| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT Abdomen and Pelvis W/ Contrast |
$3,228.96 |
$5,766.00 |
44% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT Abdomen and Pelvis W/ Contrast |
$3,228.96 |
$5,766.00 |
44% |
| CT scan of the head or brain, no contrast dye
CPT 70450
Head W/O Contrast |
$1,447.04 |
$2,584.00 |
44% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
Head W/O Contrast |
$1,447.04 |
$2,584.00 |
44% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT Pelvis W/ Contrast |
$1,972.32 |
$3,522.00 |
44% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT Pelvis W/ Contrast |
$1,972.32 |
$3,522.00 |
44% |
| Diagnostic mammogram, both breasts
CPT 77066
Mammography Dx-Bil |
$680.96 |
$1,216.00 |
44% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
Mammography Dx-Bil |
$680.96 |
$1,216.00 |
44% |
| Diagnostic mammogram, one breast one side
CPT 77065
Mammography Dx-Rt |
$262.64 |
$469.00 |
44% |
| Diagnostic mammogram, one breast one side
CPT 77065
Mammography Dx-Lt |
$262.64 |
$469.00 |
44% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
Mammography Dx-Lt |
$262.64 |
$469.00 |
44% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
Mammography Dx-Rt |
$262.64 |
$469.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MRI Toe Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
Hip Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MRI Knee Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
Ankle Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Toe Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Ankle Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Ankle Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Hip Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
Hip Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Knee Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Toe Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye one side
CPT 73721
MRI Knee Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
Ankle Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MRI Toe Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MRI Knee Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
Hip Joint W/O Contrast-Bil |
$2,684.08 |
$4,793.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Knee Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Toe Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Knee Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
MRI Toe Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Ankle Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Hip Joint W/O Contrast-Rt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Ankle Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side
CPT 73721
Hip Joint W/O Contrast-Lt |
$1,342.32 |
$2,397.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
Hip Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
Ankle Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Hip Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
Hip Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
Ankle Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
Hip Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Bil |
$2,775.92 |
$4,957.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Ankle Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Hip Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Toe Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
MRI Knee Joint W/O and W/ Contrast-Lt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side
CPT 73723
Hip Joint W/O and W/ Contrast-Rt |
$1,388.24 |
$2,479.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
Brain W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
Iac W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
Pituitary W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye
CPT 70551
MRI Posterior Fossa W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
Brain W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
Pituitary W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
Iac W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI Posterior Fossa W/O Contrast |
$889.84 |
$1,589.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
Iac W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI Posterior Fossa W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
Pituitary W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye
CPT 70553
Brain W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
Pituitary W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI Posterior Fossa W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
Brain W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
Iac W/O and W/ Contrast |
$1,630.72 |
$2,912.00 |
44% |
| MRI of the lower back, no contrast dye
CPT 72148
MRI L-Spine W/O Contrast |
$2,256.24 |
$4,029.00 |
44% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MRI L-Spine W/O Contrast |
$2,256.24 |
$4,029.00 |
44% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB Ultra > 14 Weeks 1st Fetus, Complete |
$520.24 |
$929.00 |
44% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB Ultra > 14 Weeks 1st Fetus, Complete |
$520.24 |
$929.00 |
44% |
| Screening mammogram, both breasts
CPT 77067
Mammography Screening-Bil |
$454.16 |
$811.00 |
44% |
| Screening mammogram, both breasts one side
CPT 77067
Mammography Screening-Lt |
$174.72 |
$312.00 |
44% |
| Screening mammogram, both breasts one side
CPT 77067
Mammography Screening-Rt |
$174.72 |
$312.00 |
44% |
| Screening mammogram, both breasts inpatient
CPT 77067
Mammography Screening-Bil |
$454.16 |
$811.00 |
44% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
Mammography Screening-Rt |
$174.72 |
$312.00 |
44% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
Mammography Screening-Lt |
$174.72 |
$312.00 |
44% |
| Transvaginal pelvic ultrasound
CPT 76830
Transvaginal US Non OB |
$832.16 |
$1,486.00 |
44% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
Transvaginal US Non OB |
$832.16 |
$1,486.00 |
44% |
| Ultrasound of the abdomen, complete
CPT 76700
US Abdomen Complete |
$677.60 |
$1,210.00 |
44% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US Abdomen Complete |
$677.60 |
$1,210.00 |
44% |
| X-ray of the lower back, 4 or more views
CPT 72110
Spine Lumbosacral Min 4 Views |
$747.04 |
$1,334.00 |
44% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
Spine Lumbosacral Min 4 Views |
$747.04 |
$1,334.00 |
44% |