| Abdomen 2 views (74019) |
$177.75 |
$237 |
1.9× |
| Ankle 2 views (73600) |
$116.25 |
$155 |
1.5× |
| Arthrogram hip (73525) |
$135.75 |
$181 |
0.4× |
| Bone &/joint imaging whole body (78306) |
$501.75 |
$669 |
1.4× |
| Bone age studies (77072) |
$127.50 |
$170 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$501.75 |
$669 |
1.4× |
| Bone survey complete (77075) |
$273 |
$364 |
3.0× |
| Cervical spine 2 or 3 views (72040) |
$499.88 |
$666.50 |
6.6× |
| Chest 1 view (71045) |
$64.88 |
$86.50 |
0.9× |
| Chest 3 views (71047) |
$116.25 |
$155 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$210.75 |
$281 |
1.4× |
| Clavicle complete (73000) |
$116.25 |
$155 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$116.25 |
$155 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,839.50 |
$7,786 |
19.1× |
| CT abdomen and pelvis without contrast (74176) |
$5,812.88 |
$7,750.50 |
27.8× |
| CT abdomen w contrast (74160) |
$1,665.30 |
$2,220.40 |
10.8× |
| CT abdomen w wo contrast (74170) |
$1,425 |
$1,900 |
9.3× |
| CT abdomen w/o contrast (74150) |
$930 |
$1,240 |
10.2× |
| CT angiography upper extremity lt (73206) |
$1,425 |
$1,900 |
9.3× |
| CT c-spine w/o contrast (72125) |
$1,801.88 |
$2,402.50 |
19.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,412.25 |
$1,883 |
9.2× |
| CT cervical spine with contrast (72126) |
$1,175.25 |
$1,567 |
3.8× |
| CT chest w/wo contrast (71270) |
$997.88 |
$1,330.50 |
6.5× |
| CT chest with contrast (71260) |
$3,331.50 |
$4,442 |
21.7× |
| CT head/brain with contrast (70460) |
$977.25 |
$1,303 |
6.4× |
| CT head/brain without and with contrast (70470) |
$832.13 |
$1,109.50 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$64.88 |
$86.50 |
0.9× |
| CT iac w contrast (70481) |
$1,063.50 |
$1,418 |
6.9× |
| CT lower ext w/o (73700) |
$104.63 |
$139.50 |
1.1× |
| CT lower extremity w wo contrast (73702) |
$942 |
$1,256 |
6.1× |
| CT lower extremity with contrast (73701) |
$474 |
$632 |
3.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,412.25 |
$1,883 |
9.2× |
| CT lumbar spine w/o contrast (72131) |
$2,620.88 |
$3,494.50 |
28.6× |
| CT lumbar spine with contrast (72132) |
$1,175.25 |
$1,567 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,296.19 |
$1,728.25 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$741.38 |
$988.50 |
8.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,239 |
$1,652 |
8.1× |
| CT neck soft tissue w contrast (70491) |
$2,382.38 |
$3,176.50 |
15.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,272.75 |
$1,697 |
8.3× |
| CT orbits w/o contrast (70480) |
$923.25 |
$1,231 |
10.1× |
| CT pelvis w & w/o contrast (72194) |
$1,182 |
$1,576 |
7.7× |
| CT pelvis w/o contrast (72192) |
$313.50 |
$418 |
3.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,272.75 |
$1,697 |
8.3× |
| CT soft tissue neck w/o contrast (70490) |
$706.88 |
$942.50 |
7.7× |
| CT thoracic spine w/contrast (72129) |
$1,175.25 |
$1,567 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$2,637 |
$3,516 |
28.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,412.25 |
$1,883 |
9.2× |
| CT thorax w/o contrast (71250) |
$1,621.13 |
$2,161.50 |
17.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,173 |
$1,564 |
7.6× |
| CT upper extremity w/o contrast rt (73200) |
$214.50 |
$286 |
2.3× |
| CT upper extremity with contrast (73201) |
$1,710 |
$2,280 |
5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,221.75 |
$1,629 |
7.9× |
| Cta Abdomen (74175) |
$1,425 |
$1,900 |
9.3× |
| CTA abdomen pelvis (74174) |
$2,850 |
$3,800 |
9.3× |
| CTA chest (71275) |
$2,508 |
$3,344 |
16.3× |
| Cta Head (70496) |
$2,212.88 |
$2,950.50 |
14.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,425 |
$1,900 |
9.3× |
| Cta Neck (70498) |
$2,280 |
$3,040 |
14.8× |
| Cta Pelvis (72191) |
$1,425 |
$1,900 |
9.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$78.75 |
$105 |
0.9× |
| Esophagus (74220) |
$312 |
$416 |
2.0× |
| Fluoroscopy up to 1 hr (76000) |
$253.50 |
$338 |
1.2× |
| Foot 2 views (73620) |
$110.44 |
$147.25 |
1.4× |
| Forearm 2 views (73090) |
$260.25 |
$347 |
3.4× |
| Hand 2 views (73120) |
$214.50 |
$286 |
2.3× |
| Hand 3 views (73130) |
$195.38 |
$260.50 |
2.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$588.75 |
$785 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,318.88 |
$1,758.50 |
3.8× |
| Ht muscle image spect sing (78451) |
$1,542.75 |
$2,057 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$127.88 |
$170.50 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$937.50 |
$1,250 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$671.25 |
$895 |
1.4× |
| Knee 3 views (73562) |
$416.63 |
$555.50 |
5.5× |
| Lung Ventilation Imaging (78579) |
$447.75 |
$597 |
1.3× |
| Lymphoscintigraphy (78195) |
$780 |
$1,040 |
1.6× |
| Meckels Diverticulum (78290) |
$712.50 |
$950 |
2.0× |
| MRA head w & w/o contrast (70546) |
$2,250.75 |
$3,001 |
7.4× |
| MRA head w/o contrast (70544) |
$1,098.29 |
$1,464.38 |
5.3× |
| MRA head with contrast (70545) |
$1,875.75 |
$2,501 |
6.1× |
| MRA neck w/o contrast (70547) |
$1,597.50 |
$2,130 |
7.6× |
| MRI abdomen w contrast (74182) |
$2,219.25 |
$2,959 |
7.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,672.25 |
$3,563 |
8.7× |
| MRI abdomen w/o contrast (74181) |
$1,936.50 |
$2,582 |
9.3× |
| MRI any jnt lwr ext with con lt (73722) |
$844.50 |
$1,126 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,639.50 |
$2,186 |
2.4× |
| MRI cervical spine w/o contrast (72141) |
$4,390.13 |
$5,853.50 |
21.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,425.75 |
$1,901 |
4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,639.50 |
$2,186 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,425.75 |
$1,901 |
6.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$432.75 |
$577 |
2.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,190.25 |
$1,587 |
3.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,494.75 |
$1,993 |
4.9× |
| MRI pelvis w contrast (72196) |
$2,055 |
$2,740 |
6.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,465.25 |
$3,287 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$1,787.25 |
$2,383 |
8.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,919.25 |
$2,559 |
6.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,224 |
$1,632 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,409.75 |
$3,213 |
7.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,080.50 |
$2,774 |
6.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,497.50 |
$3,330 |
8.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,746 |
$2,328 |
5.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,628.75 |
$3,505 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$4,267.13 |
$5,689.50 |
20.4× |
| MRI tmj (70336) |
$785.25 |
$1,047 |
3.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,568.25 |
$2,091 |
7.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,710 |
$2,280 |
5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,212 |
$1,616 |
5.8× |
| Myelogram Cervical (72240) |
$1,297.50 |
$1,730 |
1.9× |
| Myelogram Lumbar (72265) |
$1,297.50 |
$1,730 |
1.9× |
| Myelography 2 or more regions (72270) |
$1,297.50 |
$1,730 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,484.75 |
$3,313 |
2.2× |
| Neck soft tissue (70360) |
$70.88 |
$94.50 |
0.9× |
| Nm gastric emptying study (78264) |
$501 |
$668 |
1.4× |
| Osseous survey limited (77074) |
$204 |
$272 |
2.2× |
| Parathyroid imaging (78070) |
$456 |
$608 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$78.75 |
$105 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,966.50 |
$2,622 |
6.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$447.75 |
$597 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$600 |
$800 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$192.73 |
$256.97 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$154.50 |
$206 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$172.50 |
$230 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$197.25 |
$263 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$65.75 |
$87.66 |
0.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$86.63 |
$115.50 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$175.88 |
$234.50 |
2.3× |
| Radiologic exam colon single contrast study (74270) |
$428.25 |
$571 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$513.38 |
$684.50 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$421.50 |
$562 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$82.50 |
$110 |
1.1× |
| Ribs bilateral 3 views (71110) |
$101.25 |
$135 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,309.06 |
$3,078.75 |
4.9× |
| Scanogram (77073) |
$108.75 |
$145 |
1.2× |
| Scapula complete (73010) |
$214.50 |
$286 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$136.50 |
$182 |
5.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$215.25 |
$287 |
2.3× |
| Small bowel series (74250) |
$381.75 |
$509 |
2.5× |
| Spine thoracic 3 views (72072) |
$502.50 |
$670 |
5.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$456 |
$608 |
1.3× |
| Tmj unilateral (70328) |
$155.25 |
$207 |
2.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,419.38 |
$1,892.50 |
4.1× |
| Ultrasound, abdomen limited (76705) |
$390.34 |
$520.45 |
4.3× |
| Upper Extremity Infant (73092) |
$214.50 |
$286 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$211.13 |
$281.50 |
2.3× |
| Us breast unilateral complete (76641) |
$420 |
$560 |
4.6× |
| Us breast unilateral limited (76642) |
$661.88 |
$882.50 |
8.7× |
| Us chest (76604) |
$142.50 |
$190 |
1.6× |
| Us compl joint r-t w/image documentation (76881) |
$339.75 |
$453 |
3.7× |
| Us ob transvaginal (76817) |
$122.25 |
$163 |
1.3× |
| Us pelvic non ob complete (76856) |
$356.63 |
$475.50 |
3.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$212.25 |
$283 |
2.3× |
| Us pregnancy ltd (76815) |
$212.25 |
$283 |
2.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$173.63 |
$231.50 |
1.9× |
| Us retroperitoneal complete (76770) |
$760.88 |
$1,014.50 |
8.3× |
| Us retroperitoneal limited (76775) |
$212.25 |
$283 |
2.3× |
| Us scrotum and contents (76870) |
$403.13 |
$537.50 |
4.4× |
| Us soft tissue head/neck (76536) |
$360.38 |
$480.50 |
3.9× |
| Us xtr non-vasc lmtd (76882) |
$475.50 |
$634 |
5.2× |
| Wrist 2 views (73100) |
$110.44 |
$147.25 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$83.25 |
$111 |
0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$157.50 |
$210 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$195.38 |
$260.50 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$504 |
$672 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$82.50 |
$110 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$260.25 |
$347 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$184.88 |
$246.50 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$192 |
$256 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$416.63 |
$555.50 |
5.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$138 |
$184 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$151.50 |
$202 |
2.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$477 |
$636 |
5.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$127.50 |
$170 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$645 |
$860 |
7.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$303 |
$404 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$151.50 |
$202 |
2.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$127.50 |
$170 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$192 |
$256 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$96.38 |
$128.50 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$126.05 |
$168.06 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$278.25 |
$371 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$242.25 |
$323 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$398.25 |
$531 |
5.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$416.63 |
$555.50 |
5.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$392.25 |
$523 |
5.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$352.50 |
$470 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$233.25 |
$311 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$165 |
$220 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$98.25 |
$131 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$152.25 |
$203 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$171.75 |
$229 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$204.75 |
$273 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$116.25 |
$155 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$115.50 |
$154 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$160.36 |
$213.81 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$260.25 |
$347 |
3.4× |
| Xr shoulder 1 view (73020) |
$116.25 |
$155 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$631.50 |
$842 |
6.9× |
| Xr tibia/fibula 2 views (73590) |
$260.25 |
$347 |
3.4× |
| Xr tmj bilateral (70330) |
$155.25 |
$207 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$260.25 |
$347 |
3.4× |