CPT CODES. Ph: (307) Fax: (307) CATSCAN IV Contrast: 87.00
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1 Ph: (307) Fax: (307) CPT CODES CATSCAN IV Contrast: Abdomen w/o contrast $ Abdomen w/ contrast $ w/ contrast: $ Abdomen w_w/o contrast $ w/ contrast: $ Abdomen-Pelvis w/o contrast $ Abdomen-Pelvis w/contrast $ w/ contrast: $ Abdomen-Pelvis w_w/o contrast $ w/ contrast: $ Brain/Head w/o contrast $ Brain/Head w/ contrast $ w/ contrast: $ Brain/Head w_w/o contrast $ w/ contrast: $ Cervical w/o contrast $ Cervical w/ contrast $ w/ contrast: $ Cervical w_w/o contrast $ w/ contrast: $ Chest w/o contrast $ Chest w/ contrast $ w/ contrast: $ Chest w_w/o contrast $ w/ contrast: $ CT Angio Abdomen $ CT Angio Abdomen-Pelvis $ CT Angio Chest $ CT Angio Head $ CT Angio Lower Extremity $ CT Angio Neck $ CT Angio Pelvis $ CT Angio Upper Extremity $ Lower Extremity w/o contrast $ Lower Extremity w/contrast $ w/ contrast: $ Lower Extremity w_w/o contrast $ w/ contrast: $ Lumbar w/o contrast $ Lumbar w/contrast $ w/ contrast: $ Lumar w_w/o contrast $ w/ contrast: $ Maxillofacial (Sinus) w/o contrast $ Maxillofacial (Sinus) w/contrast $ w/ contrast: $ Maxillofacial (Sinus) w_w/o contrast$ w/ contrast: $ Pelvis w/o contrast $ Pelvis w/contrast $ w/ contrast: $ Pelvis w_w/o contrast $ w/ contrast: $ Soft Tissue Neck w/o contrast $ Soft Tissue Neck w/ contrast $ w/ contrast: $ Soft Tissue Neck w_w/o contrast $ w/ contrast: $ Thoracic w/o contrast $
2 72129 Thoracic w/ contrast $ w/ contrast: $ Thoracic w_w/o contrast $ w/ contrast: $ Upper Extremity w/o contrast $ Upper Extremity w/contrast $ w/ contrast: $ Upper Extremity w_w/o contrast $ w/ contrast: $ DEXA Dexa Bone Density $ MAMMOGRAPHY (DIGITAL) G0202 Screening $ = $ G0206 Diagnostic-Unilateral $ = $ G0204 Diagnostic-Bilateral $ = $ Computer Aided Detection $ MRA Abdomen $ Chest $ Head w/o contrast $ Head w/contrast $ Head w_w/o contrast $ Lower Extremity $ Neck w/o contrast $ Neck w/contrast $ Neck w_w/o contrast $ Pelvis $ MRI IV Contrast: Abdomen w/o contrast $ Abdomen w/contrast $ w/ contrast: $ Abdomen w_w/o contrast $ w/ contrast: $ Ankle w/o contrast $ Ankle w/contrast $ w/ contrast: $ Ankle w_w/o contrast $ w/ contrast: $ Brain w/o contrast $ Brain w/contrast $ w/ contrast: $ Brain w_w/o contrast $ w/ contrast: $ Breast Unilateral $ w/ contrast: $ Breast Bilateral $ w/ contrast: $ Cervical w/o contrast $ Cervical w/contrast $ w/ contrast: $ Cervical w_w/o contrast $ w/ contrast: $ Chest w/o contrast $ Chest w/contrast $ w/ contrast: $ Chest w_w/o contrast $ w/ contrast: $ Hip w/o contrast $ Hip w/contrast $ w/ contrast: $ Hip w_w/o contrast $ w/ contrast: $ Knee w/o contrast $
3 73722 Knee w/contrast $ Knee w_w/o contrast $ w/ contrast: $ Lower Extremity w/o contrast $ Lower Extremity w/contrast $ w/ contrast: $ Lower Extremity w_w/o contrast $ w/ contrast: $ Lumbar w/o contrast $ Lumbar w/contrast $ w/ contrast: $ Lumbar w_w/o contrast $ w/ contrast: $ Orbit Face/Neck w/o contrast $ Orbit Face/Neck w/contrast $ w/ contrast: $ Orbit Face/Neck w_w/o contrast $ w/ contrast: $ Pelvis w/o contrast $ Pelvis w/contrast $ w/ contrast: $ Pelvis w_w/o contrast $ w/ contrast: $ Shoulder w/o contrast $ Shoulder w/contrast $ w/ contrast: $ Shoulder w_w/o contrast $ w/ contrast: $ Thoracic w/o contrast $ Thoracic w/contrast $ w/ contrast: $ Thoracic w_w/o contrast $ w/ contrast: $ TMJ $ Upper Extremity w/o contrast $ Upper Extremity w/contrast $ w/ contrast: $ Upper Extremity w_w/o contrast $ w/ contrast: $ Upper Extremity (Joint) w/o contrast $ Upper Extremity (Joint) w/contrast $ w/ contrast: $ Upper Extremity (Joint) w_w/o contrast $ w/ contrast: $ ULTRASOUND Abdomen $ Arterial Upper/Lower-ABI only $ Arterial Lower Extremity, Bilateral $ Arterial Lower Extremity, Unilateral $ Arterial Upper Extremity, Bilateral $ Arterial Upper Extremity, Unilateral $ Breast (not to use as of 1/2/15) $ Breast Limited $ Breast Full $ Carotid Bilateral $ Extremity, Non-Vascular $ Gallbladder $ Gallbladder with Kinevac $ Kidneys, Renal, Bladder $ Liver $ Pelvic (non-obstetric) $ OB less than 14wks $ OB greater than 14wks $ OB-Transvaginal $ Testicular (Scrotal) $ Thyroid (Soft Tissue Neck) $ Transvaginal (Pelvic) $ = Venous Extremity, Bilateral $
4 93971 Venous Extremity, Unilateral $ X-RAY Abdomen 1view (KUB) $ Abdomen Series Complete $ Ankle Complete $ Chest 1view $ Chest 2view (PA & LAT) $ Clavicle Complete $ Elbow Complete $ Eye-Foreign Body $ Forearm Complete $ Femur $ Finger $ Foot Complete $ Hand Complete $ Hip, Unilateral $ Hip, Bilateral $ Humerus $ Knee Complete $ Pelvis Complete $ Rib Complete, Unilateral $ Rib Complete, Bilateral $ Sacrum and Coccyx $ Scapula Complete $ Shoulder Arthrogram $ Shoulder Complete $ Sinuses Complete $ Skull Complete $ Spine-Cervical Complete $ Spine-Lumbar Complete $ Spine-Thoracic Complete $ Sternum Complete $ Tibia, Fibula $ Toe $ Wrist Arthrogram $ Wrist Complete $ *Prices Subject to Change Updated 5/13/2014
5 **ALL self-pay patients are always given 10% off the price listed below. Another 10% off if the patient pays entire bill within 30 days from the time of their visit. Please note that all self-pay patients are required to pay at least half down at the time of visit. There are payment arrangements that can be set up on a month to month basis, after initial down payment is made. We do have applications for payment help located at our facility such as Medicaid applications and Breast and Cervical applications for mammograms and such. If you have any questions whatsoever please call us at our office. Thank you!
We Accept Care Credit
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