| Abdomen 2 views (74019) |
$230.76 |
$1,923 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$570.72 |
$4,756 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,162.16 |
$18,018 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$2,129.64 |
$17,747 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,317.88 |
$27,649 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,218.08 |
$18,484 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,147.20 |
$34,560 |
0.8× |
| Ankle 2 views (73600) |
$188.40 |
$1,570 |
2.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$270 |
$2,250 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,129.64 |
$17,747 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,145.72 |
$17,881 |
0.7× |
| Arthrogram elbow (73085) |
$532.68 |
$4,439 |
1.6× |
| Arthrogram hip (73525) |
$580.32 |
$4,836 |
1.7× |
| Arthrogram shoulder (73040) |
$659.28 |
$5,494 |
2.0× |
| Arthrogram wrist (73115) |
$491.40 |
$4,095 |
1.5× |
| Arthrography knee lt (73580) |
$532.68 |
$4,439 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$1,143.72 |
$9,531 |
3.0× |
| Bone age studies (77072) |
$216.24 |
$1,802 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$770.88 |
$6,424 |
2.0× |
| Bone survey complete (77075) |
$577.44 |
$4,812 |
5.7× |
| Cervical spine 2 or 3 views (72040) |
$241.56 |
$2,013 |
2.9× |
| Chest 1 view (71045) |
$190.44 |
$1,587 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$170.88 |
$1,424 |
1.0× |
| Clavicle complete (73000) |
$201.96 |
$1,683 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$46.68 |
$389 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,570.40 |
$21,420 |
7.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,266.80 |
$18,890 |
9.8× |
| CT abdomen w contrast (74160) |
$2,013.48 |
$16,779 |
11.9× |
| CT abdomen w wo contrast (74170) |
$2,133.96 |
$17,783 |
12.6× |
| CT abdomen w/o contrast (74150) |
$1,269.72 |
$10,581 |
12.6× |
| CT angiography upper extremity lt (73206) |
$952.56 |
$7,938 |
5.6× |
| CT c-spine w/o contrast (72125) |
$2,170.08 |
$18,084 |
21.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,232.72 |
$18,606 |
13.2× |
| CT cervical spine with contrast (72126) |
$2,161.92 |
$18,016 |
6.4× |
| CT chest with contrast (71260) |
$1,612.56 |
$13,438 |
9.5× |
| CT head/brain with contrast (70460) |
$1,541.64 |
$12,847 |
9.1× |
| CT head/brain without and with contrast (70470) |
$1,953.60 |
$16,280 |
11.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$120.96 |
$1,008 |
1.4× |
| CT iac w contrast (70481) |
$1,393.80 |
$11,615 |
8.2× |
| CT lower ext w/o (73700) |
$1,383.36 |
$11,528 |
13.7× |
| CT lower extremity w wo contrast (73702) |
$1,430.04 |
$11,917 |
8.5× |
| CT lower extremity with contrast (73701) |
$1,140.60 |
$9,505 |
6.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,866.24 |
$15,552 |
11.0× |
| CT lumbar spine w/o contrast (72131) |
$2,073.24 |
$17,277 |
20.6× |
| CT lumbar spine with contrast (72132) |
$1,452.48 |
$12,104 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,425.12 |
$11,876 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$1,354.08 |
$11,284 |
13.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,554.96 |
$12,958 |
9.2× |
| CT neck soft tissue w contrast (70491) |
$1,238.88 |
$10,324 |
7.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,418.40 |
$11,820 |
8.4× |
| CT orbits w/o contrast (70480) |
$1,247.16 |
$10,393 |
12.4× |
| CT pelvis w & w/o contrast (72194) |
$1,501.80 |
$12,515 |
8.9× |
| CT pelvis w/o contrast (72192) |
$1,616.40 |
$13,470 |
16.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,300.68 |
$10,839 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$828.84 |
$6,907 |
8.2× |
| CT thoracic spine w/contrast (72129) |
$1,391.16 |
$11,593 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$1,691.88 |
$14,099 |
16.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,760.76 |
$14,673 |
10.4× |
| CT thorax w/o contrast (71250) |
$1,351.80 |
$11,265 |
13.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,202.88 |
$10,024 |
7.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,240.32 |
$10,336 |
12.3× |
| CT upper extremity with contrast (73201) |
$1,129.20 |
$9,410 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,631.64 |
$13,597 |
9.6× |
| Cta Abdomen (74175) |
$1,946.76 |
$16,223 |
11.5× |
| CTA abdomen pelvis (74174) |
$1,711.56 |
$14,263 |
5.1× |
| CTA chest (71275) |
$2,015.76 |
$16,798 |
11.9× |
| Cta Head (70496) |
$1,040.88 |
$8,674 |
6.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,114.40 |
$17,620 |
6.3× |
| CTA lwr ext w&w/o contrast (73706) |
$942.72 |
$7,856 |
5.6× |
| Cta Neck (70498) |
$985.20 |
$8,210 |
5.8× |
| Cta Pelvis (72191) |
$890.52 |
$7,421 |
5.3× |
| Cystography minimum 3 views rs&i (74430) |
$392.52 |
$3,271 |
1.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$243.36 |
$2,028 |
2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$97.56 |
$813 |
1.2× |
| Esophagus (74220) |
$375.84 |
$3,132 |
2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$240.60 |
$2,005 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$344.76 |
$2,873 |
1.5× |
| Foot 2 views (73620) |
$190.20 |
$1,585 |
2.3× |
| Forearm 2 views (73090) |
$188.88 |
$1,574 |
2.2× |
| Gated Heart Planar Single (78472) |
$811.92 |
$6,766 |
2.1× |
| Hand 2 views (73120) |
$184.56 |
$1,538 |
1.8× |
| Hand 3 views (73130) |
$253.32 |
$2,111 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,394.52 |
$11,621 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$188.04 |
$1,567 |
2.2× |
| Hysterosalpingogram (74740) |
$476.88 |
$3,974 |
2.1× |
| Kidney imaging morphology (78700) |
$503.76 |
$4,198 |
1.3× |
| Knee 3 views (73562) |
$265.20 |
$2,210 |
3.2× |
| Lymphoscintigraphy (78195) |
$528.72 |
$4,406 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$14.16 |
$118 |
0.5× |
| MRA head w & w/o contrast (70546) |
$889.20 |
$7,410 |
2.6× |
| MRA head w/o contrast (70544) |
$867.42 |
$7,228.50 |
3.8× |
| MRA head with contrast (70545) |
$946.74 |
$7,889.50 |
2.8× |
| MRA neck w contrast (70548) |
$946.26 |
$7,885.50 |
2.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$885.06 |
$7,375.50 |
2.6× |
| MRA neck w/o contrast (70547) |
$807 |
$6,725 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$964.62 |
$8,038.50 |
2.9× |
| MRI abdomen w/o contrast (74181) |
$710.94 |
$5,924.50 |
3.1× |
| MRI any jnt lwr ext with con lt (73722) |
$903.72 |
$7,531 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,091.46 |
$9,095.50 |
1.4× |
| MRI c-spine with contrast (72142) |
$1,220.16 |
$10,168 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$1,129.38 |
$9,411.50 |
4.9× |
| MRI chest w/o contrast (71550) |
$803.64 |
$6,697 |
3.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$965.40 |
$8,045 |
2.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,056.78 |
$8,806.50 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,106.16 |
$9,218 |
4.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$856.56 |
$7,138 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$832.02 |
$6,933.50 |
2.5× |
| MRI orbit/face/neck w/contrast (70542) |
$206.10 |
$1,717.50 |
0.6× |
| MRI pelvis w contrast (72196) |
$892.20 |
$7,435 |
2.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$816.24 |
$6,802 |
2.4× |
| MRI pelvis w/o contrast (72195) |
$834.06 |
$6,950.50 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$929.82 |
$7,748.50 |
2.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,252.98 |
$10,441.50 |
3.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,066.14 |
$8,884.50 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,366.92 |
$11,391 |
4.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,123.26 |
$9,360.50 |
3.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,127.28 |
$9,394 |
3.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,221.72 |
$10,181 |
5.3× |
| MRI tmj (70336) |
$838.80 |
$6,990 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,078.38 |
$8,986.50 |
4.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$970.92 |
$8,091 |
2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,021.02 |
$8,508.50 |
4.4× |
| Myocardial Spect Multiple Studies (78452) |
$3,002.76 |
$25,023 |
2.4× |
| Neck soft tissue (70360) |
$181.20 |
$1,510 |
2.2× |
| Nm gastric emptying study (78264) |
$666.84 |
$5,557 |
1.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$283.44 |
$2,362 |
2.8× |
| Osseous survey infant (77076) |
$230.76 |
$1,923 |
2.3× |
| Osseous survey limited (77074) |
$461.88 |
$3,849 |
4.6× |
| Parathyroid imaging (78070) |
$1,370.88 |
$11,424 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$212.04 |
$1,767 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$910.74 |
$7,589.50 |
2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$550.32 |
$4,586 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,152.96 |
$9,608 |
2.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$72.60 |
$605 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$138.48 |
$1,154 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$346.32 |
$2,886 |
3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$230.76 |
$1,923 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$220.68 |
$1,839 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$72.96 |
$608 |
0.9× |
| Radiologic exam colon single contrast study (74270) |
$506.88 |
$4,224 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$455.16 |
$3,793 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$422.88 |
$3,524 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$249.36 |
$2,078 |
3.0× |
| Radiological examination surgical specimen (76098) |
$567.84 |
$4,732 |
1.1× |
| Ribs bilateral 3 views (71110) |
$230.76 |
$1,923 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$243.36 |
$2,028 |
2.4× |
| Scanogram (77073) |
$231 |
$1,925 |
2.3× |
| Scapula complete (73010) |
$230.76 |
$1,923 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$14.40 |
$120 |
0.6× |
| Small bowel series (74250) |
$230.76 |
$1,923 |
1.4× |
| Thoracolumbar 2 views (72080) |
$302.16 |
$2,518 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$407.76 |
$3,398 |
1.1× |
| Thyroid uptake measurement (78012) |
$407.76 |
$3,398 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$407.76 |
$3,398 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$571.80 |
$4,765 |
5.7× |
| Unlisted Ultrasound Procedure (76999) |
$309 |
$2,575 |
3.7× |
| Urethrocystography retrograde rs&i (74450) |
$272.52 |
$2,271 |
1.2× |
| Urethrocystography voiding (74455) |
$349.80 |
$2,915 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$306.36 |
$2,553 |
3.0× |
| Us breast unilateral complete (76641) |
$334.44 |
$2,787 |
3.3× |
| Us breast unilateral limited (76642) |
$334.44 |
$2,787 |
4.0× |
| Us chest (76604) |
$237.72 |
$1,981 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$270.48 |
$2,254 |
2.7× |
| Us ob transvaginal (76817) |
$195 |
$1,625 |
1.9× |
| Us pelvic non ob complete (76856) |
$625.80 |
$5,215 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$153.96 |
$1,283 |
1.5× |
| Us pregnancy ltd (76815) |
$336.72 |
$2,806 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$420 |
$3,500 |
4.2× |
| Us retroperitoneal complete (76770) |
$567.24 |
$4,727 |
5.6× |
| Us retroperitoneal limited (76775) |
$383.88 |
$3,199 |
3.8× |
| Us scrotum and contents (76870) |
$510 |
$4,250 |
5.1× |
| Us soft tissue head/neck (76536) |
$388.44 |
$3,237 |
3.9× |
| Us xtr non-vasc lmtd (76882) |
$177.96 |
$1,483 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,423.88 |
$20,199 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$711.96 |
$5,933 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$445.32 |
$3,711 |
0.3× |
| Wrist 2 views (73100) |
$181.20 |
$1,510 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$230.76 |
$1,923 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$367.32 |
$3,061 |
4.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$460.08 |
$3,834 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$249.96 |
$2,083 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$246.48 |
$2,054 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$122.64 |
$1,022 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$181.20 |
$1,510 |
2.2× |
| X-ray exam hip uni 4/> views (73503) |
$230.76 |
$1,923 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$346.32 |
$2,886 |
3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$577.44 |
$4,812 |
5.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$230.76 |
$1,923 |
2.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$241.56 |
$2,013 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$292.20 |
$2,435 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$125.76 |
$1,048 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$266.40 |
$2,220 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$241.56 |
$2,013 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$54.72 |
$456 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$346.32 |
$2,886 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$656.40 |
$5,470 |
6.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$230.76 |
$1,923 |
2.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$241.56 |
$2,013 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$346.32 |
$2,886 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$230.76 |
$1,923 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$490.44 |
$4,087 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$302.16 |
$2,518 |
3.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$230.76 |
$1,923 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$346.32 |
$2,886 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$241.56 |
$2,013 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$305.40 |
$2,545 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$362.40 |
$3,020 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$461.88 |
$3,849 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$234.48 |
$1,954 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$120.96 |
$1,008 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$241.56 |
$2,013 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$346.32 |
$2,886 |
3.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$346.32 |
$2,886 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$181.20 |
$1,510 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$291.84 |
$2,432 |
3.5× |
| Xr c-spine 6 or more views (72052) |
$611.76 |
$5,098 |
6.1× |
| Xr finger(s) 2+ views (73140) |
$181.20 |
$1,510 |
2.2× |
| Xr shoulder 1 view (73020) |
$181.20 |
$1,510 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$723.60 |
$6,030 |
7.2× |
| Xr tibia/fibula 2 views (73590) |
$253.44 |
$2,112 |
3.0× |
| Xr tmj bilateral (70330) |
$241.56 |
$2,013 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$253.56 |
$2,113 |
3.0× |