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All Services Radiology Services

CPT 76700

Ultrasound of abdomen, complete

$1,258.00 Standard Charge

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CPT 72100

X-ray Lower Sacral Spine, 2 or 3 views

$391.00 Standard Charge

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CPT 71046

X-ray of chest; 2 Views

$357.00 Standard Charge

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CPT 72125

CT scan of cervical spine without contrast

$2,387.00 Standard Charge

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CPT 72110

X-ray, lower back, minimum four views

$506.00 Standard Charge

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CPT 71275

CT Angiogram Chest with and without Contrast

$3,331.00 Standard Charge

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CPT 77063

3D Mammogram Screening (Tomosynthesis)

$87.00 Standard Charge

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CPT 73110

X-ray Wrist, 3+ Views

$428.00 Standard Charge

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CPT 77067

Mammogram Screening

$418.00 Standard Charge

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CPT 76805

Abdominal ultrasound of pregnant uterus, first trimester

$859.00 Standard Charge

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CPT 73030

X-ray Shoulder, 2 Views

$378.00 Standard Charge

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CPT 76830

Ultrasound, transvaginal

$1,025.00 Standard Charge

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CPT 72148

MRI lumbar spine without contrast material

$3,652.00 Standard Charge

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CPT 76536

Ultrasound exam of head and neck

$788.00 Standard Charge

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CPT 71045

X-ray of chest; Single View

$277.00 Standard Charge

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CPT 74177

CT scan of abdomen & pelvis with contrast material

$5,160.00 Standard Charge

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CPT 74018

X-ray abdomen, 1 view

$277.00 Standard Charge

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CPT 73721

MRI scan of leg joint

$3,652.00 Standard Charge

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CPT 71260

CT Scan of thorax, with contrast material

$2,587.00 Standard Charge

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CPT 78452

Image of the heart to assess perfusion

$5,209.00 Standard Charge

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CPT 77066

Mammography of both breasts

$601.00 Standard Charge

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CPT 73610

X-ray Ankle, 3 Views

$468.00 Standard Charge

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CPT 72131

CT scan of lumbar spine without contrast

$2,387.00 Standard Charge

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CPT 73630

X-ray exam of foot

$428.00 Standard Charge

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CPT 70553

MRI scan of brain before and after contrast

$4,259.00 Standard Charge

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CPT 72170

X-ray Pelvis, 1-2 Views

$314.00 Standard Charge

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CPT 71250

CT Scan of thorax, without contrast material

$2,320.00 Standard Charge

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CPT 77080

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

$554.00 Standard Charge

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CPT 73560

X-ray Knee, 1-2 Views

$354.00 Standard Charge

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CPT 73130

X-ray Hand, 3 Views

$428.00 Standard Charge

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CPT 76641

Ultrasound of breasts (both)

$785.00 Standard Charge

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CPT 76817

Ultrasound, pregnancy, transvaginal

$827.00 Standard Charge

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CPT 77386

Radiation therapy delivery

$1,746.00 Standard Charge

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CPT 72193

CT scan, pelvis, with contrast

$2,587.00 Standard Charge

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CPT 76705

Ultrasound of abdomen, limited

$1,042.00 Standard Charge

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CPT 76816

Ultrasound, pregnancy, transabdominal (pelvis)

$643.00 Standard Charge

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CPT 74176

CT scan of abdomen & pelvis without contrast material

$4,778.00 Standard Charge

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CPT 70450

CT scan, head or brain, without contrast

$2,387.00 Standard Charge

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CPT 73502

X-ray Hip and Pelvis, 2 Views

$428.00 Standard Charge

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CPT 73562

X-ray exam of knee, 3 views

$428.00 Standard Charge

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CPT 77065

Diagnostic mammography, unilateral

$510.00 Standard Charge

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