| CPT code | Description | Self-Pay Price |
|---|---|---|
| 76700 | Abdomen Complete | $250.00 |
| 93975* | Abdomen duplex complete (venous/arterial) | $350.00 |
| 76705 | Abdomen Limited/RUQ or LUQ or appendix or hernia | $200.00 |
| 93976* | Abdomen duplex limited (venous/arterial) | $250.00 |
| 76775 | Aorta | $200.00 |
| 76770 | Renal | $200.00 |
| 76857 | Pre and post void (PVR) bladder only | $200.00 |
| 76776 | Renal transplant | $200.00 |
| 93976* | Renal transplant duplex (venous/arterial) | $250.00 |
| 76856 | Pelvic complete transabdominal | $200.00 |
| 76830** | Pelvic endovaginal & or IUD check | $200.00 |
| 76830** | Endovaginal pelvic in conjunction with additional study | $150.00 |
| 76870 | Scrotum/testicular | $200.00 |
| 93976* | Scrotal/testicular duplex | $250.00 |
| 76536 | Thyroid/soft tissue neck | $200.00 |
| 76604 | Chest/soft tissue/back | $200.00 |
| 76642 | Pediatric breast | $200.00 |
| 76882 | Extremity, limb unilateral,Ltd.,non-vascular/soft tissue | $200.00 |
| 76801 | OB 1st trimester, <14weeks single fetus | $200.00 |
| 76817 | OB endovaginal only 1st trimester complete | $200.00 |
| 76802 | OB 1st trimester, <14 weeks, twins, each additional fetus | $150.00 |
| 76805 | OB 2/3rd trimester, >14 weeks, OB complete/anatomy | $250.00 |
| 76817* | OB endovaginal Ltd, in addition to transabdominal, i.e. cvx length/previa | $150.00 |
| 76810 | OB 2/3rd trimester, >14weeks, OB each addt’l fetus | $150.00 |
| 76815 | OB Ltd (position or AFI or placenta or heartbeat, etc.) | $200.00 |
| 76816* | OB Ltd each addt’l fetus | $150.00 |
| 76819 | OB BPP (biophysical profile ultrasound) | $200.00 |
| 93880 | Carotid, duplex, bilateral | $300.00 |
| 93925 | Arterial legs, bilateral | $300.00 |
| 93926 | Arterial leg, unilateral | $200.00 |
| 93930 | Arterial arms/bilateral | $300.00 |
| 93931 | Arterial arm/unilateral | $200.00 |
| 93970 | Venous legs/bilateral r/o DVT | $300.00 |
| 93971 | Venous leg/unilateral r/o DVT | $200.00 |
| 76642 | Limited breast/palpable lump Rt or Lt | $200.00 |
| - | Fun Pics / Elective OB (25-32 weeks) | $200.00 |
| 99050 | After hours/holiday charge | $150.00 |
* represent additional study & amount to be charged in addition to non-duplex exam
** 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.