334.25 |
$334.25 |
$233.98–$300.83 |
— |
— |