|
MRI Exam Description |
CPT |
Global Cash Price |
|
MR ABD OR ADRENAL GLANDS W/WO CON |
74183 |
$ 618.00 |
|
MR ABD OR ADRENAL GLANDS WO CONT |
74181 |
$ 359.00 |
|
MR BRAIN IAC OR PITUITARY WO CO |
70553 |
$ 578.00 |
|
MR BRAIN IAC OR PITUITARY W/WO CO |
70551 |
$ 316.00 |
|
MRI Cervical WO Contrast |
7241 |
$ 308.00 |
|
MRI Cervical W/WO Contrast |
72156 |
$ 582.00 |
|
MR CHEST WO CONTRAST |
71550 |
$ 565.00 |
|
MR LOW EXT W CONTRAST |
73718 |
$ 389.00 |
|
MR LOW EXT W/WO CONTRAST |
73720 |
$ 615.00 |
|
MR LOW JOINT WO CONTRAST |
73721 |
$ 325.00 |
|
MR LOW JOINT W/WO CONTRAST |
73723 |
$ 705.00 |
|
MR LUMBAR WO CONTRAST |
72148 |
$ 308.00 |
|
MR LUMBAR W/WO CONTRAST |
72158 |
$ 580.00 |
|
MR ORBIT/FACE/NECK W/WO CONTRAST |
70543 |
$ 615.00 |
|
MR PELVIS W/WO CONTRAST |
72197 |
$ 620.00 |
|
MR THORACIC WO CONTRAST |
72146 |
$ 310.00 |
|
MR THORACIC W/WO CONTRAST |
72157 |
$ 585.00 |
|
MR UPPER EXT WO CONTRAST |
73218 |
$ 500.00 |
|
MR UPPER EXT W/WO |
73220 |
$ 740.00 |
|
MR UPPER JNT WO CONTRAST |
73221 |
$ 325.00 |
|
MR UPPER JNT W/WO CONTRAST |
73223 |
$ 890.00 |
|
MRA ABDOMEN |
74185 |
$ 615.00 |
|
MRA HEAD WO CONTRAST |
70544 |
$ 395.00 |
| MRI Exam Description | CPT | New Cash Price |
|---|---|---|
| MRI Temporomandibular joint(s) | 70336 | $523.00 |
| MRI Orbit, Face, & Neck w/o contrast | 70540 | $446.00 |
| MRI Orbit, Face & Neck w/ contast | 70542 | $530.00 |
| MRI Orbit, Face & Neck w/ & w/o contrast | 70543 | $670.00 |
| MRA Head w/o contrast | 70544 | $423.00 |
| MRA Head w/ contrast | 70545 | $447.00 |
| MRA Head w/ & w/o contrast | 70546 | $646.00 |
| MRA Neck w/o contrast | 70547 | $424.00 |
| MRA Neck w/ contrast | 70548 | $485.00 |
| MRA Neck w/ & w/o contrast | 70549 | $679.00 |
| MRI Brain w/o contrast | 70551 | $387.00 |
| MRI Brain w/ contrast | 70552 | $535.00 |
| MRI Brain w/ & w/o contrast | 70553 | $631.00 |
| MRI Chest w/o contrast | 71550 | $563.00 |
| MRI Chest w/ contrast | 71551 | $737.00 |
| MRI Chest w/ & w/o contrast | 71552 | $885.00 |
| MRA Chest w/ or w/o contrast | 71555 | $657.00 |
| MRI Spinal Canal, Cervical w/o contrast | 72141 | $379.00 |
| MRI Spinal Canal, Cervical w/ contrast | 72142 | $545.00 |
| MRI Spinal Canal, Thoracic w/o contrast | 72146 | $377.00 |
| MRI Spinal Canal, Throacic w/ contrast | 72147 | $537.00 |
| MRI Spinal Canal, Lumbar w/o contrast | 72148 | $378.00 |
| MRI Spinal Canal, Lumbar w/ contrast | 72149 | $534.00 |
| MRI Spinal Canal, Cervical w/ & w/o contrast | 72156 | $634.00 |
| MRI Spinal Canal, Thoracic w/ & w/o contrast | 72157 | $635.00 |
| MRI Spinal Canal, Lumbar w/ & w/o contrast | 72158 | $632.00 |
| MRA Spinal Canal w/ or w/o contrast | 72159 | $681.00 |
| MRI Pelvis w/o contrast | 72195 | $453.00 |
| MRI Pelvis w/ contrast | 72196 | $532.00 |
| MRI Pelvis w/ & w/o contrast | 72197 | $668.00 |
| MRA Pelvis w/ or w/o contrast | 72198 | $665.00 |
| MRI UE (other than joint) w/o contrast | 73218 | $554.00 |
| MRI UE (other than joint) w/ contrast | 73219 | $655.00 |
| MRI UE (other than joint) w/ & w/o contrast | 73220 | $811.00 |
| MRI UE (joint) w/o contrast | 73221 | $399.00 |
| MRI UE (joint) w/ contrast | 73222 | $618.00 |
| MRI UE (joint) w/ & w/o contrast | 73223 | $766.00 |
| MRA UE w/ or w/o contrast | 73225 | $675.00 |
| MRI LE (other than joint) w/o contrast | 73718 | $441.00 |
| MRI LE (other than joint) w/ contrast | 73719 | $518.00 |
| MRI LE (other than joint) w/ & w/o contrast | 73720 | $668.00 |
| MRI LE (joint) w/o contrast | 73721 | $399.00 |
| MRI LE (joint) w/ contrast | 73722 | $618.00 |
| MRI LE (joint) w/ & w/o contrast | 73723 | $764.00 |
| MRI Abdomen w/o contrast | 74181 | $388.00 |
| MRI Abdomen w/ contrast | 74182 | $599.00 |
| MRI Abdomen w/ & w/o contrast | 74183 | $670.00 |
All prices include the radiologist fee.
| MRI Exam Description | CPT | Cash Price |
|---|---|---|
| MRI TMJ | 70336 | $523.00 |
| MRI Orbit/Face/Neck WO | 70540 | $446.00 |
| MRI Orbit/Face/Neck W | 70542 | $530.00 |
| MRI Orbit/Face/Neck W/WO | 70543 | $670.00 |
| MRA Head WO | 70544 | $423.00 |
| MRA Head W | 70545 | $447.00 |
| MRA Head W/WO | 70546 | $646.00 |
| MRA Neck WO | 70547 | $424.00 |
| MRA Neck W | 70548 | $485.00 |
| MRA Neck W/WO | 70549 | $679.00 |
| MRI Brain WO | 70551 | $387.00 |
| MRI Brain W | 70552 | $535.00 |
| MRI Brain W/WO | 70553 | $631.00 |
| MRI Chest WO | 71550 | $563.00 |
| MRI Chest W | 71551 | $737.00 |
| MRI Chest W/WO | 71552 | $885.00 |
| MRA Chest | 71555 | $657.00 |
| MRI Cervical WO | 72141 | $379.00 |
| MRI Cervical W | 72142 | $545.00 |
| MRI Thoracic WO | 72146 | $377.00 |
| MRI Thoracic W | 72147 | $537.00 |
| MRI Lumbar WO | 72148 | $378.00 |
| MRI Lumbar W | 72149 | $534.00 |
| MRI Cervical W/WO | 72156 | $634.00 |
| MRI Thoracic W/WO | 72157 | $635.00 |
| MRI Lumbar W/WO | 72158 | $632.00 |
| MRA Spinal Canal | 72159 | $681.00 |
| MRI Pelvis WO | 72195 | $453.00 |
| MRI Pelvis W | 72196 | $532.00 |
| MRI Pelvis W/WO | 72197 | $668.00 |
| MRA Pelvis | 72198 | $665.00 |
| MRI UE Non-Joint WO | 73218 | $554.00 |
| MRI UE Non-Joint W | 73219 | $655.00 |
| MRI UE Non-Joint W/WO | 73220 | $811.00 |
| MRI UE Joint WO | 73221 | $399.00 |
| MRI UE Joint W | 73222 | $618.00 |
| MRI UE Joint W/WO | 73223 | $766.00 |
| MRA UE | 73225 | $675.00 |
| MRI LE Non-Joint WO | 73718 | $441.00 |
| MRI LE Non-Joint W | 73719 | $518.00 |
| MRI LE Non-Joint W/WO | 73720 | $668.00 |
| MRI LE Joint WO | 73721 | $399.00 |
| MRI LE Joint W | 73722 | $618.00 |
| MRI LE Joint W/WO | 73723 | $764.00 |
| MRI Abdomen WO | 74181 | $388.00 |
| MRI Abdomen W | 74182 | $599.00 |
| MRI Abdomen W/WO | 74183 | $670.00 |
