|
CT scan, head, without contrast70450
|
116 |
$107 |
$392 |
$1,342 |
|
X-ray, chest, 2 views71046
|
115 |
$51 |
$93 |
$317 |
|
CT scan, head, with and without contrast70470
|
115 |
$166 |
$521 |
$1,509 |
|
X-ray, chest, 1 view71045
|
115 |
$38 |
$87 |
$216 |
|
X-ray, neck spine, 2-3 views72040
|
115 |
$63 |
$106 |
$408 |
|
X-ray, lower back spine, 4 or more views72110
|
115 |
$85 |
$143 |
$491 |
|
X-ray, pelvis72170
|
115 |
$43 |
$107 |
$306 |
|
X-ray, tailbone72220
|
115 |
$48 |
$98 |
$313 |
|
X-ray, abdomen, 1 view74018
|
115 |
$47 |
$93 |
$299 |
|
Ultrasound, abdomen, complete76700
|
115 |
$107 |
$205 |
$670 |
|
Ultrasound, abdomen, limited76705
|
115 |
$104 |
$170 |
$511 |
|
Pelvic ultrasound, complete76856
|
115 |
$104 |
$198 |
$525 |
|
CT scan, abdomen and pelvis, without contrast74176
|
114 |
$231 |
$533 |
$1,941 |
|
X-ray, nasal bones70160
|
114 |
$49 |
$107 |
$322 |
|
CT scan, eye socket and inner ear, without contrast70480
|
114 |
$108 |
$388 |
$1,342 |
|
CT scan, face and jaw, without contrast70486
|
114 |
$108 |
$327 |
$1,342 |
|
CT scan, soft tissues of the neck, without contrast70490
|
114 |
$107 |
$326 |
$1,342 |
|
CT scan, chest, without contrast71250
|
114 |
$107 |
$317 |
$1,342 |
|
CT scan, chest, with contrast71260
|
114 |
$178 |
$472 |
$1,707 |
|
X-ray, neck spine, 4-5 views72050
|
114 |
$89 |
$138 |
$552 |
|
X-ray, lower back spine, 2-3 views72100
|
114 |
$64 |
$122 |
$388 |
|
CT scan, neck spine, without contrast72125
|
114 |
$107 |
$450 |
$1,401 |
|
X-ray, upper arm bone73060
|
114 |
$53 |
$101 |
$345 |
|
X-ray, elbow, 2 views73070
|
114 |
$46 |
$95 |
$314 |
|
CT scan, abdomen, without contrast74150
|
114 |
$108 |
$331 |
$1,342 |
|
CT scan, abdomen, with and without contrast74170
|
114 |
$181 |
$521 |
$1,743 |
|
CT scan, abdomen and pelvis, with contrast74177
|
114 |
$335 |
$800 |
$2,162 |
|
CT scan, abdomen and pelvis, with and without contrast74178
|
114 |
$337 |
$853 |
$2,361 |
|
Ultrasound, soft tissues of the head and neck76536
|
114 |
$108 |
$215 |
$583 |
|
Ultrasound, scrotum76870
|
114 |
$104 |
$187 |
$604 |
|
Bone age X-ray77072
|
114 |
$37 |
$101 |
$267 |
|
X-ray, facial bones70150
|
113 |
$76 |
$128 |
$390 |
|
X-ray, sinuses70220
|
113 |
$60 |
$110 |
$397 |
|
X-ray, skull, limited70250
|
113 |
$57 |
$114 |
$326 |
|
X-ray, soft tissues of the neck70360
|
113 |
$49 |
$93 |
$231 |
|
CT scan, soft tissues of the neck, with contrast70491
|
113 |
$177 |
$450 |
$1,512 |
|
X-ray, ribs both sides, with chest71111
|
113 |
$76 |
$139 |
$454 |
|
CT scan, chest, with and without contrast71270
|
113 |
$179 |
$465 |
$1,527 |
|
CT angiogram, chest71275
|
113 |
$183 |
$519 |
$1,885 |
|
CT scan, mid-back spine, without contrast72128
|
113 |
$107 |
$407 |
$1,561 |
|
CT scan, lower back spine, without contrast72131
|
113 |
$108 |
$410 |
$1,470 |
|
CT scan, pelvis, without contrast72192
|
113 |
$107 |
$304 |
$1,342 |
|
CT scan, pelvis, with contrast72193
|
113 |
$180 |
$465 |
$1,457 |
|
X-ray, collarbone73000
|
113 |
$53 |
$100 |
$295 |
|
X-ray, shoulder, 2 or more views73030
|
113 |
$59 |
$104 |
$406 |
|
X-ray, forearm73090
|
113 |
$47 |
$94 |
$340 |
|
X-ray, hand, 3 or more views73130
|
113 |
$63 |
$107 |
$385 |
|
CT scan, arm, without contrast73200
|
113 |
$110 |
$319 |
$1,331 |
|
X-ray, knee, 1-2 views73560
|
113 |
$57 |
$99 |
$288 |
|
X-ray, lower leg73590
|
113 |
$52 |
$99 |
$333 |
|
X-ray, ankle, 3 or more views73610
|
113 |
$61 |
$107 |
$359 |
|
X-ray, foot, 3 or more views73630
|
113 |
$57 |
$107 |
$352 |
|
CT scan, leg, without contrast73700
|
113 |
$108 |
$328 |
$1,328 |
|
CT scan, abdomen, with contrast74160
|
113 |
$180 |
$458 |
$1,515 |
|
Ultrasound, kidneys and back of the abdomen, complete76770
|
113 |
$106 |
$187 |
$520 |
|
CT scan, face and jaw, with contrast70487
|
112 |
$174 |
$450 |
$1,342 |
|
X-ray, wrist, 2 views73100
|
112 |
$54 |
$100 |
$287 |
|
X-ray, wrist, 3 or more views73110
|
112 |
$72 |
$118 |
$339 |
|
X-ray, finger73140
|
112 |
$69 |
$106 |
$288 |
|
X-ray, thigh bone, 2 or more views73552
|
112 |
$59 |
$99 |
$278 |
|
X-ray, foot, 2 views73620
|
112 |
$46 |
$93 |
$288 |
|
X-ray, heel73650
|
112 |
$46 |
$95 |
$270 |
|
CT scan, head, with contrast70460
|
111 |
$166 |
$410 |
$1,342 |
|
CT scan, eye socket and inner ear, with contrast70481
|
111 |
$177 |
$458 |
$1,519 |
|
CT angiogram, head70496
|
111 |
$184 |
$519 |
$1,652 |
|
X-ray, ribs one side, with chest71101
|
111 |
$64 |
$118 |
$392 |
|
X-ray, elbow, 3 or more views73080
|
111 |
$53 |
$103 |
$357 |
|
CT scan, arm, with contrast73201
|
111 |
$335 |
$496 |
$1,429 |
|
X-ray, toe73660
|
111 |
$50 |
$94 |
$227 |
|
Transvaginal ultrasound76830
|
111 |
$107 |
$197 |
$547 |
|
Whole-body bone survey X-ray77075
|
111 |
$104 |
$187 |
$620 |
|
MRI, brain, without contrast70551
|
110 |
$240 |
$654 |
$1,831 |
|
MRI, brain, with and without contrast70553
|
110 |
$358 |
$955 |
$2,289 |
|
CT angiogram, neck70498
|
110 |
$183 |
$457 |
$1,653 |
|
X-ray, ankle, 2 views73600
|
110 |
$53 |
$100 |
$262 |
|
X-ray, abdomen, 2 views74019
|
110 |
$56 |
$112 |
$311 |
|
CT angiogram, abdomen and pelvis74174
|
110 |
$346 |
$679 |
$1,941 |
|
Ultrasound, chest76604
|
110 |
$95 |
$181 |
$340 |
|
Pregnancy ultrasound, transvaginal76817
|
110 |
$100 |
$152 |
$365 |
|
Ultrasound, joint or limb, limited76882
|
110 |
$93 |
$142 |
$440 |
|
MRI, lower spine, without contrast72148
|
109 |
$238 |
$678 |
$1,869 |
|
MR angiogram, head, without contrast70544
|
109 |
$245 |
$621 |
$2,260 |
|
X-ray, mid-back spine, 3 views72072
|
109 |
$63 |
$118 |
$431 |
|
MRI, neck spine, without contrast72141
|
109 |
$238 |
$605 |
$1,846 |
|
MRI, mid-back spine, without contrast72146
|
109 |
$243 |
$654 |
$1,961 |
|
MRI, neck spine, with and without contrast72156
|
109 |
$358 |
$905 |
$2,255 |
|
MRI, lower back spine, with and without contrast72158
|
109 |
$354 |
$906 |
$2,255 |
|
X-ray, hand, 2 views73120
|
109 |
$52 |
$109 |
$310 |
|
MRI, joint of the arm, without contrast73221
|
109 |
$245 |
$655 |
$1,920 |
|
X-ray, hip, one side, 2-3 views73502
|
109 |
$78 |
$118 |
$318 |
|
X-ray, knee, 3 views73562
|
109 |
$69 |
$112 |
$381 |
|
CT scan, leg, with contrast73701
|
109 |
$177 |
$429 |
$1,342 |
|
Pregnancy ultrasound, limited76815
|
109 |
$100 |
$138 |
$345 |
|
MRI, knee, without contrast73721
|
108 |
$245 |
$640 |
$1,863 |
|
MRI, pelvis, without contrast72195
|
108 |
$242 |
$610 |
$1,839 |
|
MRI, pelvis, with and without contrast72197
|
108 |
$358 |
$901 |
$2,256 |
|
MRI, arm, without contrast73218
|
108 |
$269 |
$687 |
$1,833 |
|
X-ray, knee, 4 or more views73564
|
108 |
$79 |
$128 |
$429 |
|
MRI, leg, without contrast73718
|
108 |
$245 |
$654 |
$1,828 |
|
MRI, abdomen, without contrast74181
|
108 |
$242 |
$592 |
$1,865 |
|
MRI, abdomen, with and without contrast74183
|
108 |
$356 |
$936 |
$2,260 |
|
Pregnancy ultrasound, before 14 weeks76801
|
108 |
$103 |
$171 |
$410 |
|
MRI, eye socket, face and neck, with and without contrast70543
|
107 |
$356 |
$877 |
$2,256 |
|
MR angiogram, neck, without contrast70547
|
107 |
$241 |
$582 |
$2,260 |
|
MRI, brain, with contrast70552
|
107 |
$343 |
$782 |
$2,246 |
|
MRI, mid-back spine, with and without contrast72157
|
107 |
$356 |
$906 |
$2,182 |
|
X-ray, sacroiliac joints72202
|
107 |
$62 |
$116 |
$341 |
|
Ultrasound, breast, complete76641
|
107 |
$105 |
$210 |
$510 |
|
Ultrasound, breast, limited76642
|
107 |
$86 |
$156 |
$439 |
|
CT scan, chest, low-dose lung cancer screening71271
|
106 |
$105 |
$187 |
$577 |
|
CT scan, lower back spine, with contrast72132
|
106 |
$306 |
$487 |
$1,440 |
|
Ultrasound, kidneys and back of the abdomen, limited76775
|
106 |
$100 |
$187 |
$416 |
|
Pelvic ultrasound, limited76857
|
106 |
$97 |
$137 |
$307 |
|
X-ray, spine, single view72020
|
105 |
$37 |
$91 |
$258 |
|
X-ray, both hips, 2 views73521
|
105 |
$67 |
$114 |
$390 |
|
Diagnostic mammogram, one breast77065
|
105 |
$79 |
$169 |
$325 |
|
Diagnostic mammogram, both breasts77066
|
105 |
$100 |
$199 |
$423 |
|
X-ray, shoulder, 1 view73020
|
104 |
$33 |
$92 |
$251 |
|
CT angiogram, leg73706
|
104 |
$190 |
$521 |
$1,703 |
|
Swallowing study, video X-ray74230
|
104 |
$135 |
$222 |
$506 |
|
Mammogram, screening, both breasts77067
|
103 |
$84 |
$147 |
$292 |
|
X-ray, ribs, one side71100
|
103 |
$57 |
$97 |
$308 |
|
Small bowel X-ray series74250
|
103 |
$159 |
$254 |
$698 |
|
X-ray, mid-back spine, 2 views72070
|
102 |
$51 |
$109 |
$325 |
|
X-ray, hip, one side, 1 view73501
|
102 |
$52 |
$92 |
$257 |
|
Bone density scan (DEXA), spine and hip77080
|
102 |
$64 |
$144 |
$521 |
|
MR angiogram, neck, with and without contrast70549
|
101 |
$348 |
$859 |
$2,367 |
|
X-ray, chest, 3 views71047
|
100 |
$64 |
$104 |
$300 |
|
MRI, joint of the arm, with contrast73222
|
100 |
$684 |
$932 |
$2,260 |
|
Upper GI series with air contrast74246
|
99 |
$161 |
$299 |
$785 |
|
X-ray, entire spine, 1 view72081
|
98 |
$66 |
$100 |
$283 |
|
X-ray, entire spine, 2-3 views72082
|
98 |
$101 |
$163 |
$333 |
|
Upper GI series (barium swallow)74240
|
98 |
$155 |
$281 |
$599 |
|
X-ray, infant, chest and abdomen76010
|
98 |
$46 |
$89 |
$230 |
|
Nuclear stress test, heart blood flow78452
|
98 |
$570 |
$1,512 |
$3,519 |
|
X-ray, pelvis, 3 or more views72190
|
96 |
$66 |
$120 |
$323 |
|
X-ray, chest, 4 or more views71048
|
94 |
$68 |
$113 |
$305 |
|
X-ray, mid and lower back spine, 2 views72080
|
92 |
$54 |
$100 |
$364 |
|
Ultrasound guidance for placing an IV line76937
|
92 |
$35 |
$132 |
$614 |
|
Bile duct X-ray during surgery74300
|
91 |
$32 |
$184 |
$904 |
|
X-ray, both hips, 3-4 views73522
|
89 |
$87 |
$136 |
$326 |
|
Heart CT calcium score75571
|
89 |
$82 |
$141 |
$425 |
|
Ultrasound, brain (through the skull)76506
|
85 |
$105 |
$198 |
$481 |
|
Bone density scan (DEXA), wrist, heel or finger77081
|
85 |
$48 |
$91 |
$271 |
|
X-ray, lower back spine, bending views72120
|
84 |
$65 |
$112 |
$428 |
|
Fetal wellbeing scan with non-stress test76818
|
84 |
$103 |
$185 |
$375 |
|
Ultrasound, infant hips76885
|
84 |
$90 |
$163 |
$471 |
|
X-ray, abdomen, 3 or more views74021
|
82 |
$66 |
$114 |
$321 |
|
CT angiogram, heart arteries75574
|
82 |
$322 |
$567 |
$1,128 |
|
Angiogram, artery of one arm or leg75710
|
81 |
$150 |
$2,822 |
$6,180 |
|
CT scan, heart, with contrast75572
|
78 |
$274 |
$453 |
$1,182 |
|
Panoramic dental X-ray70355
|
73 |
$19 |
$91 |
$208 |
|
Cardiac MRI, with contrast75561
|
72 |
$325 |
$635 |
$1,828 |
|
Joint survey X-ray, 2 or more joints77077
|
68 |
$59 |
$112 |
$275 |