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All Services Radiology Services

CPT 72193

CT scan, pelvis, with contrast

$2,150.00 Standard Charge

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CPT 73060

X-ray humerus, 1 view

$430.00 Standard Charge

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CPT 77073

Bone length scanogram

$655.00 Standard Charge

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CPT 70450

CT scan, head or brain, without contrast

$2,580.00 Standard Charge

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CPT 73700

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

$2,580.00 Standard Charge

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CPT 73630

X-ray exam of foot

$410.00 Standard Charge

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CPT 72141

MRI neck spine without contrast material

$3,015.00 Standard Charge

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CPT 70553

MRI scan of brain before and after contrast

$3,655.00 Standard Charge

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CPT 73100

X-ray Wrist, 3 Views

$430.00 Standard Charge

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CPT 70551

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

$3,145.00 Standard Charge

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CPT 73564

X-ray Knee, 4 or More Views

$930.00 Standard Charge

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CPT 73723

MRI scan of hip, knee, ankle, or foot joints with and without contrast

$3,375.00 Standard Charge

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CPT 76642

Ultrasound of breast (single)

$580.00 Standard Charge

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CPT 72110

X-ray, lower back, minimum four views

$785.00 Standard Charge

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CPT 71260

CT Scan of thorax, with contrast material

$3,070.00 Standard Charge

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CPT 72040

X-ray Lower Sacral Spine, 2-3 Views

$400.00 Standard Charge

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CPT 72128

CT scan of thoracic spine without contrast

$2,610.00 Standard Charge

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CPT 71101

X-ray ribs, unilateral, 3 or more views

$710.00 Standard Charge

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CPT 74178

CT scan of abdomen & pelvis with and without contrast material

$5,720.00 Standard Charge

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CPT 76801

Ultrasound, pregnancy, 1st trimester

$520.00 Standard Charge

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CPT 73090

X-ray Upper Arm, 2 Views

$505.00 Standard Charge

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CPT 73110

X-ray Wrist, 3+ Views

$540.00 Standard Charge

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CPT 76536

Ultrasound exam of head and neck

$665.00 Standard Charge

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CPT 72050

X-ray cervical spine, 4 or more views

$500.00 Standard Charge

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CPT 72100

X-ray Lower Sacral Spine, 2 or 3 views

$520.00 Standard Charge

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CPT 73722

MRI scan of hip, knee, ankle, or foot joints with contrast

$1,970.00 Standard Charge

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CPT 76870

Ultrasound, testical

$730.00 Standard Charge

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CPT 73222

MRI scan of shoulder, elbow, or hand joints with contrast

$1,425.00 Standard Charge

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CPT 71250

CT Scan of thorax, without contrast material

$2,130.00 Standard Charge

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CPT 73610

X-ray Ankle, 3 Views

$545.00 Standard Charge

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CPT 73140

X-ray Fingers, 2 Views

$280.00 Standard Charge

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CPT 73590

X-ray Lower Leg, 2 Views

$510.00 Standard Charge

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CPT 73560

X-ray Knee, 1-2 Views

$420.00 Standard Charge

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CPT 73502

X-ray Hip and Pelvis, 2 Views

$690.00 Standard Charge

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CPT 74177

CT scan of abdomen & pelvis with contrast material

$4,825.00 Standard Charge

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CPT 73552

X-ray Femur, 2 Views

$330.00 Standard Charge

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CPT 77067

Mammogram Screening

$640.00 Standard Charge

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CPT 73600

X-ray Ankle, 2 Views

$365.00 Standard Charge

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CPT 73521

X-ray hip and pelvis, 2 views

$780.00 Standard Charge

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CPT 73221

MRI of upper extremity joint; without contrast material

$2,385.00 Standard Charge

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CPT 72158

MRI lumbar spine without & with contrast material

$4,215.00 Standard Charge

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CPT 71045

X-ray of chest; Single View

$390.00 Standard Charge

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CPT 73718

MRI scan of leg without contrast

$2,420.00 Standard Charge

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CPT 76816

Ultrasound, pregnancy, transabdominal (pelvis)

$470.00 Standard Charge

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CPT 78452

Image of the heart to assess perfusion

$7,155.00 Standard Charge

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CPT 73721

MRI scan of leg joint

$2,260.00 Standard Charge

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CPT 74019

X-ray abdomen, 2 views

$395.00 Standard Charge

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CPT 73000

X-ray clavicle, 1 view

$400.00 Standard Charge

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CPT 74018

X-ray abdomen, 1 view

$315.00 Standard Charge

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CPT 71275

CT Angiogram Chest with and without Contrast

$3,470.00 Standard Charge

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CPT 76770

Ultrasound exam of abdomenal back wall, complete

$1,100.00 Standard Charge

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CPT 76830

Ultrasound, transvaginal

$670.00 Standard Charge

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CPT 70498

CTA scan of neck

$3,515.00 Standard Charge

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CPT 72114

X-ray complete lumbar spine (with bending), 6 or more views

$570.00 Standard Charge

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CPT 71046

X-ray of chest; 2 Views

$400.00 Standard Charge

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CPT 76705

Ultrasound of abdomen, limited

$665.00 Standard Charge

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CPT 70486

CT scan, maxillofacial area; without contrast material

$2,165.00 Standard Charge

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CPT 73030

X-ray Shoulder, 2 Views

$440.00 Standard Charge

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CPT 73660

X-ray toes, 2 or more views

$285.00 Standard Charge

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CPT 74183

MRI of abdomen without & with contrast material

$3,750.00 Standard Charge

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CPT 72120

X-ray complete lumbar spine (with bending), 2-3 views

$430.00 Standard Charge

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CPT 77065

Diagnostic mammography, unilateral

$500.00 Standard Charge

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CPT 77066

Mammography of both breasts

$605.00 Standard Charge

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CPT 77080

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

$610.00 Standard Charge

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CPT 74220

X-ray esophagus (esophogram)

$395.00 Standard Charge

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CPT 76856

Ultrasound, pelvic, complete

$905.00 Standard Charge

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CPT 74176

CT scan of abdomen & pelvis without contrast material

$5,145.00 Standard Charge

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CPT 72148

MRI lumbar spine without contrast material

$2,620.00 Standard Charge

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CPT 72146

MRI chest spine without contrast material

$2,780.00 Standard Charge

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CPT 73080

X-ray Elbow, 3 Views

$720.00 Standard Charge

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CPT 70491

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

$2,680.00 Standard Charge

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CPT 72192

CT scan of pelvis without contrast

$2,585.00 Standard Charge

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CPT 72131

CT scan of lumbar spine without contrast

$2,595.00 Standard Charge

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CPT 72125

CT scan of cervical spine without contrast

$2,575.00 Standard Charge

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CPT 74230

X-ray, swallowing function study

$1,035.00 Standard Charge

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CPT 70496

CTA scan of head

$3,015.00 Standard Charge

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CPT 72070

X-ray thoracic spine, 2 views

$560.00 Standard Charge

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CPT 76000

Flouroscopy, or x-ray "movie" that takes less than an hour

$1,140.00 Standard Charge

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CPT 73620

X-ray Foot, 2 Views

$310.00 Standard Charge

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CPT 73522

X-ray Both Hips and Pelvis, 3-4 Views

$820.00 Standard Charge

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CPT 77063

3D Mammogram Screening (Tomosynthesis)

$110.00 Standard Charge

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CPT 73130

X-ray Hand, 3 Views

$495.00 Standard Charge

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CPT 70030

X-ray eye, foreign body

$125.00 Standard Charge

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CPT 72170

X-ray Pelvis, 1-2 Views

$655.00 Standard Charge

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CPT 76805

Abdominal ultrasound of pregnant uterus, first trimester

$585.00 Standard Charge

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CPT 73562

X-ray exam of knee, 3 views

$440.00 Standard Charge

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CPT 76942

Ultrasound guidance for biopsy

$745.00 Standard Charge

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CPT 76700

Ultrasound of abdomen, complete

$1,330.00 Standard Charge

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CPT 73200

CT scan of shoulder, arm, or hand without contrast

$1,500.00 Standard Charge

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