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All Services Radiology Services

CPT 77067

Mammogram Screening

$303.00 Standard Charge

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CPT 72131

CT scan of lumbar spine without contrast

$1,453.00 Standard Charge

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CPT 70486

CT scan, maxillofacial area; without contrast material

$1,453.00 Standard Charge

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CPT 72141

MRI neck spine without contrast material

$1,844.00 Standard Charge

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CPT 76819

Fetal biophysical profile without non-stress test

$229.00 Standard Charge

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CPT 72128

CT scan of thoracic spine without contrast

$1,453.00 Standard Charge

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CPT 73610

X-ray Ankle, 3 Views

$308.00 Standard Charge

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CPT 73620

X-ray Foot, 2 Views

$229.00 Standard Charge

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CPT 70498

CTA scan of neck

$2,564.00 Standard Charge

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CPT 76770

Ultrasound exam of abdomenal back wall, complete

$764.00 Standard Charge

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CPT 72110

X-ray, lower back, minimum four views

$549.00 Standard Charge

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CPT 73521

X-ray hip and pelvis, 2 views

$229.00 Standard Charge

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CPT 71260

CT Scan of thorax, with contrast material

$1,496.00 Standard Charge

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CPT 73218

MRI scan of shoulder, arm, or hand without contrast

$1,844.00 Standard Charge

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CPT 73721

MRI scan of leg joint

$1,844.00 Standard Charge

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CPT 73140

X-ray Fingers, 2 Views

$234.00 Standard Charge

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CPT 73060

X-ray humerus, 1 view

$305.00 Standard Charge

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CPT 70491

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

$1,496.00 Standard Charge

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CPT 76705

Ultrasound of abdomen, limited

$764.00 Standard Charge

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CPT 76642

Ultrasound of breast (single)

$764.00 Standard Charge

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CPT 76815

Ultrasound, pregnancy

$742.00 Standard Charge

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CPT 73552

X-ray Femur, 2 Views

$229.00 Standard Charge

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CPT 73502

X-ray Hip and Pelvis, 2 Views

$229.00 Standard Charge

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CPT 71046

X-ray of chest; 2 Views

$321.00 Standard Charge

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CPT 72146

MRI chest spine without contrast material

$1,844.00 Standard Charge

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CPT 76942

Ultrasound guidance for biopsy

$764.00 Standard Charge

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CPT 70450

CT scan, head or brain, without contrast

$1,453.00 Standard Charge

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CPT 76536

Ultrasound exam of head and neck

$1,063.00 Standard Charge

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CPT 74019

X-ray abdomen, 2 views

$336.00 Standard Charge

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CPT 70360

X-ray of neck soft tissue

$229.00 Standard Charge

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CPT 78452

Image of the heart to assess perfusion

$1,865.00 Standard Charge

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CPT 76700

Ultrasound of abdomen, complete

$764.00 Standard Charge

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CPT 73080

X-ray Elbow, 3 Views

$336.00 Standard Charge

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CPT 71101

X-ray ribs, unilateral, 3 or more views

$441.00 Standard Charge

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CPT 76805

Abdominal ultrasound of pregnant uterus, first trimester

$764.00 Standard Charge

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CPT 70496

CTA scan of head

$2,560.00 Standard Charge

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CPT 72040

X-ray Lower Sacral Spine, 2-3 Views

$373.00 Standard Charge

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CPT 71100

X-ray Ribs One Side, 2 Views

$237.00 Standard Charge

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CPT 74178

CT scan of abdomen & pelvis with and without contrast material

$1,607.00 Standard Charge

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CPT 73630

X-ray exam of foot

$298.00 Standard Charge

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CPT 73090

X-ray Upper Arm, 2 Views

$274.00 Standard Charge

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CPT 76816

Ultrasound, pregnancy, transabdominal (pelvis)

$764.00 Standard Charge

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CPT 77065

Diagnostic mammography, unilateral

$303.00 Standard Charge

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CPT 73130

X-ray Hand, 3 Views

$302.00 Standard Charge

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CPT 73221

MRI of upper extremity joint; without contrast material

$1,844.00 Standard Charge

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CPT 72148

MRI lumbar spine without contrast material

$1,844.00 Standard Charge

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CPT 76801

Ultrasound, pregnancy, 1st trimester

$764.00 Standard Charge

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CPT 74183

MRI of abdomen without & with contrast material

$1,964.00 Standard Charge

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CPT 76817

Ultrasound, pregnancy, transvaginal

$764.00 Standard Charge

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CPT 77063

3D Mammogram Screening (Tomosynthesis)

$102.00 Standard Charge

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CPT 73562

X-ray exam of knee, 3 views

$291.00 Standard Charge

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CPT 73560

X-ray Knee, 1-2 Views

$229.00 Standard Charge

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CPT 73718

MRI scan of leg without contrast

$1,844.00 Standard Charge

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CPT 71250

CT Scan of thorax, without contrast material

$1,453.00 Standard Charge

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CPT 73564

X-ray Knee, 4 or More Views

$478.00 Standard Charge

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CPT 73030

X-ray Shoulder, 2 Views

$310.00 Standard Charge

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CPT 72220

X-ray sacrum and coccyx, 2 or more views

$249.00 Standard Charge

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CPT 73700

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

$1,453.00 Standard Charge

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CPT 73590

X-ray Lower Leg, 2 Views

$315.00 Standard Charge

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CPT 77066

Mammography of both breasts

$303.00 Standard Charge

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CPT 76641

Ultrasound of breasts (both)

$764.00 Standard Charge

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CPT 74177

CT scan of abdomen & pelvis with contrast material

$1,496.00 Standard Charge

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CPT 74018

X-ray abdomen, 1 view

$298.00 Standard Charge

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CPT 70553

MRI scan of brain before and after contrast

$2,062.00 Standard Charge

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CPT 77080

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

$438.00 Standard Charge

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CPT 72125

CT scan of cervical spine without contrast

$1,453.00 Standard Charge

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CPT 73200

CT scan of shoulder, arm, or hand without contrast

$1,453.00 Standard Charge

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CPT 70551

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

$1,844.00 Standard Charge

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CPT 76870

Ultrasound, testical

$764.00 Standard Charge

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CPT 74176

CT scan of abdomen & pelvis without contrast material

$1,453.00 Standard Charge

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CPT 76830

Ultrasound, transvaginal

$764.00 Standard Charge

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CPT 76856

Ultrasound, pelvic, complete

$764.00 Standard Charge

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CPT 76882

Ultrasound, shoulder joint/soft tissue

$764.00 Standard Charge

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CPT 71045

X-ray of chest; Single View

$237.00 Standard Charge

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CPT 71275

CT Angiogram Chest with and without Contrast

$2,528.00 Standard Charge

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CPT 72193

CT scan, pelvis, with contrast

$1,496.00 Standard Charge

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CPT 72082

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

$461.00 Standard Charge

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CPT 73110

X-ray Wrist, 3+ Views

$316.00 Standard Charge

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CPT 72100

X-ray Lower Sacral Spine, 2 or 3 views

$387.00 Standard Charge

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