| Abdomen 1 View (74018) |
$412.30 |
$589 |
4.4× |
| Abdomen 2 views (74019) |
$518 |
$740 |
4.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$907.20 |
$1,296 |
2.1× |
| Adrenal Cortex & Medulla Img (78075) |
$2,433.20 |
$3,476 |
1.8× |
| Angio internal mammary (75756) |
$1,910.30 |
$2,729 |
0.6× |
| Angio pulmonary bilat (75743) |
$3,719.10 |
$5,313 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,436.70 |
$3,481 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$6,570.20 |
$9,386 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$6,297.90 |
$8,997 |
1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,512.60 |
$5,018 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,251.90 |
$3,217 |
0.7× |
| Ankle 2 views (73600) |
$392 |
$560 |
4.2× |
| Aortography thoracic serialography rs&i (75605) |
$4,779.60 |
$6,828 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,668.40 |
$3,812 |
0.8× |
| Artery X-Rays Abdomen (75726) |
$5,306.70 |
$7,581 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,298.10 |
$3,283 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$3,778.60 |
$5,398 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,555.30 |
$5,079 |
0.6× |
| Arthrogram ankle (73615) |
$578.90 |
$827 |
1.5× |
| Arthrogram hip (73525) |
$942.20 |
$1,346 |
2.5× |
| Arthrogram Wrist (73115) |
$568.40 |
$812 |
1.5× |
| Bone age studies (77072) |
$422.80 |
$604 |
3.8× |
| Bone Imaging 3 Phase (78315) |
$3,402.70 |
$4,861 |
7.9× |
| Bone Imaging Whole Body (78306) |
$3,080 |
$4,400 |
7.2× |
| Bone marrow imaging; whole body (78104) |
$794.50 |
$1,135 |
1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,856.70 |
$4,081 |
4.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,749.70 |
$11,071 |
5.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,062.10 |
$5,803 |
10.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,585 |
$6,550 |
5.5× |
| Cat Scan Follow-Up Study (76380) |
$912.80 |
$1,304 |
9.8× |
| Cerebrospinal Fluid Scan (78630) |
$1,442 |
$2,060 |
2.5× |
| Chest 1 view (71045) |
$432.60 |
$618 |
4.6× |
| Chest 2 views (71046) |
$617.40 |
$882 |
6.6× |
| Chest 3 views (71047) |
$745.50 |
$1,065 |
8.0× |
| Chest 4 or more views (71048) |
$811.30 |
$1,159 |
7.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$251.30 |
$359 |
2.2× |
| Cholecystography Oral Contrast (74290) |
$446.60 |
$638 |
2.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$316.40 |
$452 |
2.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,050 |
$1,500 |
1.2× |
| Clavicle complete (73000) |
$487.20 |
$696 |
5.2× |
| Contrast Exam Abdominl Aorta (75625) |
$3,104.50 |
$4,435 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$1,119.30 |
$1,599 |
3.0× |
| Contrast X-Ray Of Elbow (73085) |
$542.50 |
$775 |
1.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$928.90 |
$1,327 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,823.30 |
$8,319 |
15.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,935.40 |
$5,622 |
15.4× |
| CT abdomen w contrast (74160) |
$2,587.20 |
$3,696 |
13.8× |
| CT abdomen w wo contrast (74170) |
$2,930.90 |
$4,187 |
15.6× |
| CT abdomen w/o contrast (74150) |
$2,060.80 |
$2,944 |
18.4× |
| CT Angio Abdomen and Pelvis (74174) |
$6,114.50 |
$8,735 |
16.4× |
| CT Angio Chest (71275) |
$4,338.60 |
$6,198 |
23.1× |
| CT Angio Head (70496) |
$2,835 |
$4,050 |
15.1× |
| CT angio hrt w/3d image (75574) |
$3,228.40 |
$4,612 |
8.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,725.10 |
$3,893 |
14.5× |
| CT Angio Neck (70498) |
$2,900.80 |
$4,144 |
15.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,950.80 |
$5,644 |
21.0× |
| CT cervical spine w/ contrast (72126) |
$3,003.70 |
$4,291 |
8.0× |
| CT cervical spine w/o contrast (72125) |
$2,386.30 |
$3,409 |
21.3× |
| CT cervical spine w/wo cont (72127) |
$3,138.10 |
$4,483 |
16.7× |
| CT chest w contrast (71260) |
$3,133.20 |
$4,476 |
16.7× |
| CT chest w/wo contrast (71270) |
$4,132.10 |
$5,903 |
22.0× |
| CT head/brain with contrast (70460) |
$2,208.50 |
$3,155 |
11.7× |
| CT head/brain without and with contrast (70470) |
$2,699.90 |
$3,857 |
14.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,341.50 |
$3,345 |
6.3× |
| CT hrt w/3d image congen (75573) |
$2,373 |
$3,390 |
6.3× |
| CT iac w contrast (70481) |
$3,075.80 |
$4,394 |
16.4× |
| CT l-spine w&w/o contrast (72133) |
$2,893.80 |
$4,134 |
15.4× |
| CT lower ext w/o (73700) |
$2,221.80 |
$3,174 |
19.8× |
| CT lower extremity w/contrast material (73701) |
$2,530.50 |
$3,615 |
13.5× |
| CT lumbar spine w contrast (72132) |
$2,755.20 |
$3,936 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$2,406.60 |
$3,438 |
21.5× |
| CT maxillofacial w contrast (70487) |
$3,122 |
$4,460 |
16.6× |
| CT maxillofacial wo contrast (70486) |
$2,538.20 |
$3,626 |
22.7× |
| CT neck tissue combo (70492) |
$2,762.90 |
$3,947 |
14.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,493 |
$4,990 |
18.6× |
| CT orbits w/o contrast (70480) |
$3,301.90 |
$4,717 |
29.5× |
| CT pelvis w&w/o contrast (72194) |
$2,041.20 |
$2,916 |
10.9× |
| CT pelvis w/o contrast (72192) |
$1,784.30 |
$2,549 |
15.9× |
| CT scan of leg combo (73702) |
$2,595.60 |
$3,708 |
13.8× |
| CT scans face/jaw combo (70488) |
$3,857.70 |
$5,511 |
20.5× |
| CT soft tissue neck w contrast (70491) |
$2,415 |
$3,450 |
12.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,352.40 |
$1,932 |
12.1× |
| CT thoracic spine w contrast (72129) |
$2,220.40 |
$3,172 |
11.8× |
| CT thoracic spine w/o contrast (72128) |
$2,117.50 |
$3,025 |
18.9× |
| CT thoracic spine w/wo cont (72130) |
$2,739.10 |
$3,913 |
14.6× |
| CT thorax w/o contrast (71250) |
$2,501.80 |
$3,574 |
22.3× |
| CT upper ext wo (73200) |
$2,496.90 |
$3,567 |
22.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,762.50 |
$5,375 |
20.0× |
| CT upper extremity with contrast (73201) |
$2,550.80 |
$3,644 |
6.8× |
| Cta Abdomen (74175) |
$3,077.20 |
$4,396 |
16.4× |
| CTA pelvis (72191) |
$2,143.40 |
$3,062 |
11.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$338.80 |
$484 |
1.3× |
| Dilation ureters/urethra rs&i (74485) |
$2,211.30 |
$3,159 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$618.80 |
$884 |
5.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,069.60 |
$1,528 |
9.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,997.80 |
$2,854 |
17.8× |
| Dxa Bone Density Axial (77080) |
$682.50 |
$975 |
6.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$123.20 |
$176 |
1.3× |
| Echo exam of fetal heart (76825) |
$1,584.10 |
$2,263 |
2.7× |
| Echo Guide For Artery Repair (76936) |
$1,301.30 |
$1,859 |
5.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,372.70 |
$1,961 |
5.4× |
| Esophageal Motility Study (78258) |
$1,010.10 |
$1,443 |
2.4× |
| Esophagram (74220) |
$861.70 |
$1,231 |
4.6× |
| Fetal Biophys Profile W/Nst (76818) |
$639.10 |
$913 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$457.10 |
$653 |
4.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,045.40 |
$2,922 |
8.0× |
| Fluoroscopy up to 1 hr (76000) |
$676.20 |
$966 |
2.6× |
| Follow-Up Angiography (75898) |
$2,750.30 |
$3,929 |
0.8× |
| Foot 2 views (73620) |
$392 |
$560 |
4.2× |
| Forearm 2 views (73090) |
$492.80 |
$704 |
5.3× |
| Gastric emptying imaging study (78264) |
$2,344.30 |
$3,349 |
5.5× |
| Gastroesophageal Reflux Exam (78262) |
$1,020.60 |
$1,458 |
2.4× |
| Gated Heart Planar Single (78472) |
$1,332.80 |
$1,904 |
3.1× |
| GI Endoscopic US S&I (76975) |
$900.90 |
$1,287 |
3.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$2,381.40 |
$3,402 |
4.1× |
| Hand 2 views (73120) |
$492.10 |
$703 |
4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,664.40 |
$8,092 |
1.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$5,003.60 |
$7,148 |
1.5× |
| Hepatobil Syst Image W/Drug (78227) |
$3,448.20 |
$4,926 |
5.9× |
| Hepatobiliary System Imaging (78226) |
$1,394.40 |
$1,992 |
3.3× |
| Ht Muscle Image Spect Sing (78451) |
$2,084.60 |
$2,978 |
1.5× |
| Hysterosalpingogram (74740) |
$702.80 |
$1,004 |
2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,110.90 |
$1,587 |
11.9× |
| Infant hip ultrasound, limited static exam (76886) |
$975.80 |
$1,394 |
10.5× |
| Interstitial radiation source applic complex (77778) |
$3,806.60 |
$5,438 |
5.1× |
| K Flow/Funct Image Multiple (78709) |
$2,479.40 |
$3,542 |
4.3× |
| K Flow/Funct Image W/O Drug (78707) |
$2,411.50 |
$3,445 |
4.1× |
| Kidney Imaging Morphol (78700) |
$2,174.20 |
$3,106 |
5.1× |
| Knee 3 Views (73562) |
$559.30 |
$799 |
6.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,720.90 |
$3,887 |
4.7× |
| Lung perfusion differential (78597) |
$2,487.10 |
$3,553 |
5.8× |
| Lymph System Imaging (78195) |
$1,804.60 |
$2,578 |
3.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$985.60 |
$1,408 |
0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$774.20 |
$1,106 |
1.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,517.90 |
$3,597 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,910.30 |
$2,729 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$4,319 |
$6,170 |
16.9× |
| Magnetic Resonance Elastography (76391) |
$1,918.70 |
$2,741 |
7.5× |
| Meckels Divert Exam (78290) |
$2,195.20 |
$3,136 |
5.1× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$815.50 |
$1,165 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$5,322.10 |
$7,603 |
14.2× |
| MRA head w/o contrast (70544) |
$3,945.20 |
$5,636 |
15.4× |
| MRA head with contrast (70545) |
$4,090.10 |
$5,843 |
10.9× |
| MRA neck w contrast (70548) |
$3,944.50 |
$5,635 |
10.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,754.40 |
$6,792 |
12.7× |
| MRA neck w/o contrast (70547) |
$3,805.20 |
$5,436 |
14.9× |
| MRI abdomen w contrast (74182) |
$4,435.90 |
$6,337 |
11.9× |
| MRI abdomen w/o contrast (74181) |
$3,934.70 |
$5,621 |
15.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,917.90 |
$5,597 |
4.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,297.30 |
$6,139 |
11.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,585.70 |
$6,551 |
5.5× |
| MRI brain functional w/o physician admnistration (70554) |
$1,636.60 |
$2,338 |
6.4× |
| MRI brain functional w/physician admnistration (70555) |
$4,038.30 |
$5,769 |
15.8× |
| MRI cardiac w/o contrast (75557) |
$3,470.60 |
$4,958 |
13.6× |
| MRI cervical spine w contrast (72142) |
$4,119.50 |
$5,885 |
11.0× |
| MRI cervical spine w/o cont (72141) |
$3,948 |
$5,640 |
15.4× |
| MRI chest w/o contrast (71550) |
$4,111.80 |
$5,874 |
16.1× |
| MRI chest with contrast (71551) |
$4,440.80 |
$6,344 |
5.3× |
| MRI chest wo w contrast (71552) |
$5,533.50 |
$7,905 |
14.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,615.50 |
$5,165 |
9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,223.10 |
$6,033 |
11.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,138.10 |
$4,483 |
12.3× |
| MRI lumbar spine w contrast (72149) |
$3,747.80 |
$5,354 |
10.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,667.60 |
$6,668 |
12.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,099.20 |
$5,856 |
16.0× |
| MRI orbit face neck w contrast (70542) |
$4,248.30 |
$6,069 |
11.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,487.30 |
$7,839 |
14.7× |
| MRI pelvis w contrast (72196) |
$4,263 |
$6,090 |
11.4× |
| MRI pelvis w/o & w contrast (72197) |
$5,412.40 |
$7,732 |
14.5× |
| MRI pelvis w/o contrast (72195) |
$3,712.10 |
$5,303 |
14.5× |
| MRI spectroscopy (76390) |
$2,907.80 |
$4,154 |
31.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,460.10 |
$4,943 |
13.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,517.50 |
$5,025 |
9.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,231.90 |
$4,617 |
12.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,450.20 |
$7,786 |
14.6× |
| MRI, abdomen, combo (74183) |
$5,586 |
$7,980 |
14.9× |
| MRI, dorsal spine combo (72157) |
$4,680.20 |
$6,686 |
12.5× |
| MRI, dorsal spine contrast (72147) |
$4,328.10 |
$6,183 |
11.6× |
| MRI, joint upper extrem (73221) |
$3,901.80 |
$5,574 |
15.3× |
| MRI, joint upper extrem combo (73223) |
$5,258.40 |
$7,512 |
14.1× |
| MRI, lumbar spine combo (72158) |
$4,704.70 |
$6,721 |
12.6× |
| Myelogram cervical (72240) |
$1,442.70 |
$2,061 |
1.7× |
| Myelogram Lumbar (72265) |
$1,575 |
$2,250 |
1.9× |
| Myelography thoracic (72255) |
$1,502.20 |
$2,146 |
1.8× |
| Myelograpy 2/more regions rs&i (72270) |
$1,698.90 |
$2,427 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,198.30 |
$4,569 |
2.3× |
| Nm csf leak detection (78650) |
$1,766.10 |
$2,523 |
1.3× |
| Nonvascular Shunt X-Ray (75809) |
$451.50 |
$645 |
4.0× |
| Nuclear Rx Intra-Arterial (79445) |
$825.30 |
$1,179 |
3.3× |
| Nuclear Rx Oral Admin (79005) |
$2,289.70 |
$3,271 |
9.2× |
| Ob us nuchal meas 1 gest (76813) |
$389.90 |
$557 |
3.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$256.90 |
$367 |
2.3× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$487.20 |
$696 |
4.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$468.30 |
$669 |
3.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$119.70 |
$171 |
1.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$324.80 |
$464 |
2.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$273 |
$390 |
8.8× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$392 |
$560 |
3.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,953.70 |
$2,791 |
3.4× |
| Parathyroid Planar Imaging (78070) |
$1,033.90 |
$1,477 |
2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,597.40 |
$2,282 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$556.50 |
$795 |
5.0× |
| Perineogram (74775) |
$466.20 |
$666 |
1.8× |
| Peritoneogram Rs&I (74190) |
$1,183.70 |
$1,691 |
2.0× |
| Pet Image W/Ct Lmtd (78814) |
$2,555.70 |
$3,651 |
1.7× |
| PET image w/CT, full body (78816) |
$9,627.80 |
$13,754 |
6.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$9,169.30 |
$13,099 |
6.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,949.30 |
$8,499 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$913.50 |
$1,305 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$651 |
$930 |
5.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$600.60 |
$858 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$534.10 |
$763 |
5.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$459.20 |
$656 |
4.9× |
| Radex elbow complete minimum 3 views (73080) |
$534.80 |
$764 |
5.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$833 |
$1,190 |
7.4× |
| Radex fingr minimum 2 views (73140) |
$438.20 |
$626 |
4.7× |
| Radex foot complete minimum 3 views (73630) |
$559.30 |
$799 |
6.0× |
| Radex Hand Minimum 3 Views (73130) |
$530.60 |
$758 |
5.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$556.50 |
$795 |
6.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$523.60 |
$748 |
4.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$637 |
$910 |
6.8× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$561.40 |
$802 |
6.0× |
| Radex shoulder complete minimum 2 views (73030) |
$553 |
$790 |
5.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$316.40 |
$452 |
3.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$893.20 |
$1,276 |
4.8× |
| Radex Spine 1 View Specify Level (72020) |
$415.80 |
$594 |
4.5× |
| Radex Sternum Minimum 2 Views (71120) |
$499.80 |
$714 |
5.4× |
| Radex Toe Minimum 2 Views (73660) |
$424.20 |
$606 |
4.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$534.10 |
$763 |
4.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$487.20 |
$696 |
5.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,530.20 |
$2,186 |
13.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$709.80 |
$1,014 |
6.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$563.50 |
$805 |
5.0× |
| Radiologic exam colon double contrast study (74280) |
$1,458.80 |
$2,084 |
7.8× |
| Radiologic exam colon single contrast study (74270) |
$1,313.20 |
$1,876 |
7.0× |
| Radiologic exam knee complete 4/more views (73564) |
$893.20 |
$1,276 |
8.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$850.50 |
$1,215 |
4.5× |
| Radiologic exam swallow function contrast study (74230) |
$898.10 |
$1,283 |
4.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,165.50 |
$1,665 |
6.2× |
| Radiologic examination femur 1 view (73551) |
$398.30 |
$569 |
4.3× |
| Radiologic examination femur minimum 2 views (73552) |
$515.20 |
$736 |
5.5× |
| Radiologic examination knee 1/2 views (73560) |
$483.70 |
$691 |
5.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$899.50 |
$1,285 |
8.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$340.90 |
$487 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$525.70 |
$751 |
5.6× |
| Renal Cyst Study (74470) |
$947.80 |
$1,354 |
1.6× |
| Ribs bilateral 3 views (71110) |
$780.50 |
$1,115 |
7.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$666.40 |
$952 |
1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,459.40 |
$4,942 |
5.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,345.70 |
$3,351 |
4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,391.20 |
$3,416 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,624.60 |
$5,178 |
2.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,052.30 |
$5,789 |
2.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,269 |
$4,670 |
2.4× |
| Salivary Gland Imaging (78230) |
$1,132.60 |
$1,618 |
2.6× |
| Scapula (73010) |
$483 |
$690 |
4.3× |
| Sella turcica (70240) |
$172.20 |
$246 |
1.8× |
| Shoulder 1 view (73020) |
$380.80 |
$544 |
4.1× |
| Shoulder Arthrography (73040) |
$607.60 |
$868 |
1.6× |
| Sialogram (70390) |
$480.20 |
$686 |
1.9× |
| Skull less than 4 views (70250) |
$483 |
$690 |
4.3× |
| Speech evaluation, complex (70371) |
$560.70 |
$801 |
2.2× |
| Spleen Imaging (78185) |
$866.60 |
$1,238 |
2.0× |
| Superior sagittal sinus venogram (75870) |
$2,235.80 |
$3,194 |
0.7× |
| Testicular Imaging W/Flow (78761) |
$1,115.10 |
$1,593 |
2.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$597.10 |
$853 |
3.2× |
| Thoracic spine 2 views (72070) |
$621.60 |
$888 |
5.5× |
| Thoracic spine 3 views (72072) |
$670.60 |
$958 |
6.0× |
| Thoracolumbar 2 views (72080) |
$532 |
$760 |
5.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$642.60 |
$918 |
1.5× |
| Thyroid Met Imaging Body (78018) |
$2,762.90 |
$3,947 |
4.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,498.30 |
$3,569 |
5.8× |
| Ultrasound elastography first target lesion (76982) |
$262.50 |
$375 |
2.3× |
| Ultrasound Elastography Parenchyma (76981) |
$506.10 |
$723 |
4.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,328.60 |
$1,898 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$1,255.10 |
$1,793 |
11.2× |
| Umbilical-artery Doppler (OB) (76820) |
$721 |
$1,030 |
6.4× |
| Unlisted fluoroscopic procedure (76496) |
$730.10 |
$1,043 |
7.8× |
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines |
$1,176.70–$5,952.10 |
$1,681–$8,503 |
varies |
| Unlisted us procedure (76999) |
$519.40 |
$742 |
5.6× |
| Upper gi w/o kub (74240) |
$1,100.40 |
$1,572 |
5.9× |
| Ureteral Reflux Study (78740) |
$1,290.80 |
$1,844 |
3.0× |
| Urethrocystogram voiding (74455) |
$1,486.10 |
$2,123 |
5.8× |
| Urethrocystography retrograde (74450) |
$565.60 |
$808 |
2.2× |
| Us chest (76604) |
$1,021.30 |
$1,459 |
9.1× |
| Us complete joint (76881) |
$1,238.30 |
$1,769 |
11.1× |
| Us exam, pelvic, limited (76857) |
$850.50 |
$1,215 |
7.6× |
| Us head (76506) |
$1,339.80 |
$1,914 |
12.0× |
| Us kidney transplant (76776) |
$1,032.50 |
$1,475 |
9.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$676.90 |
$967 |
6.0× |
| Us ob detailed single fetus (76811) |
$1,334.20 |
$1,906 |
5.2× |
| Us ob limited 1 or more fetuses (76815) |
$282.10 |
$403 |
2.5× |
| Us ob transvaginal (76817) |
$722.40 |
$1,032 |
6.4× |
| Us pelvic non ob complete (76856) |
$1,499.40 |
$2,142 |
13.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$488.60 |
$698 |
4.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$764.40 |
$1,092 |
6.8× |
| Us retroperitoneal complete (76770) |
$1,574.30 |
$2,249 |
14.1× |
| Us retroperitoneal limited (76775) |
$1,404.90 |
$2,007 |
12.5× |
| Us scrotum and contents (76870) |
$1,348.90 |
$1,927 |
12.0× |
| Us spinal canal and contents (76800) |
$1,600.20 |
$2,286 |
14.3× |
| Us thyroid (76536) |
$1,357.30 |
$1,939 |
12.1× |
| Vein X-Ray Chest (75827) |
$4,046.70 |
$5,781 |
2.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$4,398.10 |
$6,283 |
1.3× |
| Vein X-Ray Spleen/Liver (75810) |
$2,750.30 |
$3,929 |
0.8× |
| Venogram Sinus/Jugular (75860) |
$2,101.40 |
$3,002 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$3,012.10 |
$4,303 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,858.40 |
$5,512 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$3,103.80 |
$4,434 |
1.8× |
| Venography extremity unilateral rs&i (75820) |
$1,339.80 |
$1,914 |
0.8× |
| Venography Orbital Rs&I (75880) |
$447.30 |
$639 |
0.7× |
| Venography Renal Bilateral (75833) |
$3,675.70 |
$5,251 |
1.1× |
| Venography Renal Unilateral (75831) |
$3,224.20 |
$4,606 |
1.0× |
| Venous sampling by catheter (75893) |
$3,304 |
$4,720 |
0.6× |
| Wrist 2 views (73100) |
$389.20 |
$556 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$413.70 |
$591 |
4.4× |
| X-ray antegrade pyelogram tube (74425) |
$728 |
$1,040 |
1.9× |
| X-Ray Aorta Leg Arteries (75630) |
$5,966.10 |
$8,523 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$384.30 |
$549 |
4.1× |
| X-Ray Exam Breast Specimen (76098) |
$476 |
$680 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$568.40 |
$812 |
6.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$649.60 |
$928 |
5.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$813.40 |
$1,162 |
7.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$424.90 |
$607 |
4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$457.80 |
$654 |
4.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$480.90 |
$687 |
4.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$693.70 |
$991 |
6.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$723.10 |
$1,033 |
6.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$852.60 |
$1,218 |
7.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$647.50 |
$925 |
6.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$753.20 |
$1,076 |
6.7× |
| X-ray humerus (73060) |
$541.80 |
$774 |
5.8× |
| X-ray IV pyelogram (ivp) (74400) |
$729.40 |
$1,042 |
3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$518 |
$740 |
5.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$422.80 |
$604 |
4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$490.70 |
$701 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$660.10 |
$943 |
5.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$239.40 |
$342 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$654.50 |
$935 |
7.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$750.40 |
$1,072 |
8.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$800.80 |
$1,144 |
7.1× |
| X-ray thoracic spine 4 vw (72074) |
$726.60 |
$1,038 |
6.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$602 |
$860 |
1.6× |
| X-Rays Bone Length Studies (77073) |
$561.40 |
$802 |
5.0× |
| X-Rays Bone Survey Complete (77075) |
$1,197 |
$1,710 |
10.7× |
| Xr c-spine 4 or 5 views (72050) |
$855.40 |
$1,222 |
7.6× |
| Xr facial bones less than 3 views (70140) |
$377.30 |
$539 |
4.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$350 |
$500 |
3.1× |
| Xr myelogram posterior fossa (70010) |
$843.50 |
$1,205 |
2.3× |
| Xr orbits complete 4 views (70200) |
$868 |
$1,240 |
7.7× |