| Abdominal CT scan without and with contrast
CPT 74170
Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections |
$20,600.86 |
$20,600.86 |
$401.74–$1,975.00 |
419% above |
— |
| Abdominal CT scan without and with contrast
CPT 74170
Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections UNSCHEDULED |
$20,600.86 |
$20,600.86 |
$7,708.93–$7,871.22 |
419% above |
— |
| Abdominal CT scan without and with contrast
CPT 74170
CT ABDOMEN W&WO CONT |
$20,600.86 |
$20,600.86 |
$968.24–$18,952.79 |
419% above |
— |
| Abdominal X-ray, 2 views
CPT 74019
ABD XR 2V |
$5,409.15 |
$5,409.15 |
$254.23–$4,976.42 |
745% above |
— |
| Abdominal X-ray, 2 views
CPT 74019
Radiologic examination, abdomen; 2 views |
$5,409.15 |
$5,409.15 |
— |
745% above |
— |
| Abdominal X-ray, 2 views
CPT 74019
Radiologic examination, abdomen; 2 views Other Diagnostic Radiology FS |
$5,409.15 |
$5,409.15 |
$245.18 |
745% above |
— |
| Abdominal X-ray, 2 views
CPT 74019
Radiologic examination, abdomen; 2 views UNSCHEDULED |
$5,409.15 |
$5,409.15 |
$461.85–$471.58 |
745% above |
— |
| Ankle X-ray, complete, 3 or more views one side
CPT 73610
XR ANKLE 3 + V LT |
$2,932.36 |
$2,932.36 |
$137.82–$2,697.77 |
372% above |
— |
| Ankle X-ray, complete, 3 or more views one side
CPT 73610
XR ANKLE 3 + V RT |
$2,932.36 |
$2,932.36 |
$137.82–$2,697.77 |
372% above |
— |
| Ankle-brachial index (ABI), blood pressure test for leg arteries
CPT 93922
DOP ART 1-2 LEVELS BIL |
$3,100.53 |
$3,100.53 |
$145.72–$2,852.49 |
403% above |
— |
| Arm CT scan without contrast (shoulder to hand, any part) one side
CPT 73200
CT UP EXTREM W/O CONT RT |
$16,491.49 |
$16,491.49 |
$775.10–$15,172.17 |
600% above |
— |
| Arm CT scan without contrast (shoulder to hand, any part) one side
CPT 73200
CT UP EXTREM W/O CONT LT |
$16,491.49 |
$16,491.49 |
$775.10–$15,172.17 |
600% above |
— |
| Barium swallow (esophagus X-ray with contrast)
CPT 74220
Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study |
$4,263.57 |
$4,263.57 |
— |
407% above |
— |
| Barium swallow (esophagus X-ray with contrast)
CPT 74220
Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Other Diagnostic Radiology FS |
$4,263.57 |
$4,263.57 |
$401.74 |
407% above |
— |
| Barium swallow (esophagus X-ray with contrast)
CPT 74220
Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study UNSCHEDULED |
$4,263.57 |
$4,263.57 |
$773.54–$789.82 |
407% above |
— |
| Barium swallow (esophagus X-ray with contrast)
CPT 74220
XR ESOPHAGUS |
$4,263.57 |
$4,263.57 |
$200.39–$3,922.48 |
407% above |
— |
| Bone scan, whole body (nuclear medicine)
CPT 78306
Bone and/or joint imaging; whole body |
$10,982.20 |
$10,982.20 |
$848.52 |
333% above |
— |
| Bone scan, whole body (nuclear medicine)
CPT 78306
NM BONE WHOLE BODY |
$10,982.20 |
$10,982.20 |
$516.16–$10,103.62 |
333% above |
— |
| Bone scan, whole body (nuclear medicine)
CPT 78306
Bone and/or joint imaging; whole body UNSCHEDULED |
$10,982.20 |
$10,982.20 |
$511.92–$522.69 |
333% above |
— |
| Breast ultrasound, complete, one breast
CPT 76641
US BRST UNI W AX COMP |
$622.49 |
$622.49 |
$29.26–$572.69 |
7% above |
— |
| Breast ultrasound, limited (one breast or one area)
CPT 76642
US BRST UNI W AX LTD |
$622.49 |
$622.49 |
$29.26–$572.69 |
20% above |
— |
| CT angiography (CTA) of the abdomen and pelvis
CPT 74174
Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing UNSCHEDULED |
$25,709.17 |
$25,709.17 |
$4,773.46–$4,873.95 |
334% above |
— |
| CT angiography (CTA) of the abdomen and pelvis
CPT 74174
CTA ABD&PEL W CONT |
$25,709.17 |
$25,709.17 |
$1,208.33–$23,652.44 |
334% above |
— |
| CT angiography (CTA) of the abdomen and pelvis
CPT 74174
Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing |
$25,709.17 |
$25,709.17 |
$767.00–$1,975.00 |
334% above |
— |
| CT angiography (CTA) of the head
CPT 70496
CTA HEAD |
$23,024.94 |
$23,024.94 |
$1,082.17–$21,182.94 |
551% above |
— |
| CT angiography (CTA) of the head
CPT 70496
Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing |
$23,024.94 |
$23,024.94 |
$401.74–$1,975.00 |
551% above |
— |
| CT angiography (CTA) of the head
CPT 70496
Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing UNSCHEDULED |
$23,024.94 |
$23,024.94 |
$3,560.72–$3,635.69 |
551% above |
— |
| CT angiography (CTA) of the neck
CPT 70498
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing |
$23,024.94 |
$23,024.94 |
$401.74–$1,975.00 |
450% above |
— |
| CT angiography (CTA) of the neck
CPT 70498
CTA NECK |
$23,024.94 |
$23,024.94 |
$1,082.17–$21,182.94 |
450% above |
— |
| CT angiography (CTA) of the neck
CPT 70498
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing UNSCHEDULED |
$23,024.94 |
$23,024.94 |
$2,988.37–$3,051.28 |
450% above |
— |
| CT angiography of the chest (CTA), for blood clots in the lungs
CPT 71275
CTA CHEST |
$23,024.94 |
$23,024.94 |
$1,082.17–$21,182.94 |
415% above |
— |
| CT angiography of the chest (CTA), for blood clots in the lungs
CPT 71275
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing UNSCHEDULED |
$23,024.94 |
$23,024.94 |
$2,966.64–$3,029.10 |
415% above |
— |
| CT angiography of the chest (CTA), for blood clots in the lungs
CPT 71275
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing |
$23,024.94 |
$23,024.94 |
$401.74–$1,975.00 |
415% above |
— |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score
CPT 75574
CT HEART W CN ART/GRAFTS |
$23,024.94 |
$23,024.94 |
$1,082.17–$21,182.94 |
1080% above |
— |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score
CPT 75574
Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo UNSCHEDULED |
$23,024.94 |
$23,024.94 |
$2,092.99–$2,137.06 |
1080% above |
— |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score
CPT 75574
Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo |
$23,024.94 |
$23,024.94 |
$401.74–$1,975.00 |
1080% above |
— |
| CT of the heart without contrast dye to measure coronary calcium
CPT 75571
CT HEART WO CN W QUAN CA |
$17,650.89 |
$17,650.89 |
$829.59–$16,238.82 |
3164% above |
— |
| CT of the heart without contrast dye to measure coronary calcium
CPT 75571
Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium UNSCHEDULED |
$17,650.89 |
$17,650.89 |
$106.72–$108.97 |
3164% above |
— |
| CT of the heart without contrast dye to measure coronary calcium
CPT 75571
Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium |
$17,650.89 |
$17,650.89 |
$182.03–$1,975.00 |
3164% above |
— |
| CT scan of abdomen and pelvis, no contrast dye
CPT 74176
Computed tomography, abdomen and pelvis; without contrast material |
$32,369.83 |
$32,369.83 |
$517.79–$1,975.00 |
485% above |
— |
| CT scan of abdomen and pelvis, no contrast dye
CPT 74176
CT ABD&PELVIS W/O CONT |
$32,369.83 |
$32,369.83 |
$1,521.38–$29,780.24 |
485% above |
— |
| CT scan of abdomen and pelvis, no contrast dye
CPT 74176
Computed tomography, abdomen and pelvis; without contrast material UNSCHEDULED |
$32,369.83 |
$32,369.83 |
$3,833.69–$3,914.40 |
485% above |
— |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
Computed tomography, abdomen and pelvis; with contrast material(s) UNSCHEDULED |
$34,634.24 |
$34,634.24 |
$4,456.11–$4,549.92 |
481% above |
— |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
Computed tomography, abdomen and pelvis; with contrast material(s) |
$34,634.24 |
$34,634.24 |
$767.00–$1,975.00 |
481% above |
— |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD&PELVIS W/CONT |
$34,634.24 |
$34,634.24 |
$1,627.81–$31,863.50 |
481% above |
— |
| CT scan of abdomen and pelvis, without and then with contrast dye
CPT 74178
CT ABD&PELVIS W&WO CONT |
$35,649.33 |
$35,649.33 |
$1,675.52–$32,797.38 |
411% above |
— |
| CT scan of abdomen and pelvis, without and then with contrast dye
CPT 74178
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions |
$35,649.33 |
$35,649.33 |
$767.00–$1,975.00 |
411% above |
— |
| CT scan of abdomen and pelvis, without and then with contrast dye
CPT 74178
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions UNSCHEDULED |
$35,649.33 |
$35,649.33 |
$4,815.01–$4,916.38 |
411% above |
— |
| CT scan of the abdomen with contrast
CPT 74160
CT ABDOMEN W/CONT |
$18,330.36 |
$18,330.36 |
$861.53–$16,863.93 |
436% above |
— |
| CT scan of the abdomen with contrast
CPT 74160
Computed tomography, abdomen; with contrast material(s) |
$18,330.36 |
$18,330.36 |
$401.74–$1,975.00 |
436% above |
— |
| CT scan of the abdomen with contrast
CPT 74160
Computed tomography, abdomen; with contrast material(s) UNSCHEDULED |
$18,330.36 |
$18,330.36 |
$2,756.03–$2,814.05 |
436% above |
— |
| CT scan of the abdomen without contrast
CPT 74150
Computed tomography, abdomen; without contrast material UNSCHEDULED |
$17,058.98 |
$17,058.98 |
$2,779.63–$2,838.15 |
434% above |
— |
| CT scan of the abdomen without contrast
CPT 74150
Computed tomography, abdomen; without contrast material |
$17,058.98 |
$17,058.98 |
$1,478.00 |
434% above |
— |
| CT scan of the abdomen without contrast
CPT 74150
CT ABDOMEN W/O CONT |
$17,058.98 |
$17,058.98 |
$801.77–$15,694.26 |
434% above |
— |
| CT scan of the face and sinuses, no contrast dye
CPT 70486
Computed tomography, maxillofacial area; without contrast material |
$17,230.16 |
$17,230.16 |
$245.18–$1,975.00 |
505% above |
— |
| CT scan of the face and sinuses, no contrast dye
CPT 70486
CT MAXIFAC W/O CNT |
$17,230.16 |
$17,230.16 |
$809.82–$15,851.75 |
505% above |
— |
| CT scan of the face and sinuses, no contrast dye
CPT 70486
Computed tomography, maxillofacial area; without contrast material UNSCHEDULED |
$17,230.16 |
$17,230.16 |
$1,952.26–$1,993.36 |
505% above |
— |
| CT scan of the head or brain, no contrast dye
CPT 70450
Computed tomography, head or brain; without contrast material UNSCHEDULED |
$16,594.16 |
$16,594.16 |
$2,009.88–$2,052.19 |
443% above |
— |
| CT scan of the head or brain, no contrast dye
CPT 70450
Computed tomography, head or brain; without contrast material |
$16,594.16 |
$16,594.16 |
$245.18–$1,975.00 |
443% above |
— |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD/BRAIN W/O CONT |
$16,594.16 |
$16,594.16 |
$779.93–$15,266.63 |
443% above |
— |
| CT scan of the head with contrast
CPT 70460
Computed tomography, head or brain; with contrast material(s) |
$16,608.88 |
$16,608.88 |
$401.74–$1,975.00 |
344% above |
— |
| CT scan of the head with contrast
CPT 70460
Computed tomography, head or brain; with contrast material(s) UNSCHEDULED |
$16,608.88 |
$16,608.88 |
$3,238.65–$3,306.84 |
344% above |
— |
| CT scan of the head with contrast
CPT 70460
CT HEAD/BRAIN W/CONT |
$16,608.88 |
$16,608.88 |
$780.62–$15,280.17 |
344% above |
— |
| CT scan of the head without and with contrast
CPT 70470
CT HD/BR W&W/O CONT |
$17,332.99 |
$17,332.99 |
$814.65–$15,946.35 |
293% above |
— |
| CT scan of the head without and with contrast
CPT 70470
Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections |
$17,332.99 |
$17,332.99 |
$401.74–$1,975.00 |
293% above |
— |
| CT scan of the head without and with contrast
CPT 70470
Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections UNSCHEDULED |
$17,332.99 |
$17,332.99 |
$2,739.96–$2,797.64 |
293% above |
— |
| CT scan of the lower back (lumbar spine) without contrast
CPT 72131
Computed tomography, lumbar spine; without contrast material |
$18,042.31 |
$18,042.31 |
$245.18–$1,975.00 |
450% above |
— |
| CT scan of the lower back (lumbar spine) without contrast
CPT 72131
CT L-SPINE W/O CONTRAST |
$18,042.31 |
$18,042.31 |
$847.99–$16,598.93 |
450% above |
— |
| CT scan of the lower back (lumbar spine) without contrast
CPT 72131
Computed tomography, lumbar spine; without contrast material UNSCHEDULED |
$18,042.31 |
$18,042.31 |
$2,272.45–$2,320.29 |
450% above |
— |
| CT scan of the neck (cervical spine), no contrast dye
CPT 72125
CT C-SPINE W/O CONTRAST |
$16,760.52 |
$16,760.52 |
$787.74–$15,419.68 |
394% above |
— |
| CT scan of the neck (cervical spine), no contrast dye
CPT 72125
Computed tomography, cervical spine; without contrast material UNSCHEDULED |
$16,760.52 |
$16,760.52 |
$2,263.94–$2,311.61 |
394% above |
— |
| CT scan of the neck (cervical spine), no contrast dye
CPT 72125
Computed tomography, cervical spine; without contrast material |
$16,760.52 |
$16,760.52 |
$245.18–$1,975.00 |
394% above |
— |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W/CONTRAST |
$19,074.50 |
$19,074.50 |
$896.50–$17,548.54 |
345% above |
— |
| CT scan of the pelvis, with contrast dye
CPT 72193
Computed tomography, pelvis; with contrast material(s) |
$19,074.50 |
$19,074.50 |
$401.74–$1,975.00 |
345% above |
— |
| CT scan of the pelvis, with contrast dye
CPT 72193
Computed tomography, pelvis; with contrast material(s) UNSCHEDULED |
$19,074.50 |
$19,074.50 |
$2,762.64–$2,820.80 |
345% above |
— |
| Carotid artery ultrasound (duplex), both sides of the neck both sides
CPT 93880
Duplex scan of extracranial arteries; complete bilateral study UNSCHEDULED |
$5,350.27 |
$5,350.27 |
$995.50–$1,016.45 |
— |
— |
| Carotid artery ultrasound (duplex), both sides of the neck both sides
CPT 93880
Duplex scan of extracranial arteries; complete bilateral study SCHEDULED |
$5,350.27 |
$5,350.27 |
$161.50–$164.90 |
— |
— |
| Carotid artery ultrasound (duplex), both sides of the neck both sides
CPT 93880
Duplex scan of extracranial arteries; complete bilateral study |
$5,350.27 |
$5,350.27 |
— |
— |
— |
| Carotid artery ultrasound (duplex), both sides of the neck
CPT 93880
DUP EXTRACRANIAL BIL |
$5,350.27 |
$5,350.27 |
$251.46–$4,922.25 |
116% above |
— |
| Chest CT scan without and with contrast
CPT 71270
CT CHEST W&W/O CONT |
$20,356.25 |
$20,356.25 |
$956.74–$18,727.75 |
411% above |
— |
| Chest CT scan without and with contrast
CPT 71270
Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections |
$20,356.25 |
$20,356.25 |
$401.74–$1,975.00 |
411% above |
— |
| Chest CT scan without and with contrast
CPT 71270
Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections UNSCHEDULED |
$20,356.25 |
$20,356.25 |
$2,729.58–$2,787.04 |
411% above |
— |
| Chest X-ray, 2 views
CPT 71046
Radiologic examination, chest; 2 views UNSCHEDULED |
$1,911.36 |
$1,911.36 |
$432.57–$441.68 |
284% above |
— |
| Chest X-ray, 2 views
CPT 71046
CHEST XRAY 2 V |
$1,911.36 |
$1,911.36 |
$89.83–$1,758.45 |
284% above |
— |
| Chest X-ray, 2 views
CPT 71046
Radiologic examination, chest; 2 views Other Diagnostic Radiology FS |
$1,911.36 |
$1,911.36 |
$182.03 |
284% above |
— |
| Chest X-ray, 2 views
CPT 71046
Radiologic examination, chest; 2 views |
$1,911.36 |
$1,911.36 |
— |
284% above |
— |
| Chest X-ray, single view
CPT 71045
CHEST XRAY 1 V |
$1,525.90 |
$1,525.90 |
$71.72–$1,403.83 |
265% above |
— |
| Collarbone (clavicle) X-ray, complete one side
CPT 73000
XR CLAVICLE COMP RT |
$2,582.91 |
$2,582.91 |
$121.40–$2,376.28 |
369% above |
— |
| Collarbone (clavicle) X-ray, complete one side
CPT 73000
XR CLAVICLE COMP LT |
$2,582.91 |
$2,582.91 |
$121.40–$2,376.28 |
369% above |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys
CPT 76770
US RETROPERITONEAL COM |
$3,582.00 |
$3,582.00 |
$168.35–$3,295.44 |
182% above |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys
CPT 76770
Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete |
$3,582.00 |
$3,582.00 |
$245.18 |
182% above |
— |
| Complete ultrasound of the back of the abdomen, such as both kidneys
CPT 76770
Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete UNSCHEDULED |
$3,582.00 |
$3,582.00 |
$996.44–$1,017.41 |
182% above |
— |
| DEXA bone density scan of the hip, pelvis or spine
CPT 77080
DXA BONE DENSITY AXIAL |
$1,940.14 |
$1,940.14 |
$91.19–$1,784.93 |
218% above |
— |
| DEXA bone density scan of the wrist, heel or finger (peripheral)
CPT 77081
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) Other Diagnostic Radiology FS |
$1,915.02 |
$1,915.02 |
$182.03 |
584% above |
— |
| DEXA bone density scan of the wrist, heel or finger (peripheral)
CPT 77081
DXA BONE DENSITY PERIPHL |
$1,915.02 |
$1,915.02 |
$90.01–$1,761.82 |
584% above |
— |
| DEXA bone density scan of the wrist, heel or finger (peripheral)
CPT 77081
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) UNSCHEDULED |
$1,915.02 |
$1,915.02 |
$206.84–$211.20 |
584% above |
— |
| DEXA bone density scan of the wrist, heel or finger (peripheral)
CPT 77081
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) |
$1,915.02 |
$1,915.02 |
— |
584% above |
— |
| Diagnostic CT scan of the chest, no contrast dye
CPT 71250
Computed tomography, thorax, diagnostic; without contrast material |
$17,650.89 |
$17,650.89 |
$245.18–$1,975.00 |
506% above |
— |
| Diagnostic CT scan of the chest, no contrast dye
CPT 71250
CT CHEST W/O CONTRAST |
$17,650.89 |
$17,650.89 |
$829.59–$16,238.82 |
506% above |
— |
| Diagnostic CT scan of the chest, no contrast dye
CPT 71250
Computed tomography, thorax, diagnostic; without contrast material UNSCHEDULED |
$17,650.89 |
$17,650.89 |
$2,072.21–$2,115.83 |
506% above |
— |
| Diagnostic CT scan of the chest, with contrast dye
CPT 71260
Computed tomography, thorax, diagnostic; with contrast material(s) |
$18,233.11 |
$18,233.11 |
$401.74–$1,975.00 |
375% above |
— |
| Diagnostic CT scan of the chest, with contrast dye
CPT 71260
CT CHEST W/CONTRAST |
$18,233.11 |
$18,233.11 |
$856.96–$16,774.46 |
375% above |
— |
| Diagnostic CT scan of the chest, with contrast dye
CPT 71260
Computed tomography, thorax, diagnostic; with contrast material(s) UNSCHEDULED |
$18,233.11 |
$18,233.11 |
$2,356.50–$2,406.11 |
375% above |
— |
| Diagnostic mammogram, both breasts both sides
CPT 77066
Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Other Outpatient |
$1,525.10 |
$1,525.10 |
$106.06 |
— |
— |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAMMO DIAG CAD BI |
$1,525.10 |
$1,525.10 |
$71.68–$1,403.09 |
— |
— |
| Diagnostic mammogram, both breasts both sides
CPT 77066
Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral |
$1,525.10 |
$1,525.10 |
$263.00 |
— |
— |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG CAD UNI RT |
$1,067.56 |
$1,067.56 |
$50.18–$982.16 |
146% above |
— |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG CAD UNI LT |
$1,067.56 |
$1,067.56 |
$50.18–$982.16 |
146% above |
— |
| Duplex ultrasound of the leg arteries, both legs
CPT 93925
DUP LE ART BIL |
$3,102.19 |
$3,102.19 |
$145.80–$2,854.01 |
48% above |
— |
| Duplex ultrasound of the leg veins, both legs both sides
CPT 93970
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study SCHEDULED |
$3,847.56 |
$3,847.56 |
$161.50–$164.90 |
— |
— |
| Duplex ultrasound of the leg veins, both legs both sides
CPT 93970
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study UNSCHEDULED |
$3,847.56 |
$3,847.56 |
$950.16–$970.16 |
— |
— |
| Duplex ultrasound of the leg veins, both legs both sides
CPT 93970
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study |
$3,847.56 |
$3,847.56 |
— |
— |
— |
| Duplex ultrasound of the leg veins, both legs
CPT 93970
DUP VEIN BIL |
$3,847.56 |
$3,847.56 |
$180.84–$3,539.76 |
110% above |
— |
| Echocardiogram through the chest wall, complete, with Doppler
CPT 93306
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc SCHEDULED |
$17,435.36 |
$17,435.36 |
$134.90–$137.74 |
421% above |
— |
| Echocardiogram through the chest wall, complete, with Doppler
CPT 93306
ECHO2D COMP W CF DOP |
$17,435.36 |
$17,435.36 |
$819.46–$16,040.53 |
421% above |
— |
| Echocardiogram through the chest wall, complete, with Doppler
CPT 93306
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc UNSCHEDULED |
$17,435.36 |
$17,435.36 |
$1,757.70–$1,794.70 |
421% above |
— |
| Echocardiogram through the chest wall, complete, with Doppler
CPT 93306
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc |
$17,435.36 |
$17,435.36 |
— |
421% above |
— |
| Elbow X-ray, 2 views one side
CPT 73070
XR ELBOW 2 VIEWS LT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
361% above |
— |
| Elbow X-ray, 2 views one side
CPT 73070
XR ELBOW 2 VIEWS RT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
361% above |
— |
| Elbow X-ray, complete, 3 or more views one side
CPT 73080
XR ELBOW 3 + V LT |
$2,963.30 |
$2,963.30 |
$139.28–$2,726.24 |
396% above |
— |
| Elbow X-ray, complete, 3 or more views one side
CPT 73080
XR ELBOW 3 + V RT |
$2,963.30 |
$2,963.30 |
$139.28–$2,726.24 |
396% above |
— |
| Eye socket (orbit) CT scan without contrast
CPT 70480
CT ORBIT/SELLA/IAC WO |
$12,866.41 |
$12,866.41 |
$604.72–$11,837.10 |
391% above |
— |
| Eye socket (orbit) CT scan without contrast
CPT 70480
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material |
$12,866.41 |
$12,866.41 |
$245.18–$1,975.00 |
391% above |
— |
| Eye socket (orbit) CT scan without contrast
CPT 70480
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material UNSCHEDULED |
$12,866.41 |
$12,866.41 |
$2,257.33–$2,304.86 |
391% above |
— |
| Facial bones X-ray, complete, 3 or more views
CPT 70150
Radiologic examination, facial bones; complete, minimum of 3 views |
$3,246.34 |
$3,246.34 |
— |
328% above |
— |
| Facial bones X-ray, complete, 3 or more views
CPT 70150
Radiologic examination, facial bones; complete, minimum of 3 views Other Diagnostic Radiology FS |
$3,246.34 |
$3,246.34 |
$245.18 |
328% above |
— |
| Facial bones X-ray, complete, 3 or more views
CPT 70150
Radiologic examination, facial bones; complete, minimum of 3 views UNSCHEDULED |
$3,246.34 |
$3,246.34 |
$508.14–$518.83 |
328% above |
— |
| Facial bones X-ray, complete, 3 or more views
CPT 70150
XR FACIAL BONES 3 + V |
$3,246.34 |
$3,246.34 |
$152.58–$2,986.63 |
328% above |
— |
| Forearm X-ray (radius and ulna), 2 views one side
CPT 73090
XR FOREARM 2 VIEWS LT |
$2,755.42 |
$2,755.42 |
$129.50–$2,534.99 |
383% above |
— |
| Forearm X-ray (radius and ulna), 2 views one side
CPT 73090
XR FOREARM 2 VIEWS RT |
$2,755.42 |
$2,755.42 |
$129.50–$2,534.99 |
383% above |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder
CPT 78226
HEPA IMAG INCL GB |
$9,945.90 |
$9,945.90 |
$467.46–$9,150.23 |
388% above |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder
CPT 78226
Hepatobiliary system imaging, including gallbladder when present; |
$9,945.90 |
$9,945.90 |
$848.52 |
388% above |
— |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder
CPT 78226
Hepatobiliary system imaging, including gallbladder when present; UNSCHEDULED |
$9,945.90 |
$9,945.90 |
$1,716.14–$1,752.27 |
388% above |
— |
| Hand X-ray, 2 views one side
CPT 73120
XR HAND 2 V RT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
349% above |
— |
| Hand X-ray, 2 views one side
CPT 73120
XR HAND 2 V LT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
349% above |
— |
| Heel bone (calcaneus) X-ray, 2 or more views one side
CPT 73650
XR CALCANEUS 2 + V RT |
$2,715.60 |
$2,715.60 |
$127.63–$2,498.35 |
451% above |
— |
| Heel bone (calcaneus) X-ray, 2 or more views one side
CPT 73650
XR CALCANEUS 2 + V LT |
$2,715.60 |
$2,715.60 |
$127.63–$2,498.35 |
451% above |
— |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older
CPT 95811
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a SCHEDULED |
$9,100.85 |
$9,100.85 |
$515.85–$526.71 |
77% above |
— |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older
CPT 95811
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a UNSCHEDULED |
$9,100.85 |
$9,100.85 |
$5,769.89–$5,891.36 |
77% above |
— |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older
CPT 95811
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a |
$9,100.85 |
$9,100.85 |
$1,992.00 |
77% above |
— |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older
CPT 95811
POLY >4 PAR W/CPAP OR BV |
$9,100.85 |
$9,100.85 |
$427.74–$8,372.78 |
77% above |
— |
| Knee X-ray, 3 views one side
CPT 73562
XR KNEE 3 V LT |
$6,696.18 |
$6,696.18 |
$314.72–$6,160.49 |
877% above |
— |
| Knee X-ray, 3 views one side
CPT 73562
XR KNEE 3 V RT |
$6,696.18 |
$6,696.18 |
$314.72–$6,160.49 |
877% above |
— |
| Knee X-ray, complete, 4 or more views one side
CPT 73564
XR KNEE 4 + V LT |
$6,589.98 |
$6,589.98 |
$309.73–$6,062.78 |
753% above |
— |
| Knee X-ray, complete, 4 or more views one side
CPT 73564
XR KNEE 4 + V RT |
$6,589.98 |
$6,589.98 |
$309.73–$6,062.78 |
753% above |
— |
| Leg CT scan without contrast (hip to foot, any part) one side
CPT 73700
CT LOWER EXTRM W/O C RT |
$14,309.55 |
$14,309.55 |
$672.55–$13,164.79 |
441% above |
— |
| Leg CT scan without contrast (hip to foot, any part) one side
CPT 73700
CT LOWER EXTRM W/O C LT |
$14,309.55 |
$14,309.55 |
$672.55–$13,164.79 |
441% above |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder
CPT 76705
Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) UNSCHEDULED |
$4,100.29 |
$4,100.29 |
$552.53–$564.16 |
263% above |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder
CPT 76705
US ABDOMEN LTD |
$4,100.29 |
$4,100.29 |
$192.71–$3,772.27 |
263% above |
— |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder
CPT 76705
Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) |
$4,100.29 |
$4,100.29 |
$245.18 |
263% above |
— |
| Limited ultrasound of an arm or leg (non-vascular)
CPT 76882
US EXTREM NON VASC LTD |
$4,305.13 |
$4,305.13 |
$202.34–$3,960.72 |
576% above |
— |
| Limited ultrasound of an arm or leg (non-vascular) one side
CPT 76882
US EXTREM NON VASC LTD |
$4,305.13 |
$4,305.13 |
$202.34–$3,960.72 |
576% above |
— |
| Limited ultrasound of an arm or leg (non-vascular) one side
CPT 76882
US EXTREM NON VASC LTD |
$4,305.13 |
$4,305.13 |
$202.34–$3,960.72 |
576% above |
— |
| Low-dose CT of the chest for lung cancer screening, no contrast dye
CPT 71271
Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) UNSCHEDULED |
$2,614.11 |
$2,614.11 |
$606.37–$619.13 |
259% above |
— |
| Low-dose CT of the chest for lung cancer screening, no contrast dye
CPT 71271
LUNG CA SCREEN WO CON |
$2,614.11 |
$2,614.11 |
$122.86–$2,404.98 |
259% above |
— |
| Low-dose CT of the chest for lung cancer screening, no contrast dye
CPT 71271
Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) |
$2,614.11 |
$2,614.11 |
$182.03 |
259% above |
— |
| Lower leg X-ray (tibia and fibula), 2 views one side
CPT 73590
XR TIBIA/FIBULA 2 V RT |
$3,617.86 |
$3,617.86 |
$170.04–$3,328.43 |
474% above |
— |
| Lower leg X-ray (tibia and fibula), 2 views one side
CPT 73590
XR TIBIA/FIBULA 2 V LT |
$3,617.86 |
$3,617.86 |
$170.04–$3,328.43 |
474% above |
— |
| MR angiography (MRA) of the head without contrast
CPT 70544
MRA HD W/O CONT |
$10,636.45 |
$10,636.45 |
$499.91–$9,785.53 |
263% above |
— |
| MR angiography (MRA) of the head without contrast
CPT 70544
Magnetic resonance angiography, head; without contrast material(s) UNSCHEDULED |
$10,636.45 |
$10,636.45 |
$2,452.84–$2,504.48 |
263% above |
— |
| MR angiography (MRA) of the head without contrast
CPT 70544
Magnetic resonance angiography, head; without contrast material(s) |
$10,636.45 |
$10,636.45 |
$517.79–$3,623.00 |
263% above |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI LW JNT W/O CONT LT |
$11,928.47 |
$11,928.47 |
$560.64–$10,974.19 |
241% above |
— |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI LW JNT W/O CONT RT |
$11,928.47 |
$11,928.47 |
$560.64–$10,974.19 |
241% above |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI LW JNT W&WO CONT LT |
$15,509.13 |
$15,509.13 |
$728.93–$14,268.40 |
218% above |
— |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI LW JNT W&WO CONT RT |
$15,509.13 |
$15,509.13 |
$728.93–$14,268.40 |
218% above |
— |
| MRI of the abdomen without contrast
CPT 74181
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) |
$14,939.12 |
$14,939.12 |
$517.79–$3,623.00 |
325% above |
— |
| MRI of the abdomen without contrast
CPT 74181
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) UNSCHEDULED |
$14,939.12 |
$14,939.12 |
$3,166.87–$3,233.54 |
325% above |
— |
| MRI of the abdomen without contrast
CPT 74181
MRI ABDOMEN W/O CONT |
$14,939.12 |
$14,939.12 |
$702.14–$13,743.99 |
325% above |
— |
| MRI of the abdomen, without and then with contrast dye
CPT 74183
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences UNSCHEDULED |
$21,255.92 |
$21,255.92 |
$4,002.75–$4,087.02 |
397% above |
— |
| MRI of the abdomen, without and then with contrast dye
CPT 74183
MRI ABDOMEN W&WO CONT |
$21,255.92 |
$21,255.92 |
$999.03–$19,555.45 |
397% above |
— |
| MRI of the abdomen, without and then with contrast dye
CPT 74183
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences |
$21,255.92 |
$21,255.92 |
$828.27–$3,623.00 |
397% above |
— |
| MRI of the brain, no contrast dye
CPT 70551
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material UNSCHEDULED |
$13,254.33 |
$13,254.33 |
$2,410.34–$2,461.08 |
282% above |
— |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN W/O CONTRAST |
$13,254.33 |
$13,254.33 |
$622.95–$12,193.98 |
282% above |
— |
| MRI of the brain, no contrast dye
CPT 70551
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material |
$13,254.33 |
$13,254.33 |
$517.79–$3,623.00 |
282% above |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences UNSCHEDULED |
$20,846.34 |
$20,846.34 |
$3,520.11–$3,594.22 |
324% above |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN W&WO CONT |
$20,846.34 |
$20,846.34 |
$979.78–$19,178.63 |
324% above |
— |
| MRI of the brain, with and without contrast dye
CPT 70553
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences |
$20,846.34 |
$20,846.34 |
$828.27–$3,623.00 |
324% above |
— |
| MRI of the lower back, no contrast dye
CPT 72148
MRI L-SPINE W/O CONT |
$14,466.14 |
$14,466.14 |
$679.91–$13,308.85 |
291% above |
— |
| MRI of the lower back, no contrast dye
CPT 72148
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material |
$14,466.14 |
$14,466.14 |
$1,922.00 |
291% above |
— |
| MRI of the lower back, no contrast dye
CPT 72148
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material UNSCHEDULED |
$14,466.14 |
$14,466.14 |
$2,450.95–$2,502.55 |
291% above |
— |
| MRI of the lower back, without and then with contrast dye
CPT 72158
MRI L-SPINE W&W/O CONT |
$21,871.59 |
$21,871.59 |
$1,027.96–$20,121.86 |
340% above |
— |
| MRI of the lower back, without and then with contrast dye
CPT 72158
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar |
$21,871.59 |
$21,871.59 |
$828.27–$3,623.00 |
340% above |
— |
| MRI of the lower back, without and then with contrast dye
CPT 72158
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar UNSCHEDULED |
$21,871.59 |
$21,871.59 |
$3,392.61–$3,464.03 |
340% above |
— |
| MRI of the mid back (thoracic spine), no contrast dye
CPT 72146
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material |
$14,466.14 |
$14,466.14 |
$517.79–$3,623.00 |
283% above |
— |
| MRI of the mid back (thoracic spine), no contrast dye
CPT 72146
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material UNSCHEDULED |
$14,466.14 |
$14,466.14 |
$2,432.07–$2,483.27 |
283% above |
— |
| MRI of the mid back (thoracic spine), no contrast dye
CPT 72146
MRI T-SPINE W/O CONT |
$14,466.14 |
$14,466.14 |
$679.91–$13,308.85 |
283% above |
— |
| MRI of the neck (cervical spine) without and with contrast
CPT 72156
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical UNSCHEDULED |
$21,871.59 |
$21,871.59 |
$3,928.14–$4,010.83 |
358% above |
— |
| MRI of the neck (cervical spine) without and with contrast
CPT 72156
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical |
$21,871.59 |
$21,871.59 |
$1,922.00 |
358% above |
— |
| MRI of the neck (cervical spine) without and with contrast
CPT 72156
MRI C-SPINE W&W/O CONT |
$21,871.59 |
$21,871.59 |
$1,027.96–$20,121.86 |
358% above |
— |
| MRI of the neck (cervical spine), no contrast dye
CPT 72141
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material UNSCHEDULED |
$13,148.74 |
$13,148.74 |
$2,300.78–$2,349.21 |
250% above |
— |
| MRI of the neck (cervical spine), no contrast dye
CPT 72141
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material |
$13,148.74 |
$13,148.74 |
$517.79–$3,623.00 |
250% above |
— |
| MRI of the neck (cervical spine), no contrast dye
CPT 72141
MRI C-SPINE W/O CONT |
$13,148.74 |
$13,148.74 |
$617.99–$12,096.84 |
250% above |
— |
| MRI of the pelvis without and with contrast
CPT 72197
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences UNSCHEDULED |
$21,255.92 |
$21,255.92 |
$3,129.09–$3,194.97 |
472% above |
— |
| MRI of the pelvis without and with contrast
CPT 72197
MRI PELVIS W&WO CONT |
$21,255.92 |
$21,255.92 |
$999.03–$19,555.45 |
472% above |
— |
| MRI of the pelvis without and with contrast
CPT 72197
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences |
$21,255.92 |
$21,255.92 |
$828.27–$3,623.00 |
472% above |
— |
| MRI of the pelvis, no contrast dye
CPT 72195
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) |
$13,955.30 |
$13,955.30 |
$517.79–$3,623.00 |
329% above |
— |
| MRI of the pelvis, no contrast dye
CPT 72195
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) UNSCHEDULED |
$13,955.30 |
$13,955.30 |
$2,696.52–$2,753.29 |
329% above |
— |
| MRI of the pelvis, no contrast dye
CPT 72195
MRI PELVIS W/O CONT |
$13,955.30 |
$13,955.30 |
$655.90–$12,838.88 |
329% above |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side
CPT 73221
MRI UP JNT W/O CONT LT |
$11,928.47 |
$11,928.47 |
$560.64–$10,974.19 |
261% above |
— |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side
CPT 73221
MRI UP JNT W/O CONT RT |
$11,928.47 |
$11,928.47 |
$560.64–$10,974.19 |
261% above |
— |
| Neck (cervical spine) X-ray, 4 or 5 views
CPT 72050
Radiologic examination, spine, cervical; 4 or 5 views Other Diagnostic Radiology FS |
$5,754.12 |
$5,754.12 |
$245.18 |
554% above |
— |
| Neck (cervical spine) X-ray, 4 or 5 views
CPT 72050
Radiologic examination, spine, cervical; 4 or 5 views |
$5,754.12 |
$5,754.12 |
— |
554% above |
— |
| Neck (cervical spine) X-ray, 4 or 5 views
CPT 72050
Radiologic examination, spine, cervical; 4 or 5 views UNSCHEDULED |
$5,754.12 |
$5,754.12 |
$630.92–$644.21 |
554% above |
— |
| Neck (cervical spine) X-ray, 4 or 5 views
CPT 72050
XR C-SPINE 4-5 V |
$5,754.12 |
$5,754.12 |
$270.44–$5,293.79 |
554% above |
— |
| Neck soft tissue CT scan with contrast
CPT 70491
Computed tomography, soft tissue neck; with contrast material(s) |
$14,617.78 |
$14,617.78 |
$401.74–$1,975.00 |
339% above |
— |
| Neck soft tissue CT scan with contrast
CPT 70491
Computed tomography, soft tissue neck; with contrast material(s) UNSCHEDULED |
$14,617.78 |
$14,617.78 |
$3,278.33–$3,347.34 |
339% above |
— |
| Neck soft tissue CT scan with contrast
CPT 70491
CT NECK W/CONTRAST |
$14,617.78 |
$14,617.78 |
$687.04–$13,448.36 |
339% above |
— |
| Neck soft tissue CT scan without contrast
CPT 70490
Computed tomography, soft tissue neck; without contrast material |
$19,015.79 |
$19,015.79 |
$245.18–$1,975.00 |
535% above |
— |
| Neck soft tissue CT scan without contrast
CPT 70490
Computed tomography, soft tissue neck; without contrast material UNSCHEDULED |
$19,015.79 |
$19,015.79 |
$2,976.08–$3,038.74 |
535% above |
— |
| Neck soft tissue CT scan without contrast
CPT 70490
CT NECK W/O CONTRAST |
$19,015.79 |
$19,015.79 |
$893.74–$17,494.53 |
535% above |
— |
| Neck soft tissue X-ray
CPT 70360
Radiologic examination; neck, soft tissue |
$2,715.60 |
$2,715.60 |
— |
387% above |
— |
| Neck soft tissue X-ray
CPT 70360
Radiologic examination; neck, soft tissue Other Diagnostic Radiology FS |
$2,715.60 |
$2,715.60 |
$182.03 |
387% above |
— |
| Neck soft tissue X-ray
CPT 70360
XR NECK SOFT TISSUE |
$2,715.60 |
$2,715.60 |
$127.63–$2,498.35 |
387% above |
— |
| Neck soft tissue X-ray
CPT 70360
Radiologic examination; neck, soft tissue UNSCHEDULED |
$2,715.60 |
$2,715.60 |
$312.63–$319.21 |
387% above |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies
CPT 78452
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat |
$19,415.28 |
$19,415.28 |
$2,938.37 |
253% above |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies
CPT 78452
NM MYOCRD SPECT R/S MULT |
$19,415.28 |
$19,415.28 |
$912.52–$17,862.06 |
253% above |
— |
| Nuclear stress test imaging (SPECT), rest and stress studies
CPT 78452
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat UNSCHEDULED |
$19,415.28 |
$19,415.28 |
$3,511.62–$3,585.55 |
253% above |
— |
| Pelvic CT scan without contrast
CPT 72192
Computed tomography, pelvis; without contrast material |
$17,900.47 |
$17,900.47 |
$245.18–$1,975.00 |
488% above |
— |
| Pelvic CT scan without contrast
CPT 72192
CT PELVIS W/O CONTRAST |
$17,900.47 |
$17,900.47 |
$841.32–$16,468.43 |
488% above |
— |
| Pelvic CT scan without contrast
CPT 72192
Computed tomography, pelvis; without contrast material UNSCHEDULED |
$17,900.47 |
$17,900.47 |
$2,372.56–$2,422.51 |
488% above |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up
CPT 76857
Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) UNSCHEDULED |
$1,759.65 |
$1,759.65 |
$405.18–$413.71 |
100% above |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up
CPT 76857
US PELVIC LTD OR FU |
$1,759.65 |
$1,759.65 |
$82.70–$1,618.88 |
100% above |
— |
| Pelvic ultrasound (not pregnancy), limited or follow-up
CPT 76857
Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) |
$1,759.65 |
$1,759.65 |
$245.18 |
100% above |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy)
CPT 76856
US PELVIC COMPLETE |
$4,672.91 |
$4,672.91 |
$219.63–$4,299.08 |
251% above |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy)
CPT 76856
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete UNSCHEDULED |
$4,672.91 |
$4,672.91 |
$1,018.16–$1,039.60 |
251% above |
— |
| Pelvic ultrasound through the belly, complete (not pregnancy)
CPT 76856
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
$4,672.91 |
$4,672.91 |
$245.18 |
251% above |
— |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation UNSCHEDULED |
$5,713.63 |
$5,713.63 |
$888.76–$907.47 |
598% above |
— |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG AFTER 1ST TRI |
$5,713.63 |
$5,713.63 |
$268.54–$5,256.54 |
598% above |
— |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation |
$5,713.63 |
$5,713.63 |
$245.18 |
598% above |
— |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby
CPT 76801
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation UNSCHEDULED |
$5,513.01 |
$5,513.01 |
$596.91–$609.48 |
630% above |
— |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby
CPT 76801
US PREG 1ST TRIMTR |
$5,513.01 |
$5,513.01 |
$259.11–$5,071.97 |
630% above |
— |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby
CPT 76801
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation |
$5,513.01 |
$5,513.01 |
$245.18 |
630% above |
— |
| Pregnancy ultrasound, limited (heartbeat, position, fluid)
CPT 76815
US PREGNANCY LTD |
$3,485.85 |
$3,485.85 |
$163.83–$3,206.98 |
439% above |
— |
| Pregnancy ultrasound, limited (heartbeat, position, fluid)
CPT 76815
Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses |
$3,485.85 |
$3,485.85 |
$245.18 |
439% above |
— |
| Pregnancy ultrasound, limited (heartbeat, position, fluid)
CPT 76815
Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses UNSCHEDULED |
$3,485.85 |
$3,485.85 |
$423.13–$432.04 |
439% above |
— |
| Rib X-ray, one side, 2 views one side
CPT 71100
XR RIBS UNI 2 V LT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
298% above |
— |
| Rib X-ray, one side, 2 views one side
CPT 71100
XR RIBS UNI 2 V RT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
298% above |
— |
| Rib X-ray, one side, with a chest view, 3 or more views one side
CPT 71101
XR RIBS UNI W/CXR 3+V RT |
$3,839.01 |
$3,839.01 |
$180.43–$3,531.89 |
460% above |
— |
| Rib X-ray, one side, with a chest view, 3 or more views one side
CPT 71101
XR RIBS UNI W/CXR 3+V LT |
$3,839.01 |
$3,839.01 |
$180.43–$3,531.89 |
460% above |
— |
| Screening mammogram, both breasts both sides
CPT 77067
MAMMO SCR CAD BI |
$915.04 |
$915.04 |
$43.01–$841.84 |
— |
— |
| Screening mammogram, both breasts both sides
CPT 77067
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed |
$915.04 |
$915.04 |
$217.46 |
— |
— |
| Screening mammogram, both breasts both sides
CPT 77067
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Other Outpatient |
$915.04 |
$915.04 |
$87.36 |
— |
— |
| Shoulder X-ray, complete, 2 or more views one side
CPT 73030
XR SHOULDER 2 + V RT |
$3,272.89 |
$3,272.89 |
$153.83–$3,011.06 |
350% above |
— |
| Shoulder X-ray, complete, 2 or more views one side
CPT 73030
XR SHOULDER 2 + V LT |
$3,272.89 |
$3,272.89 |
$153.83–$3,011.06 |
350% above |
— |
| Sinus X-ray, complete, 3 or more views
CPT 70220
Radiologic examination, sinuses, paranasal, complete, minimum of 3 views Other Diagnostic Radiology FS |
$4,776.67 |
$4,776.67 |
$182.03 |
457% above |
— |
| Sinus X-ray, complete, 3 or more views
CPT 70220
Radiologic examination, sinuses, paranasal, complete, minimum of 3 views |
$4,776.67 |
$4,776.67 |
— |
457% above |
— |
| Sinus X-ray, complete, 3 or more views
CPT 70220
Radiologic examination, sinuses, paranasal, complete, minimum of 3 views UNSCHEDULED |
$4,776.67 |
$4,776.67 |
$650.75–$664.45 |
457% above |
— |
| Sinus X-ray, complete, 3 or more views
CPT 70220
XR SINUSES 3 + V |
$4,776.67 |
$4,776.67 |
$224.50–$4,394.54 |
457% above |
— |
| Skull X-ray, fewer than 4 views
CPT 70250
Radiologic examination, skull; less than 4 views UNSCHEDULED |
$2,476.77 |
$2,476.77 |
$425.02–$433.97 |
287% above |
— |
| Skull X-ray, fewer than 4 views
CPT 70250
Radiologic examination, skull; less than 4 views Other Diagnostic Radiology FS |
$2,476.77 |
$2,476.77 |
$245.18 |
287% above |
— |
| Skull X-ray, fewer than 4 views
CPT 70250
Radiologic examination, skull; less than 4 views |
$2,476.77 |
$2,476.77 |
— |
287% above |
— |
| Skull X-ray, fewer than 4 views
CPT 70250
XR SKULL < 4 V |
$2,476.77 |
$2,476.77 |
$116.41–$2,278.63 |
287% above |
— |
| Sleep study in a lab (polysomnography)
CPT 95810
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist UNSCHEDULED |
$16,079.20 |
$16,079.20 |
$5,244.75–$5,355.17 |
202% above |
— |
| Sleep study in a lab (polysomnography)
CPT 95810
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist SCHEDULED |
$16,079.20 |
$16,079.20 |
$493.05–$503.43 |
202% above |
— |
| Sleep study in a lab (polysomnography)
CPT 95810
POLYSOMNOGRAPHY >4 PAR |
$16,079.20 |
$16,079.20 |
$755.72–$14,792.86 |
202% above |
— |
| Sleep study in a lab (polysomnography)
CPT 95810
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist |
$16,079.20 |
$16,079.20 |
$1,992.00 |
202% above |
— |
| Stress echocardiogram, complete, including the stress test and supervision
CPT 93351
ECHO STRESS W CONT ECG |
$13,189.99 |
$13,189.99 |
$619.93–$12,134.79 |
396% above |
— |
| Stress echocardiogram, complete, including the stress test and supervision
CPT 93351
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or UNSCHEDULED |
$13,189.99 |
$13,189.99 |
$1,510.24–$1,542.04 |
396% above |
— |
| Stress echocardiogram, complete, including the stress test and supervision
CPT 93351
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or |
$13,189.99 |
$13,189.99 |
— |
396% above |
— |
| Stress echocardiogram, complete, including the stress test and supervision
CPT 93351
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or SCHEDULED |
$13,189.99 |
$13,189.99 |
$151.05–$154.23 |
396% above |
— |
| Swallow study (modified barium swallow, video X-ray)
CPT 74230
Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study |
$4,586.48 |
$4,586.48 |
— |
370% above |
— |
| Swallow study (modified barium swallow, video X-ray)
CPT 74230
XR SWLW FUNC W/C&V |
$4,586.48 |
$4,586.48 |
$215.56–$4,219.56 |
370% above |
— |
| Swallow study (modified barium swallow, video X-ray)
CPT 74230
Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study Other Diagnostic Radiology FS |
$4,586.48 |
$4,586.48 |
$401.74 |
370% above |
— |
| Swallow study (modified barium swallow, video X-ray)
CPT 74230
Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study UNSCHEDULED |
$4,586.48 |
$4,586.48 |
$557.25–$568.98 |
370% above |
— |
| Thigh bone (femur) X-ray, 2 or more views
CPT 73552
Radiologic examination, femur; minimum 2 views |
$3,485.19 |
$3,485.19 |
— |
562% above |
— |
| Thigh bone (femur) X-ray, 2 or more views
CPT 73552
Radiologic examination, femur; minimum 2 views Other Diagnostic Radiology FS |
$3,485.19 |
$3,485.19 |
$182.03 |
562% above |
— |
| Thigh bone (femur) X-ray, 2 or more views
CPT 73552
XR FEMUR MIN 2 VIEWS |
$3,485.19 |
$3,485.19 |
$163.80–$3,206.37 |
562% above |
— |
| Thigh bone (femur) X-ray, 2 or more views
CPT 73552
Radiologic examination, femur; minimum 2 views UNSCHEDULED |
$3,485.19 |
$3,485.19 |
$456.19–$465.79 |
562% above |
— |
| Thoracic spine (mid back) CT scan without contrast
CPT 72128
Computed tomography, thoracic spine; without contrast material |
$16,031.57 |
$16,031.57 |
$245.18–$1,975.00 |
432% above |
— |
| Thoracic spine (mid back) CT scan without contrast
CPT 72128
CT T-SPINE W/O CONTRAST |
$16,031.57 |
$16,031.57 |
$753.48–$14,749.04 |
432% above |
— |
| Thoracic spine (mid back) CT scan without contrast
CPT 72128
Computed tomography, thoracic spine; without contrast material UNSCHEDULED |
$16,031.57 |
$16,031.57 |
$2,076.94–$2,120.66 |
432% above |
— |
| Toe X-ray, 2 or more views one side
CPT 73660
XR TOE(S) 2 + V LT |
$2,180.46 |
$2,180.46 |
$102.48–$2,006.02 |
346% above |
— |
| Toe X-ray, 2 or more views one side
CPT 73660
XR TOE(S) 2 + V RT |
$2,180.46 |
$2,180.46 |
$102.48–$2,006.02 |
346% above |
— |
| Transvaginal pelvic ultrasound
CPT 76830
Ultrasound, transvaginal UNSCHEDULED |
$2,867.26 |
$2,867.26 |
$914.27–$933.52 |
185% above |
— |
| Transvaginal pelvic ultrasound
CPT 76830
US TRANSVAGINAL |
$2,867.26 |
$2,867.26 |
$134.76–$2,637.88 |
185% above |
— |
| Transvaginal pelvic ultrasound
CPT 76830
Ultrasound, transvaginal |
$2,867.26 |
$2,867.26 |
$245.18 |
185% above |
— |
| Transvaginal ultrasound during pregnancy
CPT 76817
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
$3,168.99 |
$3,168.99 |
$245.18 |
247% above |
— |
| Transvaginal ultrasound during pregnancy
CPT 76817
Ultrasound, pregnant uterus, real time with image documentation, transvaginal UNSCHEDULED |
$3,168.99 |
$3,168.99 |
$442.03–$451.33 |
247% above |
— |
| Transvaginal ultrasound during pregnancy
CPT 76817
US PREG UT TRANSVAGINAL |
$3,168.99 |
$3,168.99 |
$148.94–$2,915.47 |
247% above |
— |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN COMPLETE |
$7,134.74 |
$7,134.74 |
$335.33–$6,563.96 |
363% above |
— |
| Ultrasound of the abdomen, complete
CPT 76700
Ultrasound, abdominal, real time with image documentation; complete UNSCHEDULED |
$7,134.74 |
$7,134.74 |
$1,344.95–$1,373.27 |
363% above |
— |
| Ultrasound of the abdomen, complete
CPT 76700
Ultrasound, abdominal, real time with image documentation; complete |
$7,134.74 |
$7,134.74 |
$245.18 |
363% above |
— |
| Ultrasound of the scrotum and testicles
CPT 76870
Ultrasound, scrotum and contents UNSCHEDULED |
$5,015.62 |
$5,015.62 |
$688.53–$703.03 |
365% above |
— |
| Ultrasound of the scrotum and testicles
CPT 76870
Ultrasound, scrotum and contents |
$5,015.62 |
$5,015.62 |
$245.18 |
365% above |
— |
| Ultrasound of the scrotum and testicles
CPT 76870
US SCROTUM AND CNTS |
$5,015.62 |
$5,015.62 |
$235.73–$4,614.37 |
365% above |
— |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid
CPT 76536
Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation |
$3,995.77 |
$3,995.77 |
$245.18 |
242% above |
— |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid
CPT 76536
Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation UNSCHEDULED |
$3,995.77 |
$3,995.77 |
$907.66–$926.77 |
242% above |
— |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid
CPT 76536
US HEAD AND NECK |
$3,995.77 |
$3,995.77 |
$187.80–$3,676.11 |
242% above |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast)
CPT 74240
Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study |
$5,289.70 |
$5,289.70 |
— |
369% above |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast)
CPT 74240
Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study UNSCHEDULED |
$5,289.70 |
$5,289.70 |
$1,997.59–$2,039.65 |
369% above |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast)
CPT 74240
XR UGI SNGL CONTRAST |
$5,289.70 |
$5,289.70 |
$248.62–$4,866.52 |
369% above |
— |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast)
CPT 74240
Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Other Diagnostic Radiology FS |
$5,289.70 |
$5,289.70 |
$401.74 |
369% above |
— |
| Upper arm X-ray (humerus), 2 views one side
CPT 73060
XR HUMERUS 2 + V LT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
381% above |
— |
| Upper arm X-ray (humerus), 2 views one side
CPT 73060
XR HUMERUS 2 + V RT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
381% above |
— |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side
CPT 93971
DUP VEIN UNI LT |
$3,601.47 |
$3,601.47 |
$169.27–$3,313.35 |
319% above |
— |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side
CPT 93971
DUP VEIN UNI RT |
$3,601.47 |
$3,601.47 |
$169.27–$3,313.35 |
319% above |
— |
| Wrist X-ray, 2 views one side
CPT 73100
XR WRIST 2 VIEWS RT |
$2,206.99 |
$2,206.99 |
$103.73–$2,030.43 |
258% above |
— |
| Wrist X-ray, 2 views one side
CPT 73100
XR WRIST 2 VIEWS LT |
$2,206.99 |
$2,206.99 |
$103.73–$2,030.43 |
258% above |
— |
| Wrist X-ray, complete, 3 or more views one side
CPT 73110
XR WRIST 3 + V RT |
$2,666.97 |
$2,666.97 |
$125.35–$2,453.61 |
276% above |
— |
| Wrist X-ray, complete, 3 or more views one side
CPT 73110
XR WRIST 3 + V LT |
$2,666.97 |
$2,666.97 |
$125.35–$2,453.61 |
276% above |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included
CPT 73502
XR HIP W PEL UN 2-3 VIEW |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
382% above |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side
CPT 73502
Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views |
$2,808.52 |
$2,808.52 |
— |
382% above |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side
CPT 73502
Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views UNSCHEDULED |
$2,808.52 |
$2,808.52 |
$426.91–$435.90 |
382% above |
— |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side
CPT 73502
Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views Other Diagnostic Radiology FS |
$2,808.52 |
$2,808.52 |
$182.03 |
382% above |
— |
| X-ray of the abdomen, 1 view
CPT 74018
Radiologic examination, abdomen; 1 view Other Diagnostic Radiology FS |
$4,237.02 |
$4,237.02 |
$182.03 |
758% above |
— |
| X-ray of the abdomen, 1 view
CPT 74018
Radiologic examination, abdomen; 1 view UNSCHEDULED |
$4,237.02 |
$4,237.02 |
$458.08–$467.72 |
758% above |
— |
| X-ray of the abdomen, 1 view
CPT 74018
ABD XR 1V |
$4,237.02 |
$4,237.02 |
$199.14–$3,898.06 |
758% above |
— |
| X-ray of the abdomen, 1 view
CPT 74018
Radiologic examination, abdomen; 1 view |
$4,237.02 |
$4,237.02 |
— |
758% above |
— |
| X-ray of the ankle, 2 views one side
CPT 73600
XR ANKLE 2 VIEWS RT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
374% above |
— |
| X-ray of the ankle, 2 views one side
CPT 73600
XR ANKLE 2 VIEWS LT |
$2,321.99 |
$2,321.99 |
$109.13–$2,136.23 |
374% above |
— |
| X-ray of the finger(s), 2 or more views one side
CPT 73140
XR FINGER(S) 2 + V LT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
494% above |
— |
| X-ray of the finger(s), 2 or more views one side
CPT 73140
XR FINGER(S) 2 + V RT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
494% above |
— |
| X-ray of the foot, 2 views one side
CPT 73620
XR FOOT 2 VIEWS RT |
$2,206.99 |
$2,206.99 |
$103.73–$2,030.43 |
350% above |
— |
| X-ray of the foot, 2 views one side
CPT 73620
XR FOOT 2 VIEWS LT |
$2,206.99 |
$2,206.99 |
$103.73–$2,030.43 |
350% above |
— |
| X-ray of the foot, complete, 3 or more views one side
CPT 73630
XR FOOT 3 + V RT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
367% above |
— |
| X-ray of the foot, complete, 3 or more views one side
CPT 73630
XR FOOT 3 + V LT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
367% above |
— |
| X-ray of the hand, 3 or more views one side
CPT 73130
XR HAND 3 + V LT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
343% above |
— |
| X-ray of the hand, 3 or more views one side
CPT 73130
XR HAND 3 + V RT |
$2,808.52 |
$2,808.52 |
$132.00–$2,583.84 |
343% above |
— |
| X-ray of the knee, 1 or 2 views one side
CPT 73560
XR KNEE 1 OR 2 V LT |
$3,551.48 |
$3,551.48 |
$166.92–$3,267.36 |
489% above |
— |
| X-ray of the knee, 1 or 2 views one side
CPT 73560
XR KNEE 1 OR 2 V RT |
$3,551.48 |
$3,551.48 |
$166.92–$3,267.36 |
489% above |
— |
| X-ray of the lower back (lumbar spine), 2 or 3 views
CPT 72100
XR L-SPINE 2/3 VIEWS |
$4,206.09 |
$4,206.09 |
$197.69–$3,869.60 |
508% above |
— |
| X-ray of the lower back (lumbar spine), 2 or 3 views
CPT 72100
Radiologic examination, spine, lumbosacral; 2 or 3 views Other Diagnostic Radiology FS |
$4,206.09 |
$4,206.09 |
$245.18 |
508% above |
— |
| X-ray of the lower back (lumbar spine), 2 or 3 views
CPT 72100
Radiologic examination, spine, lumbosacral; 2 or 3 views |
$4,206.09 |
$4,206.09 |
— |
508% above |
— |
| X-ray of the lower back (lumbar spine), 2 or 3 views
CPT 72100
Radiologic examination, spine, lumbosacral; 2 or 3 views UNSCHEDULED |
$4,206.09 |
$4,206.09 |
$462.80–$472.55 |
508% above |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
Radiologic examination, spine, lumbosacral; minimum of 4 views UNSCHEDULED |
$5,453.35 |
$5,453.35 |
$761.26–$777.29 |
387% above |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
Radiologic examination, spine, lumbosacral; minimum of 4 views |
$5,453.35 |
$5,453.35 |
— |
387% above |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
XR L-SPINE 4 + VIEWS |
$5,453.35 |
$5,453.35 |
$256.31–$5,017.08 |
387% above |
— |
| X-ray of the lower back, 4 or more views
CPT 72110
Radiologic examination, spine, lumbosacral; minimum of 4 views Other Diagnostic Radiology FS |
$5,453.35 |
$5,453.35 |
$245.18 |
387% above |
— |
| X-ray of the mid back (thoracic spine), 2 views
CPT 72070
Radiologic examination, spine; thoracic, 2 views |
$4,206.09 |
$4,206.09 |
— |
577% above |
— |
| X-ray of the mid back (thoracic spine), 2 views
CPT 72070
Radiologic examination, spine; thoracic, 2 views Other Diagnostic Radiology FS |
$4,206.09 |
$4,206.09 |
$245.18 |
577% above |
— |
| X-ray of the mid back (thoracic spine), 2 views
CPT 72070
Radiologic examination, spine; thoracic, 2 views UNSCHEDULED |
$4,206.09 |
$4,206.09 |
$482.64–$492.80 |
577% above |
— |
| X-ray of the mid back (thoracic spine), 2 views
CPT 72070
XR T-SPINE 2 VIEWS |
$4,206.09 |
$4,206.09 |
$197.69–$3,869.60 |
577% above |
— |
| X-ray of the nasal bones, 3 or more views
CPT 70160
XR NASAL BONES COMP |
$2,569.68 |
$2,569.68 |
$120.77–$2,364.11 |
299% above |
— |
| X-ray of the nasal bones, 3 or more views
CPT 70160
Radiologic examination, nasal bones, complete, minimum of 3 views Other Diagnostic Radiology FS |
$2,569.68 |
$2,569.68 |
$182.03 |
299% above |
— |
| X-ray of the nasal bones, 3 or more views
CPT 70160
Radiologic examination, nasal bones, complete, minimum of 3 views |
$2,569.68 |
$2,569.68 |
— |
299% above |
— |
| X-ray of the nasal bones, 3 or more views
CPT 70160
Radiologic examination, nasal bones, complete, minimum of 3 views UNSCHEDULED |
$2,569.68 |
$2,569.68 |
$375.91–$383.82 |
299% above |
— |
| X-ray of the neck (cervical spine), 2 or 3 views
CPT 72040
Radiologic examination, spine, cervical; 2 or 3 views Other Diagnostic Radiology FS |
$3,007.57 |
$3,007.57 |
$182.03 |
336% above |
— |
| X-ray of the neck (cervical spine), 2 or 3 views
CPT 72040
Radiologic examination, spine, cervical; 2 or 3 views |
$3,007.57 |
$3,007.57 |
— |
336% above |
— |
| X-ray of the neck (cervical spine), 2 or 3 views
CPT 72040
Radiologic examination, spine, cervical; 2 or 3 views UNSCHEDULED |
$3,007.57 |
$3,007.57 |
$408.97–$417.58 |
336% above |
— |
| X-ray of the neck (cervical spine), 2 or 3 views
CPT 72040
XR C-SPINE 2-3 VIEWS |
$3,007.57 |
$3,007.57 |
$141.36–$2,766.96 |
336% above |
— |
| X-ray of the pelvis, 1 or 2 views
CPT 72170
Radiologic examination, pelvis; 1 or 2 views UNSCHEDULED |
$2,569.68 |
$2,569.68 |
$378.74–$386.71 |
314% above |
— |
| X-ray of the pelvis, 1 or 2 views
CPT 72170
Radiologic examination, pelvis; 1 or 2 views Other Diagnostic Radiology FS |
$2,569.68 |
$2,569.68 |
$245.18 |
314% above |
— |
| X-ray of the pelvis, 1 or 2 views
CPT 72170
Radiologic examination, pelvis; 1 or 2 views |
$2,569.68 |
$2,569.68 |
— |
314% above |
— |
| X-ray of the pelvis, 1 or 2 views
CPT 72170
XR PELVIS 1/2 VIEWS |
$2,569.68 |
$2,569.68 |
$120.77–$2,364.11 |
314% above |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views
CPT 72220
Radiologic examination, sacrum and coccyx, minimum of 2 views Other Diagnostic Radiology FS |
$3,427.70 |
$3,427.70 |
$182.03 |
425% above |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views
CPT 72220
Radiologic examination, sacrum and coccyx, minimum of 2 views UNSCHEDULED |
$3,427.70 |
$3,427.70 |
$436.35–$445.54 |
425% above |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views
CPT 72220
Radiologic examination, sacrum and coccyx, minimum of 2 views |
$3,427.70 |
$3,427.70 |
— |
425% above |
— |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views
CPT 72220
XR SACRUM/COCCYX 2 + V |
$3,427.70 |
$3,427.70 |
$161.10–$3,153.48 |
425% above |
— |