CPT code | Description | Self-Pay Price |
---|---|---|
76700 | Abdomen Complete | $275.00 |
93975 | Abdomen duplex complete (venous/arterial) | $375.00 |
76705 | Abdomen Limited/RUQ or LUQ or appendix or hernia | $225.00 |
93976 | Abdomen duplex limited | $275.00 |
76775 | Aorta | $225.00 |
76770 | Renal | $225.00 |
76857 | Bladder with pre and post void | $225.00 |
76776 | Renal transplant | $225.00 |
93976 | Renal transplant duplex | $275.00 |
76856 | Pelvic complete transabdominal | $225.00 |
76830** | Endovaginal pelvic and/or IUD check | $225.00 |
76830** | Endovaginal pelvic in conjunction with additional study | $175.00 |
76870 | Scrotum/testicular | $225.00 |
93976 | Scrotal/testicular duplex | $275.00 |
76536 | Thyroid/soft tissue neck | $225.00 |
76604 | Chest/soft tissue/back | $225.00 |
76642 | Unilateral breast screening | $225.00 |
76641 | Unilateral breast limited for palpable lump | $225.00 |
76642-50 | Bilateral breast screening ultrasound | $350.00 |
76882 | Extremity, limb, unilateral, non-vascular/soft tissue | $225.00 |
76801 | OB 1st trimester < 14 weeks, single fetus | $225.00 |
76817 | OB 1st trimester < 14 weeks endovaginal, single fetus | $225.00 |
76802 | OB 1st trimester < 14 weeks, twins or +, each additional fetus | $175.00 |
76805 | OB 2/3rd trimester, > 14 weeks, OB complete/anatomy | $275.00 |
76817 | OB endovaginal Ltd, in addition to transabdominal, i.e. cvx length/previa | $175.00 |
76815 | OB Ltd (position or AFI or placenta or heartbeat, etc.) | $225.00 |
76816 | OB Ltd each additional fetus | $175.00 |
76819 | OB BPP (biophysical profile) | $225.00 |
93880 | Carotid, duplex, bilateral | $325.00 |
93925 | Arterial legs, bilateral | $325.00 |
93926 | Arterial leg, unilateral | $225.00 |
93930 | Arterial arms/bilateral | $325.00 |
93931 | Arterial arm/unilateral | $225.00 |
93970 | Venous legs/bilateral r/o DVT | $325.00 |
93971 | Venous leg/unilateral r/o DVT | $225.00 |
76706* | Aortic Ultrasound Screening (not Medicare) | $75.00 |
76705* | Gallbladder Ultrasound Screening | $75.00 |
93882* | Carotid Ultrasound Screening | $75.00 |
76536* | Thyroid Ultrasound Screening | $75.00 |
99050 | After hours/holiday charge | $250.00 |
* Screening ultrasounds do not take place of a complete diagnostic exam. They are a limited study for screening purposes only. Insurance will not be accepted for screening scans.
** endovaginal ultrasounds are in general an additional charge to a pelvic complete or OB study (ex. Pelvic complete 76856 + Pelvic endovaginal 76830 = $350.00 total)
All radiology reading fees are included in the self-pay fees.