| Abdomen 1 View (74018) |
$294 |
$392 |
3.6× |
| Abdomen 2 views (74019) |
$362.25 |
$483 |
3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,136.75 |
$2,849 |
5.6× |
| Angio pulmonary bilat (75743) |
$5,300.25 |
$7,067 |
1.8× |
| Angiography extremity bilateral rs&i (75716) |
$4,614 |
$6,152 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$4,614 |
$6,152 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,118.75 |
$6,825 |
1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,031.75 |
$6,709 |
1.7× |
| Ankle 2 views (73600) |
$291.75 |
$389 |
3.5× |
| Aortography thoracic serialography rs&i (75605) |
$5,048.25 |
$6,731 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$3,409.50 |
$4,546 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$4,614 |
$6,152 |
0.9× |
| Arthrogram hip (73525) |
$562.50 |
$750 |
1.7× |
| Arthrogram Wrist (73115) |
$776.25 |
$1,035 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$854.81 |
$1,139.75 |
6.7× |
| Bone age studies (77072) |
$403.50 |
$538 |
4.1× |
| Bone Imaging 3 Phase (78315) |
$2,121.75 |
$2,829 |
5.6× |
| Bone Imaging Limited Area (78300) |
$831 |
$1,108 |
2.2× |
| Bone Imaging Multiple Areas (78305) |
$1,645.50 |
$2,194 |
4.4× |
| Bone Imaging Whole Body (78306) |
$1,875.75 |
$2,501 |
5.0× |
| Bone survey infant (77076) |
$737.25 |
$983 |
7.5× |
| Brain imaging < 4 static views (78600) |
$1,083.75 |
$1,445 |
2.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,614.75 |
$2,153 |
3.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,343.25 |
$9,791 |
5.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,642.75 |
$4,857 |
11.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$5,732.25 |
$7,643 |
7.7× |
Cat Scan Follow-Up Study (76380)
range across 2 matching MRF lines |
$570–$1,657.50 |
$760–$2,210 |
varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,272 |
$1,696 |
2.5× |
| Chest 1 view (71045) |
$297.75 |
$397 |
3.6× |
| Chest 2 views (71046) |
$379.50 |
$506 |
4.6× |
| Chest 3 views (71047) |
$459 |
$612 |
5.6× |
| Chest 4 or more views (71048) |
$545.25 |
$727 |
5.5× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$544.50 |
$726 |
5.5× |
| Clavicle complete (73000) |
$279.75 |
$373 |
3.4× |
| Contrast Exam Abdominl Aorta (75625) |
$1,552.50 |
$2,070 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$610.50 |
$814 |
1.8× |
| Contrast X-Ray Of Elbow (73085) |
$627.75 |
$837 |
1.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$967.50 |
$1,290 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,347.25 |
$8,463 |
19.2× |
| CT abdomen and pelvis without contrast (74176) |
$4,676.25 |
$6,235 |
20.7× |
| CT abdomen w contrast (74160) |
$2,928.75 |
$3,905 |
17.6× |
| CT abdomen w wo contrast (74170) |
$3,549.75 |
$4,733 |
21.4× |
| CT abdomen w/o contrast (74150) |
$2,491.50 |
$3,322 |
25.2× |
| CT Angio Abdomen and Pelvis (74174) |
$3,876 |
$5,168 |
11.7× |
| CT Angio Chest (71275) |
$2,573.25 |
$3,431 |
15.5× |
| CT Angio Head (70496) |
$2,121.75 |
$2,829 |
12.8× |
| CT angio hrt w/3d image (75574) |
$2,573.25 |
$3,431 |
7.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,170.50 |
$2,894 |
13.1× |
| CT Angio Neck (70498) |
$2,121.75 |
$2,829 |
12.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,170.50 |
$2,894 |
13.1× |
| CT cervical spine w/ contrast (72126) |
$2,985 |
$3,980 |
9.0× |
| CT cervical spine w/o contrast (72125) |
$2,555.25 |
$3,407 |
25.8× |
| CT chest w contrast (71260) |
$3,030 |
$4,040 |
18.3× |
| CT chest w/wo contrast (71270) |
$3,669 |
$4,892 |
22.1× |
| CT head/brain with contrast (70460) |
$2,461.50 |
$3,282 |
14.8× |
| CT head/brain without and with contrast (70470) |
$3,006 |
$4,008 |
18.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,573.25 |
$3,431 |
7.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,573.25 |
$3,431 |
31.3× |
| CT hrt w/3d image congen (75573) |
$2,573.25 |
$3,431 |
7.8× |
| CT iac w contrast (70481) |
$2,577 |
$3,436 |
15.5× |
| CT l-spine w&w/o contrast (72133) |
$3,449.25 |
$4,599 |
20.8× |
CT lower ext w/o (73700)
range across 2 matching MRF lines |
$651.75–$2,206.50 |
$869–$2,942 |
varies |
| CT lower extremity w/contrast material (73701) |
$2,555.25 |
$3,407 |
15.4× |
| CT lumbar spine w contrast (72132) |
$2,985 |
$3,980 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$2,556.75 |
$3,409 |
25.8× |
| CT maxillofacial w contrast (70487) |
$2,428.50 |
$3,238 |
14.6× |
CT maxillofacial wo contrast (70486)
range across 3 matching MRF lines |
$634.50–$2,206.50 |
$846–$2,942 |
varies |
| CT neck tissue combo (70492) |
$3,113.25 |
$4,151 |
18.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,089.25 |
$4,119 |
18.6× |
| CT orbits w/o contrast (70480) |
$2,214 |
$2,952 |
22.4× |
| CT pelvis w&w/o contrast (72194) |
$3,460.50 |
$4,614 |
20.9× |
| CT pelvis w/o contrast (72192) |
$2,556.75 |
$3,409 |
25.8× |
| CT scan of leg combo (73702) |
$3,480 |
$4,640 |
21.0× |
| CT scans face/jaw combo (70488) |
$3,262.50 |
$4,350 |
19.7× |
| CT soft tissue neck w contrast (70491) |
$2,577 |
$3,436 |
15.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,214 |
$2,952 |
22.4× |
| CT thoracic spine w contrast (72129) |
$2,982 |
$3,976 |
18.0× |
| CT thoracic spine w/o contrast (72128) |
$2,555.25 |
$3,407 |
25.8× |
| CT thorax w/o contrast (71250) |
$2,555.25 |
$3,407 |
25.8× |
| CT upper ext wo (73200) |
$2,206.50 |
$2,942 |
22.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,844.50 |
$5,126 |
23.2× |
| CT upper extremity with contrast (73201) |
$3,030.75 |
$4,041 |
9.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,080.25 |
$4,107 |
18.6× |
| Cta Abdomen (74175) |
$2,469 |
$3,292 |
14.9× |
| CTA pelvis (72191) |
$2,469 |
$3,292 |
14.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$433.50 |
$578 |
4.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$535.50 |
$714 |
5.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$543 |
$724 |
5.5× |
| Dxa Bone Density Axial (77080) |
$984.75 |
$1,313 |
10.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$738 |
$984 |
9.0× |
| Echo exam of fetal heart (76825) |
$1,143.75 |
$1,525 |
2.2× |
Echo exam uterus (76831)
range across 2 matching MRF lines |
$339–$676.50 |
$452–$902 |
varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$439.50 |
$586 |
1.9× |
| Esophageal Motility Study (78258) |
$1,335.75 |
$1,781 |
3.5× |
| Esophagram (74220) |
$751.50 |
$1,002 |
4.5× |
| Fetal Biophys Profile W/Nst (76818) |
$1,005.75 |
$1,341 |
10.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$721.50 |
$962 |
7.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,247.50 |
$4,330 |
14.4× |
| Fluoroscopy up to 1 hr (76000) |
$739.50 |
$986 |
3.3× |
| Follow-Up Angiography (75898) |
$873.75 |
$1,165 |
0.3× |
| Foot 2 views (73620) |
$291.75 |
$389 |
3.5× |
| Forearm 2 views (73090) |
$323.25 |
$431 |
3.9× |
| Gastric emptying imaging study (78264) |
$1,775.25 |
$2,367 |
4.7× |
| Gastroesophageal Reflux Exam (78262) |
$1,775.25 |
$2,367 |
4.7× |
| Gastrointestinal Protein Loss (78282) |
$2,791.50 |
$3,722 |
7.4× |
| Gated Heart Planar Single (78472) |
$2,346 |
$3,128 |
6.2× |
| Hand 2 views (73120) |
$291.75 |
$389 |
2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$598.50 |
$798 |
0.2× |
| Hepatobil Syst Image W/Drug (78227) |
$1,973.25 |
$2,631 |
3.8× |
| Hepatobiliary System Imaging (78226) |
$1,540.50 |
$2,054 |
4.1× |
| Ht Muscle Image Spect Sing (78451) |
$3,263.25 |
$4,351 |
2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,126.50 |
$1,502 |
13.7× |
| Infant hip ultrasound, limited static exam (76886) |
$999.75 |
$1,333 |
12.1× |
| Joint Survey Single View (77077) |
$632.25 |
$843 |
6.4× |
| K Flow/Funct Image Multiple (78709) |
$2,181.75 |
$2,909 |
4.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,898.25 |
$2,531 |
3.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,789.50 |
$2,386 |
3.5× |
| Kidney Imaging Morphol (78700) |
$1,272 |
$1,696 |
3.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,451.25 |
$1,935 |
3.8× |
| Knee 3 Views (73562) |
$327 |
$436 |
4.0× |
| Liver & Spleen Imaging Static Only (78215) |
$2,346 |
$3,128 |
6.2× |
| Lung perfusion differential (78597) |
$1,479 |
$1,972 |
3.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,479 |
$1,972 |
2.9× |
| Lymph System Imaging (78195) |
$1,775.25 |
$2,367 |
3.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,752.75 |
$2,337 |
1.2× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,707 |
$2,276 |
2.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,236.50 |
$2,982 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,920 |
$2,560 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$3,247.50 |
$4,330 |
14.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$8,731.50 |
$11,642 |
52.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$8,146.50 |
$10,862 |
15.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$9,836.25 |
$13,115 |
59.3× |
| Magnetic Resonance Elastography (76391) |
$4,188.75 |
$5,585 |
18.6× |
| Meckels Divert Exam (78290) |
$1,270.50 |
$1,694 |
3.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,904.19 |
$3,872.25 |
8.2× |
| Mr safety determination physician/other qhp (76016) |
$60 |
$80 |
0.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$15 |
$20 |
0.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,674.75 |
$6,233 |
14.2× |
| MRA head w/o contrast (70544) |
$3,419.25 |
$4,559 |
15.1× |
| MRA head with contrast (70545) |
$3,419.25 |
$4,559 |
10.4× |
| MRA neck w contrast (70548) |
$3,419.25 |
$4,559 |
10.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,674.75 |
$6,233 |
14.2× |
| MRA neck w/o contrast (70547) |
$3,419.25 |
$4,559 |
15.1× |
| MRI abdomen w contrast (74182) |
$3,247.50 |
$4,330 |
9.8× |
| MRI abdomen w/o contrast (74181) |
$3,247.50 |
$4,330 |
14.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,908.25 |
$5,211 |
5.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,908.25 |
$5,211 |
11.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,726 |
$4,968 |
5.0× |
| MRI bone marrow blood supply (77084) |
$2,753.25 |
$3,671 |
12.2× |
| MRI brain functional w/o physician admnistration (70554) |
$5,732.25 |
$7,643 |
25.4× |
| MRI brain functional w/physician admnistration (70555) |
$6,743.25 |
$8,991 |
29.9× |
| MRI cardiac w/o cont stress (75559) |
$4,335.75 |
$5,781 |
8.4× |
| MRI cardiac w/o contrast (75557) |
$4,335.75 |
$5,781 |
19.2× |
| MRI cervical spine w contrast (72142) |
$5,492.25 |
$7,323 |
16.6× |
| MRI cervical spine w/o cont (72141) |
$4,575 |
$6,100 |
20.3× |
| MRI chest w/o contrast (71550) |
$3,247.50 |
$4,330 |
14.4× |
| MRI chest with contrast (71551) |
$4,596.75 |
$6,129 |
6.2× |
| MRI chest wo w contrast (71552) |
$3,216.75 |
$4,289 |
9.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,893.75 |
$6,525 |
14.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,908.25 |
$5,211 |
11.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,496.75 |
$3,329 |
11.1× |
| MRI lumbar spine w contrast (72149) |
$5,426.25 |
$7,235 |
16.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$6,161.25 |
$8,215 |
18.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,247.50 |
$4,330 |
14.4× |
| MRI orbit face neck w contrast (70542) |
$4,893.75 |
$6,525 |
14.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,540.75 |
$4,721 |
10.7× |
| MRI pelvis w contrast (72196) |
$5,224.50 |
$6,966 |
15.8× |
| MRI pelvis w/o & w contrast (72197) |
$4,574.25 |
$6,099 |
13.9× |
| MRI pelvis w/o contrast (72195) |
$3,247.50 |
$4,330 |
14.4× |
| MRI spectroscopy (76390) |
$2,090.25 |
$2,787 |
25.4× |
| MRI thoracic spine w/o contrast (72146) |
$4,986.75 |
$6,649 |
22.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$4,893.75 |
$6,525 |
14.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,344.50 |
$3,126 |
10.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,712.50 |
$4,950 |
11.2× |
| MRI, abdomen, combo (74183) |
$4,189.50 |
$5,586 |
12.7× |
| MRI, dorsal spine combo (72157) |
$6,161.25 |
$8,215 |
18.7× |
| MRI, dorsal spine contrast (72147) |
$5,476.50 |
$7,302 |
16.6× |
| MRI, joint upper extrem (73221) |
$2,496.75 |
$3,329 |
11.1× |
| MRI, joint upper extrem combo (73223) |
$3,726 |
$4,968 |
11.3× |
| MRI, lumbar spine combo (72158) |
$6,095.25 |
$8,127 |
18.5× |
| Myelogram cervical (72240) |
$1,764 |
$2,352 |
2.4× |
| Myelogram Lumbar (72265) |
$1,507.50 |
$2,010 |
2.0× |
| Myelography thoracic (72255) |
$1,600.50 |
$2,134 |
2.2× |
| Myelograpy 2/more regions rs&i (72270) |
$2,256 |
$3,008 |
3.0× |
| Neck soft tissue (70360) |
$353.25 |
$471 |
4.3× |
| Nonvascular Shunt X-Ray (75809) |
$624 |
$832 |
6.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$17,250.19 |
$23,000.25 |
13.2× |
| Nuclear Rx Oral Admin (79005) |
$1,293.75 |
$1,725 |
5.9× |
| Ob us nuchal meas 1 gest (76813) |
$728.25 |
$971 |
7.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$143.25 |
$191 |
1.4× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$114 |
$152 |
1.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$129 |
$172 |
1.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$151.50 |
$202 |
1.5× |
| Panoramic X-ray of jaws (70355) |
$385.50 |
$514 |
4.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$648.75 |
$865 |
1.3× |
| Parathyroid Planar Imaging (78070) |
$503.25 |
$671 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$295.50 |
$394 |
3.0× |
| Peritoneogram Rs&I (74190) |
$478.50 |
$638 |
0.9× |
| Pet Image W/Ct Lmtd (78814) |
$8,157 |
$10,876 |
6.0× |
| PET image w/CT, full body (78816) |
$8,157 |
$10,876 |
6.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$8,157 |
$10,876 |
6.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,536.75 |
$2,049 |
4.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$569.25 |
$759 |
5.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,120.50 |
$1,494 |
2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$323.25 |
$431 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$264 |
$352 |
3.2× |
| Radex elbow complete minimum 3 views (73080) |
$323.25 |
$431 |
3.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$480 |
$640 |
4.9× |
| Radex fingr minimum 2 views (73140) |
$231.75 |
$309 |
2.8× |
| Radex foot complete minimum 3 views (73630) |
$323.25 |
$431 |
3.9× |
| Radex Hand Minimum 3 Views (73130) |
$327 |
$436 |
4.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$504 |
$672 |
6.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$656.25 |
$875 |
6.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$483.75 |
$645 |
5.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$336 |
$448 |
4.1× |
| Radex shoulder complete minimum 2 views (73030) |
$336 |
$448 |
4.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$321.75 |
$429 |
3.9× |
| Radex Spine 1 View Specify Level (72020) |
$294 |
$392 |
3.6× |
| Radex Sternum Minimum 2 Views (71120) |
$399.75 |
$533 |
4.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$3,591.75 |
$4,789 |
43.6× |
| Radex Toe Minimum 2 Views (73660) |
$225.75 |
$301 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$512.25 |
$683 |
5.2× |
Radex Wrist Complete Minimum 3 Views (73110)
range across 4 matching MRF lines |
$307.50–$323.25 |
$410–$431 |
varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$565.50 |
$754 |
5.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$480 |
$640 |
4.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$523.50 |
$698 |
5.3× |
| Radiologic exam colon double contrast study (74280) |
$1,356.75 |
$1,809 |
8.2× |
| Radiologic exam colon single contrast study (74270) |
$999.75 |
$1,333 |
6.0× |
| Radiologic exam knee complete 4/more views (73564) |
$407.25 |
$543 |
4.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$504 |
$672 |
5.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$737.25 |
$983 |
4.4× |
| Radiologic exam swallow function contrast study (74230) |
$1,219.50 |
$1,626 |
7.3× |
| Radiologic exam teeth complete full mouth (70320) |
$385.50 |
$514 |
1.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$411.75 |
$549 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$988.50 |
$1,318 |
6.0× |
| Radiologic examination femur 1 view (73551) |
$312 |
$416 |
3.8× |
| Radiologic examination femur minimum 2 views (73552) |
$358.50 |
$478 |
4.4× |
| Radiologic examination knee 1/2 views (73560) |
$295.50 |
$394 |
3.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$734.25 |
$979 |
7.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$339 |
$452 |
4.1× |
| Ribs bilateral 3 views (71110) |
$435 |
$580 |
4.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,181 |
$2,908 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,297.25 |
$3,063 |
4.5× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines |
$558.75–$2,754.75 |
$745–$3,673 |
varies |
| Scapula (73010) |
$336 |
$448 |
3.4× |
| Shoulder 1 view (73020) |
$257.25 |
$343 |
3.1× |
| Shoulder Arthrography (73040) |
$776.25 |
$1,035 |
2.4× |
| Sialogram (70390) |
$1,020.75 |
$1,361 |
4.5× |
| Skull less than 4 views (70250) |
$408 |
$544 |
4.1× |
| Special treatment procedure (77470) |
$6,714.19 |
$8,952.25 |
12.8× |
| Speech evaluation, complex (70371) |
$1,219.50 |
$1,626 |
5.4× |
| Sternoclavicular joints (71130) |
$438 |
$584 |
5.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$3,591.75 |
$4,789 |
15.9× |
| Testicular Imaging W/Flow (78761) |
$1,115.25 |
$1,487 |
2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$2,012.25 |
$2,683 |
12.1× |
| Thoracic spine 2 views (72070) |
$483.75 |
$645 |
4.9× |
| Thoracic spine 3 views (72072) |
$449.25 |
$599 |
4.5× |
| Thoracolumbar 2 views (72080) |
$480 |
$640 |
5.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$813.75 |
$1,085 |
2.2× |
| Thyroid Met Imaging Body (78018) |
$2,232 |
$2,976 |
4.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,647 |
$2,196 |
4.4× |
| Tx Devices Design & Construction Complex (77334) |
$3,109.88 |
$4,146.50 |
8.8× |
| Ultrasound Breast Limited (76642) |
$547.50 |
$730 |
6.7× |
| Ultrasound Elastography Parenchyma (76981) |
$939.75 |
$1,253 |
9.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$802.50 |
$1,070 |
2.4× |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
$651–$843 |
$868–$1,124 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$429 |
$572 |
4.3× |
| Unlisted Dx Radiographic Procedure (76499) |
$1,062.75 |
$1,417 |
12.9× |
| Unlisted magnetic resonance procedure (76498) |
$4,124.25 |
$5,499 |
50.1× |
| Upper gi w/o kub (74240) |
$813 |
$1,084 |
4.9× |
| Ureteral Reflux Study (78740) |
$995.25 |
$1,327 |
2.6× |
| Urethrocystogram voiding (74455) |
$768 |
$1,024 |
3.4× |
| Urethrocystography retrograde (74450) |
$722.25 |
$963 |
3.2× |
| Us breast unilateral complete (76641) |
$408.75 |
$545 |
4.1× |
| Us chest (76604) |
$605.25 |
$807 |
6.1× |
| Us complete joint (76881) |
$846 |
$1,128 |
8.6× |
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines |
$529.50–$622.50 |
$706–$830 |
varies |
| Us head (76506) |
$1,028.25 |
$1,371 |
10.4× |
| Us kidney transplant (76776) |
$1,468.50 |
$1,958 |
14.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$544.50 |
$726 |
5.5× |
| Us ob detailed single fetus (76811) |
$1,205.25 |
$1,607 |
5.3× |
| Us ob limited 1 or more fetuses (76815) |
$496.50 |
$662 |
5.0× |
| Us ob transvaginal (76817) |
$681.75 |
$909 |
6.9× |
| Us pelvic non ob complete (76856) |
$810.75 |
$1,081 |
8.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$682.50 |
$910 |
6.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$523.50 |
$698 |
5.3× |
Us retroperitoneal complete (76770)
range across 2 matching MRF lines |
$846.75–$954 |
$1,129–$1,272 |
varies |
| Us retroperitoneal limited (76775) |
$1,359 |
$1,812 |
13.7× |
Us scrotum and contents (76870)
range across 2 matching MRF lines |
$723.75–$806.25 |
$965–$1,075 |
varies |
| Us spinal canal and contents (76800) |
$953.25 |
$1,271 |
9.6× |
| Us thyroid (76536) |
$964.50 |
$1,286 |
9.8× |
| Vein X-Ray Chest (75827) |
$5,031.75 |
$6,709 |
3.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$601.50 |
$802 |
0.2× |
| Vein X-Ray Spleen/Liver (75810) |
$55.50 |
$74 |
0.0× |
| Venogram Sinus/Jugular (75860) |
$5,048.25 |
$6,731 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$5,031.75 |
$6,709 |
1.7× |
| Venography extremity bilateral rs&i (75822) |
$1,954.50 |
$2,606 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$694.50 |
$926 |
0.5× |
| Venography Renal Bilateral (75833) |
$4,614 |
$6,152 |
1.5× |
| Venography Renal Unilateral (75831) |
$4,614 |
$6,152 |
1.5× |
| Venous sampling by catheter (75893) |
$4,735.50 |
$6,314 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$913.50 |
$1,218 |
11.1× |
| Wrist 2 views (73100) |
$307.50 |
$410 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$399.75 |
$533 |
4.9× |
| X-ray antegrade pyelogram tube (74425) |
$858 |
$1,144 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$294 |
$392 |
3.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$424.50 |
$566 |
5.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$472.50 |
$630 |
4.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$519 |
$692 |
5.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$249.75 |
$333 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$295.50 |
$394 |
3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$342.75 |
$457 |
3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$366 |
$488 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$412.50 |
$550 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$459 |
$612 |
4.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$652.50 |
$870 |
6.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$345 |
$460 |
4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$502.50 |
$670 |
5.1× |
| X-ray head for orthodontia (70350) |
$402.75 |
$537 |
4.9× |
| X-ray humerus (73060) |
$361.50 |
$482 |
4.4× |
| X-ray IV pyelogram (ivp) (74400) |
$885.75 |
$1,181 |
5.3× |
| X-ray IV pyelogram+tomography (74415) |
$1,041 |
$1,388 |
6.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$291 |
$388 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$732 |
$976 |
8.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$477.75 |
$637 |
4.8× |
| X-ray nose-rectum child f.b. (76010) |
$294 |
$392 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$519 |
$692 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$483.75 |
$645 |
4.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$483.75 |
$645 |
5.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$483.75 |
$645 |
5.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$483.75 |
$645 |
4.9× |
| X-Ray Stress View (77071) |
$248.25 |
$331 |
3.0× |
| X-ray thoracic spine 4 vw (72074) |
$633.75 |
$845 |
6.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,161.75 |
$1,549 |
3.5× |
| X-Rays Bone Length Studies (77073) |
$519 |
$692 |
5.2× |
| X-Rays Bone Survey Complete (77075) |
$1,062.75 |
$1,417 |
10.7× |
| Xr c-spine 4 or 5 views (72050) |
$502.50 |
$670 |
5.1× |
| Xr facial bones less than 3 views (70140) |
$336 |
$448 |
4.1× |
| Xr orbits complete 4 views (70200) |
$483.75 |
$645 |
4.9× |
| Xr Tomogram Single Plane (76100) |
$438 |
$584 |
4.4× |