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All Services Radiology Services

CPT 71260

CT Scan of thorax, with contrast material

$1,970.00 Standard Charge

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CPT 73610

X-ray Ankle, 3 Views

$262.00 Standard Charge

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CPT 70496

CTA scan of head

$2,641.00 Standard Charge

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CPT 74183

MRI of abdomen without & with contrast material

$2,978.00 Standard Charge

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CPT 76700

Ultrasound of abdomen, complete

$632.00 Standard Charge

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CPT 76801

Ultrasound, pregnancy, 1st trimester

$474.00 Standard Charge

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CPT 70551

MRI scan of brain (including brain stem); without contrast material

$2,229.00 Standard Charge

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CPT 76770

Ultrasound exam of abdomenal back wall, complete

$586.00 Standard Charge

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CPT 76830

Ultrasound, transvaginal

$606.00 Standard Charge

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CPT 73200

CT scan of shoulder, arm, or hand without contrast

$1,518.00 Standard Charge

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CPT 76641

Ultrasound of breasts (both)

$436.00 Standard Charge

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CPT 77067

Mammogram Screening

$294.00 Standard Charge

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CPT 76775

Ultrasound of back wall of the abdomen with limited areas viewed

$448.00 Standard Charge

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CPT 74177

CT scan of abdomen & pelvis with contrast material

$3,102.00 Standard Charge

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CPT 74178

CT scan of abdomen & pelvis with and without contrast material

$3,548.00 Standard Charge

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CPT 72100

X-ray Lower Sacral Spine, 2 or 3 views

$351.00 Standard Charge

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CPT 72070

X-ray thoracic spine, 2 views

$288.00 Standard Charge

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CPT 77063

3D Mammogram Screening (Tomosynthesis)

$127.00 Standard Charge

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CPT 70491

CT scan, soft tissue neck; with contrast material(s)

$1,837.00 Standard Charge

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CPT 76642

Ultrasound of breast (single)

$409.00 Standard Charge

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CPT 71250

CT Scan of thorax, without contrast material

$1,707.00 Standard Charge

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CPT 73700

CT scan of hip, knee, ankle, or foot without contrast

$1,713.00 Standard Charge

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CPT 72141

MRI neck spine without contrast material

$2,150.00 Standard Charge

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CPT 77066

Mammography of both breasts

$342.00 Standard Charge

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CPT 73120

X-ray Hand, 2 Views

$264.00 Standard Charge

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CPT 72170

X-ray Pelvis, 1-2 Views

$246.00 Standard Charge

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CPT 70544

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

$2,092.00 Standard Charge

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CPT 76805

Abdominal ultrasound of pregnant uterus, first trimester

$548.00 Standard Charge

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CPT 74176

CT scan of abdomen & pelvis without contrast material

$2,196.00 Standard Charge

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CPT 70552

MRI scan of brain with contrast

$2,373.00 Standard Charge

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CPT 70498

CTA scan of neck

$2,611.00 Standard Charge

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CPT 73218

MRI scan of shoulder, arm, or hand without contrast

$1,808.00 Standard Charge

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CPT 70486

CT scan, maxillofacial area; without contrast material

$1,444.00 Standard Charge

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CPT 72082

X-ray entire spine (scoliosis evaluation), 2 views

$523.00 Standard Charge

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CPT 73560

X-ray Knee, 1-2 Views

$203.00 Standard Charge

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CPT 73590

X-ray Lower Leg, 2 Views

$272.00 Standard Charge

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CPT 73620

X-ray Foot, 2 Views

$160.00 Standard Charge

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CPT 72148

MRI lumbar spine without contrast material

$2,163.00 Standard Charge

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CPT 72110

X-ray, lower back, minimum four views

$447.00 Standard Charge

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CPT 73630

X-ray exam of foot

$284.00 Standard Charge

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CPT 73600

X-ray Ankle, 2 Views

$160.00 Standard Charge

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CPT 72040

X-ray Lower Sacral Spine, 2-3 Views

$305.00 Standard Charge

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CPT 73140

X-ray Fingers, 2 Views

$203.00 Standard Charge

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CPT 76705

Ultrasound of abdomen, limited

$618.00 Standard Charge

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CPT 74018

X-ray abdomen, 1 view

$263.00 Standard Charge

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CPT 73221

MRI of upper extremity joint; without contrast material

$1,794.00 Standard Charge

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CPT 73660

X-ray toes, 2 or more views

$205.00 Standard Charge

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CPT 77065

Diagnostic mammography, unilateral

$289.00 Standard Charge

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CPT 73090

X-ray Upper Arm, 2 Views

$231.00 Standard Charge

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CPT 71275

CT Angiogram Chest with and without Contrast

$2,723.00 Standard Charge

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CPT 73130

X-ray Hand, 3 Views

$274.00 Standard Charge

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CPT 71045

X-ray of chest; Single View

$208.00 Standard Charge

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CPT 73721

MRI scan of leg joint

$1,929.00 Standard Charge

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CPT 70553

MRI scan of brain before and after contrast

$2,702.00 Standard Charge

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CPT 72202

X-ray Sacroiliac Joints, 3 or More Views

$389.00 Standard Charge

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CPT 71270

CT scan of chest with and without contrast

$2,083.00 Standard Charge

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CPT 71046

X-ray of chest; 2 Views

$276.00 Standard Charge

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CPT 70490

CT scan of neck without contrast

$1,520.00 Standard Charge

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CPT 77080

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

$473.00 Standard Charge

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CPT 73110

X-ray Wrist, 3+ Views

$274.00 Standard Charge

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CPT 72125

CT scan of cervical spine without contrast

$1,754.00 Standard Charge

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CPT 72193

CT scan, pelvis, with contrast

$2,068.00 Standard Charge

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CPT 76870

Ultrasound, testical

$470.00 Standard Charge

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CPT 76882

Ultrasound, shoulder joint/soft tissue

$467.00 Standard Charge

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CPT 72131

CT scan of lumbar spine without contrast

$1,737.00 Standard Charge

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CPT 74019

X-ray abdomen, 2 views

$367.00 Standard Charge

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CPT 70450

CT scan, head or brain, without contrast

$1,829.00 Standard Charge

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CPT 73080

X-ray Elbow, 3 Views

$271.00 Standard Charge

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CPT 73564

X-ray Knee, 4 or More Views

$344.00 Standard Charge

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CPT 76817

Ultrasound, pregnancy, transvaginal

$477.00 Standard Charge

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CPT 73030

X-ray Shoulder, 2 Views

$252.00 Standard Charge

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CPT 76857

Ultrasound of pelvis

$448.00 Standard Charge

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CPT 72128

CT scan of thoracic spine without contrast

$1,733.00 Standard Charge

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CPT 72192

CT scan of pelvis without contrast

$1,668.00 Standard Charge

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CPT 73100

X-ray Wrist, 3 Views

$186.00 Standard Charge

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CPT 73552

X-ray Femur, 2 Views

$257.00 Standard Charge

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CPT 76536

Ultrasound exam of head and neck

$753.00 Standard Charge

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CPT 73562

X-ray exam of knee, 3 views

$314.00 Standard Charge

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CPT 73502

X-ray Hip and Pelvis, 2 Views

$332.00 Standard Charge

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CPT 76856

Ultrasound, pelvic, complete

$661.00 Standard Charge

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CPT 71101

X-ray ribs, unilateral, 3 or more views

$349.00 Standard Charge

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CPT 73720

MRI scan of leg with and without contrast

$2,581.00 Standard Charge

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CPT 72080

X-ray thoracic-lumbar spine, 2 views

$250.00 Standard Charge

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