* Cash pricing is ONLY valid for patients choosing to pay in-full at the time of service.
No insurance will be billed.
| Please note: this is a full service (Global) fee which includes procedure & interpretation | ||||
| As of 1/30/2019 subject to change without notice |
| CT: Note: Additional Contrast Charge May apply*** | ||||
| CPT | Description | |||
| 75635 | CTA ABDOMINAL AORTA W RUNOFF W CONTRAST | $ 665 | ** | |
| 71275 | CTA CHEST W/O & W CONTRAST | $ 453 | ** | |
| 70498 | CTA CAROTIDS (NECK) | $ 441 | ** | |
| 70496 | CTA HEAD | $ 442 | ** | |
| 74176 | CT ABDOMEN & PELVIS WO CONTRAST | $ 303 | ||
| 74177 | CT ABDOMEN & PELVIS W CONTRAST | $ 470 | *** | |
| 74178 | CT ABDOMEN & PELVIS WO & W CONTRAST | $ 533 | *** | |
| 74150 | CT ABDOMEN WO CONTRAST | $ 226 | ||
| 74160 | CT ABDOMEN W CONTRAST | $ 348 | *** | |
| 74170 | CT ABDOMEN WO & W CONTRAST | $ 396 | *** | |
| 71250 | CT CHEST WO CONTRAST | $ 246 | ||
| 71260 | CT CHEST W CONTRAST | $ 296 | *** | |
| 71270 | CT CHEST WO & W CONTRAST | $ 355 | *** | |
| 70487 | CT FACIAL BONES / SINUS W CONTRAST | $ 253 | *** | |
| 70486 | CT FACIAL BONES / SINUS WO CONTRAST | $ 210 | ||
| 70488 | CT FACIAL BONES / SINUS WO & W CONTRAST | $ 308 | *** | |
| 70470 | CT HEAD WO & W CONTRAST | $ 289 | *** | |
| 70450 | CT HEAD WO CONTRAST | $ 175 | ||
| 70460 | CT HEAD W CONTRAST | $ 246 | *** | |
| 73700 | CT LOWER EXTREMITY WO CONTRAST | $ 271 | ||
| 73701 | CT LOWER EXTREMITY W CONTRAST | $ 341 | *** | |
| 73702 | CT LOWER EXTREMITY WO & W CONTRAST | $ 412 | *** | |
| 70491 | CT NECK W/CONTRAST | $ 307 | *** | |
| 70490 | CT NECK WO CONTRAST | $ 254 | ||
| 70492 | CT NECK WO & W CONTRAST | $ 369 | *** | |
| 70480 | CT ORBITS WO CONTRAST | $ 351 | ||
| 70481 | CT ORBITS W CONTRAST | $ 416 | *** | |
| 70482 | CT ORBITS W & W/O CONTRAST | $ 453 | *** | |
| 72192 | CT PELVIS WO CONTRAST | $ 220 | ||
| 72193 | CT PELVIS W CONTRAST | $ 341 | *** | |
| 72194 | CT PELVIS WO & W CONTRAST | $ 392 | *** | |
| 72125 | CT SPINE CERVICAL WO CONTRAST | $ 278 | ||
| 72126 | CT SPINE CERVICAL W CONTRAST | $ 344 | *** | |
| 72127 | CT SPINE CERVICAL WO & W CONTRAST | $ 407 | *** | |
| 72131 | CT SPINE LUMBAR WO CONTRAST | $ 271 | ||
| 72132 | CT SPINE LUMBAR WCONTRAST | $ 344 | *** | |
| 72133 | CT SPINE LUMBAR WO & W CONTRAST | $ 406 | *** | |
| 72128 | CT SPINE THORACIC WO CONTRAST | $ 272 | ||
| 72129 | CT SPINE THORACIC W CONTRAST | $ 345 | *** | |
| 72130 | CT SPINE THORACIC WO & W CONTRAST | $ 410 | *** | |
| 76377 | CT 3D RENDERING | $ 107 | ||
| CT CONTRAST | ||||
| Description | ||||
| ** | CTA CONTRAST CHARGE | $ 100 | ||
| *** | CT CONTRAST CHARGE | $ 75 | ||
| Mammography: | ||||
| CPT | Description | |||
| 77067 | MAMMOGRAPHY: SCREENING BILAT DIGITAL | $ 208 | ||
| 77065 | MAMMOGRAPHY: DIAGNOSTIC UNILAT DIGITAL | $ 204 | ||
| 77066 | MAMMOGRAPHY: DIAGNOSTIC BILAT DIGITAL | $ 258 | ||
| Bone Density | ||||
| CPT | Description | |||
| 77080 | DXA BONE DENSITY AXIAL SKELTON | $ 63 | ||
| BODY COMPOSITION ANALYSIS | $ 50 | |||
| Ultrasound | ||||
| CPT | Description | |||
| 76700 | US ABDOMINAL COMPLETE | $ 186 | ||
| 76705 | US ABDOMINAL LTIMITED | $ 139 | ||
| 76706 | US AORTA SCREENING AAA | $ 143 | ||
| 76641 | US BREAST, UNI COMPLETE | $ 163 | ||
| 76642 | US BREAST, UNI LIMITED | $ 134 | ||
| 76604 | US CHEST (CHEST WALL/UPPER BACK) | $ 135 | ||
| 76882 | US EXTRMITY NONVASCULAR (ie Bakers Cyst) | $ 87 | ||
| 76770 | US KIDNEY & BLADDER | $ 172 | ||
| 76775 | US KIDNEY LIMITED | $ 88 | ||
| 76856 | US PELVIS NON OB | $ 167 | ||
| 76830 | US TRANSVAGINAL | $ 186 | ||
| 76857 | US PELVIS LIMITED | $ 74 | ||
| 76870 | US TESTICULAR | $ 103 | ||
| 76536 | US THYROID | $ 177 | ||
| 76801 | OB US <14 WEEKS TRANSABDOMINAL | $ 188 | ||
| 76817 | OB US TRANSVAGINAL | $ 148 | ||
| 76802 | OB EACH ADDITIIONAL GESTATION 1st TRIMESTER | $ 99 | ||
| 76805 | OB US > 14 WEEKS TRANSABDOMINAL | $ 216 | ||
| 76810 | OB EACH ADDITIONAL GESTATION >14 WEEKS | $ 142 | ||
| 76815 | OB US LIMITED | $ 128 | ||
| 76816 | OB US FOLLOW-UP FROM PREVIOUS SCAN | $ 176 | ||
| Doppler | ||||
| 93922 | ANKEL/BRACHIAL INDEX 1-2 LEVEL BILATERAL | $ 134 | ||
| 93978 | DOPPLER: AORTA DUPLEX COMPLETE | $ 292 | ||
| 93880 | DOPPLER:CAROTID ARTERY BILATERAL | $ 310 | ||
| 93926 | DOPPLER LOWER EXTREMITY ARTERY UNI | $ 232 | ||
| 93925 | DOPPLER LOWER EXTREMITY ARTERY BILATERAL | $ 397 | ||
| 93930 | DOPPLER; UPPER EXTREMITY ARTERIAL BILATERAL | $ 318 | ||
| 93931 | DOPPLER; UPPER EXTREMITY ARTERIAL UNI | $ 198 | ||
| 93970 | DOPPLER VENOUS EXTREMITY BILATERAL | $ 299 | ||
| 93971 | DOPPLER VENOUS EXTREMITY UNI | $ 183 | ||
| X-Ray | ||||
| Definitions: Uni or Unilateral means 1 or one side. Bilateral means 2 or both sides | ||||
| CPT | Description | |||
| 74018 | ABDOMEN: 1 VIEW | $ 41 | ||
| 74019 | ABDOMEN: 2 VIEWS | $ 50 | ||
| 74021 | ABDOMEN: 3 OR MORE VIEWS | $ 59 | ||
| 73050 | ACROMIOCLAVICULAR JOINTS | $ 54 | ||
| 74022 | ACUTE ABDOMEN SERIES W/CHEST 3 VIEWS | $ 67 | ||
| 73600 | ANKLE 2 VIEWS | $ 45 | ||
| 73610 | ANKLE COMPLETE | $ 47 | ||
| 77072 | BONE AGE STUDIES | $ 35 | ||
| 77073 | BONE LENGTH STUDIES | $ 54 | ||
| 73650 | CALCANEOUS MIN 2 VIEWS | $ 41 | ||
| 71045 | CHEST SINGLE FRONTAL VIEW | $ 30 | ||
| 71046 | CHEST 2 VIEWS | $ 46 | ||
| 71047 | CHEST 3V | $ 59 | ||
| 71048 | CHEST 4 VIEWS or more | $ 63 | ||
| 73000 | CLAVICLE | $ 42 | ||
| 73070 | ELBOW 2 VIEWS | $ 41 | ||
| 73080 | ELBOW COMPLETE, MIN 3 VIEWS | $ 47 | ||
| 70150 | FACIAL BONES 3 VIEWS | $ 62 | ||
| 73551 | FEMUR 1 VIEW | $ 42 | ||
| 73552 | FEMUR 2 VIEWS | $ 50 | ||
| 73140 | FINGERS MIN 2 VIEWS | $ 49 | ||
| 73620 | FOOT 2 VIEWS | $ 39 | ||
| 73630 | FOOT COMPLETE | $ 44 | ||
| 73090 | FOREARM, 2 VIEWS | $ 39 | ||
| 73120 | HAND 2 VIEWS | $ 43 | ||
| 73130 | HAND COMPLETE | $ 48 | ||
| 73521 | HIP, BILATERAL,W PELVIS, 2 VIEWS | $ 57 | ||
| 73522 | HIP, BILATERAL, W PELVIS 3-4 VIEWS | $ 74 | ||
| 73523 | HIP,BILATERAL, W PELVIS MIN 5 VIEWS | $ 85 | ||
| 73501 | HIP, UNI, W PELVIS, 1 VIEW | $ 45 | ||
| 73502 | HIP, UNI,W PELVIS, 2-3 VIEWS | $ 62 | ||
| 73503 | HIP, UNI, MIN of 4 VIEWS | $ 78 | ||
| 73060 | HUMERUS MIN 2 VIEWS | $ 44 | ||
| 73560 | KNEE, 1-2 VIEWS | $ 47 | ||
| 73562 | KNEE, 3 VIEWS | $ 54 | ||
| 73564 | KNEE, COMP 4 OR MORE VIEWS | $ 60 | ||
| 73565 | KNEES, STANDING COMPARISON | $ 54 | ||
| 73592 | LOWER EXTREMITY INFANT 2 VIEW (<1 YR) | $ 41 | ||
| 70100 | MANDIBLE <4 VIEWS | $ 50 | ||
| 70110 | MANDIBLE COMPLETE 4 OR MORE VIEWS | $ 57 | ||
| 70120 | MASTOIDS < 3 VWS | $ 50 | ||
| 70130 | MASTOID COMPLETE, MIN 3 VIEWS PER SIDE | $ 82 | ||
| 70160 | NASAL BONES | $ 50 | ||
| 70360 | NECK SOFT TISSUE | $ 43 | ||
| 76010 | NOSE/RECTUM FOR CHILD FOREIGN BODY 1 VIEW | $ 39 | ||
| 70200 | ORBITS COMPLETE | $ 64 | ||
| 77074 | OSSEOUS SURVEY: LIMITED FOR METS | $ 97 | ||
| 77075 | OSSEOUS SURVEY: COMPLETE AXIAL & APPENDICULAR | $ 132 | ||
| 77076 | OSSEOUS SURVEY: INFANT ( <1 YR) | $ 144 | ||
| 72170 | PELVIS 1 OR 2 VIEWS | $ 48 | ||
| 72190 | PELVIS MIN 3 VIEWS | $ 57 | ||
| 71110 | RIBS: BILATERAL 3 VIEWS | $ 60 | ||
| 71111 | RIBS: BILATERAL W/CHEST, MIN 4 VIEWS | $ 71 | ||
| 71100 | RIBS: UNILATERAL 2 VIEWS | $ 50 | ||
| 71101 | RIBS: UNILATERAL W/CHEST MIN 3 VIEWS | $ 58 | ||
| 72200 | SACROILIAC JOINTS 1 OR 2 VWS | $ 43 | ||
| 72202 | SACROILIAC JOINTS 3 OR MORE | $ 50 | ||
| 72220 | SACRUM AND COCCYX MIN 2 VIEWS | $ 43 | ||
| 73010 | SCAPULA | $ 46 | ||
| 70240 | SELLA TURCIA | $ 46 | ||
| 73020 | SHOULDER, 1 VIEW | $ 35 | ||
| 73030 | SHOULDER COMPLETE MIN 2 VIEWS | $ 44 | ||
| 70210 | SINUS 1 VIEW | $ 45 | ||
| 70220 | SINUS COMPLETE MN 3 VIEWS | $ 57 | ||
| 70250 | SKULL < 4 VIEWS | $ 55 | ||
| 70260 | SKULL COMPLETE MIN 4 VIEWS | $ 69 | ||
| 72020 | SPINE: SINGLE VIEW, SPECIFY LEVEL | $ 34 | ||
| 72040 | SPINE CERVICAL 2 OR 3 VWS | $ 50 | ||
| 72050 | SPINE CERVICAL 4 or 5 VIEWS | $ 68 | ||
| 72052 | SPINE CERVICAL 6 OR MORE VIEWS | $ 84 | ||
| 72100 | SPINE LUMBAR 2 OR 3 VIEWS | $ 53 | ||
| 72110 | SPINE LUMBAR MIN 4 VIEWS | $ 74 | ||
| 72120 | SPINE LUMBAR BENDING 2 OR 3 VIEWS | $ 61 | ||
| 72114 | SPINE LUMBAR COMP MIN 6 VIEWS | $ 93 | ||
| 72070 | SPINE THORACIC 2 VIEWS | $ 51 | ||
| 72072 | SPINE THORACIC 3 VIEWS | $ 52 | ||
| 72074 | SPINE THORACIC MIN 4 VIEWS | $ 59 | ||
| 72081 | SPINE SCOLIOSIS 1 VIEW | $ 58 | ||
| 72082 | SPINE SCOLIOSIS 2-3 VIEWS | $ 94 | ||
| 72083 | SPINE SCOLIOSIS 4-5 VIEWS | $ 113 | ||
| 72084 | SPINE SCOLIOSIS MIN 6 VIEWS | $ 132 | ||
| 71130 | STERNOCLAVICULAR JOINT(S) MIN 3 VIEWS | $ 54 | ||
| 71120 | STERNUM MIN 2 VIEWS | $ 45 | ||
| 73590 | TIBIA & FIBULA, 2 VIEWS | $ 43 | ||
| 70328 | TMJ UNI | $ 46 | ||
| 70330 | TMJ BILATERAL | $ 71 | ||
| 73660 | TOES MIN 2 VIEWS | $ 43 | ||
| 73092 | UPPER EXTREMITY INFANT (<1 YR) 2 VIEW | $ 41 | ||
| 73100 | WRIST, 2 VIEWS | $ 47 | ||
| 73110 | WRIST, COMPLETE MIN 3 VIEW | $ 53 | ||
| FLUOROSCOPY: | ||||
| CPT | Description | |||
| 74270 | BARIUM ENEMA-COLON | $ 226 | ||
| 74220 | ESOPHAGRAM | $ 133 | ||
| 74250 | SMALL BOWEL W/SERIAL FILM | $ 156 | ||
| 74241 | UPPER GI WITH KUB | $ 176 | ||
| 74245 | UGI W/SMALL BOWEL | $ 257 | ||