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All Services Radiology Services

CPT 72141

MRI of the neck or spine without dye

$3,143.00 Standard Charge

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CPT 72192

CT of pelvis without dye

$2,056.00 Standard Charge

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CPT 76856

Complete ultrasound of the pelvis

$1,359.00 Standard Charge

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CPT 72202

X-ray Sacroiliac Joints, 3 or More Views

$488.00 Standard Charge

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CPT 76775

Ultrasound of back wall of the abdomen with limited areas viewed

$1,552.00 Standard Charge

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CPT 77066

Mammography of both breasts

$1,125.00 Standard Charge

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CPT 74160

CT of abdomen with dye

$3,335.00 Standard Charge

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CPT 76857

Limited ultrasound of the pelvis

$414.00 Standard Charge

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CPT 73650

Radiologic examination of the heel

$488.00 Standard Charge

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CPT 76881

Ultrasound Joint Soft Tissue - Complete

$779.00 Standard Charge

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CPT 74022

Serial radiologic examination of the abdomen

$972.00 Standard Charge

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CPT 73721

MRI of lower extremity joint (knee/ankle) without dye

$2,481.00 Standard Charge

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CPT 73630

Radiologic examination of the foot with 3 or more views

$488.00 Standard Charge

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CPT 70486

CT Scan of the face and jaw without dye

$2,066.00 Standard Charge

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CPT 72157

MRI of chest and spine with and without dye

$2,481.00 Standard Charge

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CPT 73140

Radiologic examination of the finger(s)

$488.00 Standard Charge

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CPT 73610

Radiologic examination of the ankle with 3 views

$488.00 Standard Charge

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CPT 76817

Transvaginal ultrasound of uterus

$754.00 Standard Charge

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CPT 73000

Radiologic examination of the collar bone

$507.00 Standard Charge

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CPT 70260

X-ray of skull, complete, minimum of 4 views

$1,166.00 Standard Charge

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CPT 71100

X-ray Ribs One Side, 2 Views

$488.00 Standard Charge

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CPT 74177

CT scan of abdomen and pelvis with contrast

$4,410.00 Standard Charge

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CPT 71260

CT scan of the thorax with dye

$2,386.00 Standard Charge

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CPT 76642

Limited ultrasound of the breast

$714.00 Standard Charge

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CPT 71101

Radiologic examination of one side of the chest/ribs

$488.00 Standard Charge

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CPT 73552

X-ray Femur, 2 Views

$405.00 Standard Charge

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CPT 73590

Radiologic examination of the lower leg

$565.00 Standard Charge

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CPT 72197

MRI of pelvis before and after dye

$5,118.00 Standard Charge

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CPT 76805

Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus

$1,552.00 Standard Charge

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CPT 73502

X-ray Hip and Pelvis, 2 Views

$482.00 Standard Charge

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CPT 71275

Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest

$4,385.00 Standard Charge

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CPT 77065

Mammography of one breast

$906.00 Standard Charge

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CPT 74150

CT of abdomen without dye

$2,521.00 Standard Charge

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CPT 76870

Ultrasound of the scrotum

$1,087.00 Standard Charge

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CPT 70491

CT scan of neck with dye

$2,819.00 Standard Charge

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CPT 72193

CT scan, pelvis, with contrast

$3,040.00 Standard Charge

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CPT 70551

MRI of brain stem without dye

$3,186.00 Standard Charge

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CPT 73110

Up to 3 views

$584.00 Standard Charge

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CPT 74170

CT of abdomen with and without dye

$3,862.00 Standard Charge

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CPT 76705

A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen

$728.00 Standard Charge

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CPT 74181

MRI of abdomen without dye

$3,069.00 Standard Charge

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CPT 72148

MRI scan of lower spinal canal

$3,146.00 Standard Charge

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CPT 73221

MRI of upper extremity without dye

$2,481.00 Standard Charge

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CPT 70553

MRI scan of brain before and after contrast

$2,363.00 Standard Charge

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CPT 73080

Radiologic examination, elbow; 3 or more views

$584.00 Standard Charge

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CPT 73090

Radiologic examination of the forearm

$488.00 Standard Charge

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CPT 70544

Magnetic resonance angiography, head; without contrast material(s)

$1,891.00 Standard Charge

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CPT 73560

Radiologic examination of the kne with 1 or 2 views

$538.00 Standard Charge

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CPT 71250

CT scan of the thorax without dye

$2,053.00 Standard Charge

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CPT 72156

MRI of neck/spine with and without dye

$4,808.00 Standard Charge

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CPT 72146

MRI of chest and spine without dye

$3,140.00 Standard Charge

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CPT 77067

Mammography of both breasts-2 or more views

$872.00 Standard Charge

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CPT 77080

Scan to measure bone mineral density (BMD) at the spine and hip

$778.00 Standard Charge

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CPT 73660

Radiologic examination of the toe(s)

$488.00 Standard Charge

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CPT 73564

Radiologic examination of the kne with 4 or more views

$488.00 Standard Charge

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CPT 74183

MRI of abdomen without and with dye

$5,124.00 Standard Charge

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CPT 72040

Radiologic examination of the neck/spine, 2-3 views

$584.00 Standard Charge

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CPT 73030

Radiologic examination of the shoulder

$584.00 Standard Charge

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CPT 71045

Single view X-Ray, Chest

$352.00 Standard Charge

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CPT 72110

X-ray of lower and sacral spine, minimum of 4 views

$887.00 Standard Charge

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CPT 72131

CT scan of lower spine without dye

$2,085.00 Standard Charge

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CPT 72100

X-ray of the lower spine 2-3 views

$972.00 Standard Charge

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CPT 72072

Radiologic examination of the middle spine, 3 views

$488.00 Standard Charge

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CPT 76700

Ultrasound of abdomen with all areas scanned

$525.00 Standard Charge

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CPT 73600

Radiologic examination of the ankle with 2 views

$488.00 Standard Charge

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CPT 72052

X-ray Lower Sacral Spine, 4 or More Views

$887.00 Standard Charge

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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

$4,774.00 Standard Charge

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CPT 73700

CT scan of leg without dye

$2,019.00 Standard Charge

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CPT 71111

X-ray of Both Sides of Ribs, Including Chest, Minimum of 4 Views

$622.00 Standard Charge

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CPT 70450

CT scan head or brain without dye

$302.24 Standard Charge

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CPT 73070

Radiologic examination, elbow; 2 views

$382.00 Standard Charge

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CPT 72158

MRI of lower back with and without dye

$4,799.00 Standard Charge

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CPT 70360

X-ray of neck soft tissue

$126.00 Standard Charge

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CPT 73130

X-ray of the hand with 3 or more views

$488.00 Standard Charge

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CPT 73120

X-ray of the hand with 2 views

$488.00 Standard Charge

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CPT 74176

CT of abdomen and pelvis without dye

$4,774.00 Standard Charge

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CPT 71046

2 views, front and back

$488.00 Standard Charge

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CPT 72050

Radiologic examination of the neck/spine, 4-5 views

$1,166.00 Standard Charge

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CPT 76830

Ultrasound of the pelvis through vagina

$881.00 Standard Charge

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CPT 76536

Ultrasound of head and neck

$841.00 Standard Charge

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CPT 73620

Radiologic examination, foot; 2 views

$488.00 Standard Charge

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CPT 72170

Radiologic examination of the pelvis

$357.00 Standard Charge

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CPT 73100

3 or more views

$488.00 Standard Charge

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CPT 73565

Radiologic examination of both knees

$439.00 Standard Charge

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CPT 73718

MRI of leg without dye

$2,481.00 Standard Charge

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CPT 76770

Ultrasound of back wall of the abdomen with all areas viewed

$828.00 Standard Charge

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CPT 70150

X-ray of bones of face, minimum of 3 views

$680.00 Standard Charge

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CPT 70110

X-ray of mandible, minimum of 4 views

$972.00 Standard Charge

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CPT 76801

Abdominal ultrasound of pregnant uterus (less than 14 weeks) single or first fetus

$1,091.00 Standard Charge

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