EXAM NAME

COST

CPT/HCPCS CODE

Abdomen (KUB) $172.00 74000
Acromioclavicular (AC) joints, bilateral $172.00 73050
Acute abdominal series (chest, frontal view and obstruction series) $273.00 74022
Ankle, 2 views $172.00 73600
Ankle, 3 views $172.00 73610
Cervical Spine, 2 or 3 views $172.00 72040
Cervical Spine, 4 or 5 views $273.00 72050
Cervical Spine, 6 or more views $273.00 72052
Chest, 2 views, frontal and lateral $172.00 71020
Chest, 2 views, frontal and lateral, with fluoroscopy $470.00 71023
Chest, 2 views, frontal and lateral, with obilque $172.00 71022
Chest, 3 views, frontal, lateral, and apical lordotic $172.00 71021
Chest, 4 views, complete $273.00 71030
Chest, frontal view $172.00 71010
Chest, special views (eg, lateral decubitus, Bucky studies) $172.00 71035
Clavicle, 2 views $172.00 73000
Elbow, 2 views $172.00 73070
Elbow, 3 views $172.00 73080
Eye for foreign body $172.00 70030
Facial bones, minimum of 3 views $273.00 70150
Femur, 2 views $182.00 73552
Finger(s), minimum 2 views, per hand $172.00 73140
Foot, 2 views $172.00 73620
Foot, 3 views $172.00 73630
Forearm, 2 views $172.00 73090
Hand, 2 views $172.00 73120
Hand, 3 views $172.00 73130
Heel (Calcaneus), 2 views $172.00 73650
Hip, unilateral, 1 view $182.00 73501
Hip, unilateral, including pelvis when performed, 2 or 3 views $182.00 73502
Hip, unilateral, including pelvis when performed, minimum 4 views $302.00 73503
Hips, bilateral, including pelvis when performed, 2 views $302.00 73521
Hips, bilateral, including pelvis when performed, 3 or 4 views $302.00 73522
Hips, bilateral, including pelvis when performed, minimum 5 views $576.00 73523
Humerus, minimum of 2 views $172.00 73060
Internal auditory meatus $172.00 70134
Knee, 1 or 2 views $172.00 73560
Knee, 3 views $172.00 73562
Knee, 4 or more views $285.00 73564
Knees, bilateral, standing AP view $172.00 73565
Lumbar spine, 2 or 3 views $172.00 72100
Lumbar spine, 2 or 3 views, bending only $273.00 72120
Lumbar spine, 4 or 5 views $273.00 72110
Lumbar spine, minimum of 6 views, including bending views $273.00 72114
Mandible, minimum of 4 views $273.00 70110
Mastoids, minimum of 3 views per side $172.00 70130
Nasal bones, minimum of 3 views $172.00 70160
Neck, soft tissue $172.00 70360
Obstruction series (Upright abdomen and supine abdomen) $172.00 74020
Orbits, minimum of 4 views $172.00 70200
Osseus survey, complete (axial and appendicular skeleton) $273.00 77075
Osseus survey, limited $273.00 77074
Pelvis, 1 or 2 views $172.00 72170
Pelvis, minimum of 3 views $172.00 72190
Ribs, bilateral, 3 views $273.00 71110
Ribs, bilateral, minimum of 4 views with posteroanterior chest $273.00 71111
Ribs, unilateral, 2 views $172.00 71100
Ribs, unilateral, minimum of 3 views with posteroanterior chest $273.00 71101
Sacroiliac joints, minimum of 3 views $172.00 72202
Sacrum and coccyx, minimum of 2 views $172.00 72220
Scapula, complete $172.00 73010
Scoliosis study, 1 view $182.00 72081
Sella turcica $172.00 70240
Shoulder, 1 view $172.00 73020
Shoulder, minimum of 2 views $172.00 73030
Sinuses, paranasal, minimum of 3 views $172.00 70220
Skull, less than 4 views $172.00 70250
Skull, minimum of 4 views $273.00 70260
Spine, 1 view $172.00 72020
Sternoclavicular joint(s), minimum of 3 views $172.00 71130
Sternum, minimum of 2 views $172.00 71120
Temporomandibular joints, bilateral $172.00 70330
Thoracic spine, 3 views $273.00 72072
Tibia and fibula, 2 views $172.00 73590
Toe(s), minimum 2 views per foot $172.00 73660
Wrist, 2 views $172.00 73100
Wrist, minimum of 3 views $172.00 73110