|
X-ray, chest, 2 views71046
|
5 |
$17 |
$80 |
$91 |
|
CT scan, abdomen and pelvis, without contrast74176
|
5 |
$177 |
$229 |
$359 |
|
X-ray, nasal bones70160
|
5 |
$18 |
$83 |
$91 |
|
X-ray, sinuses70220
|
5 |
$32 |
$82 |
$91 |
|
X-ray, soft tissues of the neck70360
|
5 |
$25 |
$83 |
$91 |
|
CT scan, head, with and without contrast70470
|
5 |
$23 |
$168 |
$529 |
|
CT scan, eye socket and inner ear, without contrast70480
|
5 |
$93 |
$106 |
$335 |
|
CT scan, eye socket and inner ear, with contrast70481
|
5 |
$151 |
$168 |
$452 |
|
CT scan, face and jaw, without contrast70486
|
5 |
$83 |
$100 |
$196 |
|
CT scan, face and jaw, with contrast70487
|
5 |
$56 |
$168 |
$445 |
|
CT scan, soft tissues of the neck, without contrast70490
|
5 |
$93 |
$100 |
$335 |
|
CT scan, soft tissues of the neck, with contrast70491
|
5 |
$112 |
$168 |
$367 |
|
X-ray, chest, 1 view71045
|
5 |
$17 |
$80 |
$91 |
|
X-ray, ribs one side, with chest71101
|
5 |
$20 |
$94 |
$109 |
|
X-ray, ribs both sides, with chest71111
|
5 |
$26 |
$97 |
$109 |
|
CT scan, chest, with and without contrast71270
|
5 |
$130 |
$168 |
$508 |
|
CT angiogram, chest71275
|
5 |
$157 |
$168 |
$406 |
|
X-ray, neck spine, 2-3 views72040
|
5 |
$18 |
$83 |
$100 |
|
X-ray, lower back spine, 2-3 views72100
|
5 |
$19 |
$97 |
$109 |
|
X-ray, lower back spine, 4 or more views72110
|
5 |
$27 |
$97 |
$109 |
|
CT scan, neck spine, without contrast72125
|
5 |
$93 |
$100 |
$410 |
|
CT scan, mid-back spine, without contrast72128
|
5 |
$93 |
$100 |
$410 |
|
CT scan, lower back spine, without contrast72131
|
5 |
$93 |
$100 |
$410 |
|
CT scan, lower back spine, with contrast72132
|
5 |
$125 |
$335 |
$532 |
|
X-ray, pelvis72170
|
5 |
$18 |
$93 |
$109 |
|
CT scan, pelvis, without contrast72192
|
5 |
$14 |
$100 |
$342 |
|
CT scan, pelvis, with contrast72193
|
5 |
$131 |
$168 |
$517 |
|
X-ray, sacroiliac joints72202
|
5 |
$18 |
$97 |
$109 |
|
X-ray, tailbone72220
|
5 |
$26 |
$78 |
$91 |
|
X-ray, collarbone73000
|
5 |
$15 |
$83 |
$91 |
|
X-ray, shoulder, 1 view73020
|
5 |
$13 |
$79 |
$91 |
|
X-ray, shoulder, 2 or more views73030
|
5 |
$16 |
$80 |
$91 |
|
X-ray, upper arm bone73060
|
5 |
$26 |
$82 |
$91 |
|
X-ray, elbow, 2 views73070
|
5 |
$26 |
$82 |
$91 |
|
X-ray, elbow, 3 or more views73080
|
5 |
$18 |
$78 |
$91 |
|
X-ray, forearm73090
|
5 |
$25 |
$82 |
$91 |
|
X-ray, wrist, 2 views73100
|
5 |
$26 |
$79 |
$91 |
|
X-ray, wrist, 3 or more views73110
|
5 |
$31 |
$83 |
$91 |
|
X-ray, hand, 2 views73120
|
5 |
$25 |
$93 |
$109 |
|
X-ray, hand, 3 or more views73130
|
5 |
$17 |
$82 |
$91 |
|
X-ray, finger73140
|
5 |
$24 |
$80 |
$91 |
|
CT scan, arm, without contrast73200
|
5 |
$93 |
$109 |
$235 |
|
X-ray, knee, 1-2 views73560
|
5 |
$18 |
$83 |
$91 |
|
X-ray, knee, 3 views73562
|
5 |
$29 |
$83 |
$91 |
|
X-ray, knee, 4 or more views73564
|
5 |
$30 |
$100 |
$109 |
|
X-ray, ankle, 2 views73600
|
5 |
$25 |
$79 |
$91 |
|
X-ray, ankle, 3 or more views73610
|
5 |
$17 |
$80 |
$91 |
|
X-ray, foot, 2 views73620
|
5 |
$24 |
$78 |
$91 |
|
X-ray, foot, 3 or more views73630
|
5 |
$16 |
$83 |
$91 |
|
X-ray, toe73660
|
5 |
$23 |
$78 |
$91 |
|
CT scan, leg, without contrast73700
|
5 |
$93 |
$109 |
$239 |
|
CT scan, leg, with contrast73701
|
5 |
$157 |
$182 |
$339 |
|
X-ray, abdomen, 1 view74018
|
5 |
$16 |
$80 |
$91 |
|
X-ray, abdomen, 2 views74019
|
5 |
$18 |
$97 |
$109 |
|
CT scan, abdomen, with contrast74160
|
5 |
$127 |
$168 |
$566 |
|
CT scan, abdomen, with and without contrast74170
|
5 |
$144 |
$168 |
$524 |
|
CT scan, abdomen and pelvis, with contrast74177
|
5 |
$50 |
$335 |
$999 |
|
CT scan, abdomen and pelvis, with and without contrast74178
|
5 |
$192 |
$335 |
$1,088 |
|
Ultrasound, soft tissues of the head and neck76536
|
5 |
$68 |
$100 |
$112 |
|
Ultrasound, abdomen, complete76700
|
5 |
$68 |
$100 |
$289 |
|
Ultrasound, abdomen, limited76705
|
5 |
$14 |
$100 |
$167 |
|
Ultrasound, kidneys and back of the abdomen, complete76770
|
5 |
$62 |
$100 |
$165 |
|
Pregnancy ultrasound, before 14 weeks76801
|
5 |
$68 |
$100 |
$156 |
|
Pregnancy ultrasound, transvaginal76817
|
5 |
$54 |
$100 |
$139 |
|
Transvaginal ultrasound76830
|
5 |
$68 |
$100 |
$151 |
|
Pelvic ultrasound, complete76856
|
5 |
$17 |
$100 |
$145 |
|
Pelvic ultrasound, limited76857
|
5 |
$45 |
$100 |
$109 |
|
Ultrasound, scrotum76870
|
5 |
$43 |
$100 |
$147 |
|
Bone age X-ray77072
|
5 |
$17 |
$97 |
$109 |