| Abdomen 2 views (74019) |
$151 |
$251 |
1.4× |
| Ankle 2 views (73600) |
$149 |
$248 |
1.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$386 |
$644 |
1.0× |
| Arthrogram hip (73525) |
$590 |
$984 |
1.6× |
| Arthrogram shoulder (73040) |
$590 |
$984 |
1.6× |
| Arthrogram wrist (73115) |
$590 |
$984 |
1.6× |
| Arthrography knee lt (73580) |
$590 |
$984 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$898 |
$1,497 |
2.1× |
| Bone age studies (77072) |
$107 |
$179 |
1.0× |
| Bone survey complete (77075) |
$469 |
$781 |
4.3× |
| Cervical spine 2 or 3 views (72040) |
$151 |
$252 |
1.6× |
| Chest 1 view (71045) |
$121 |
$202 |
1.3× |
| Chest 3 views (71047) |
$191 |
$319 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$279 |
$465 |
1.5× |
| Clavicle complete (73000) |
$211 |
$352 |
2.3× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$236 |
$393 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,070 |
$5,117 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,182 |
$3,636 |
8.7× |
| CT angiography upper extremity lt (73206) |
$825 |
$1,375 |
4.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,601 |
$2,669 |
8.7× |
| CT cervical spine with contrast (72126) |
$1,598 |
$2,663 |
4.3× |
| CT colonography screening (74263) |
$484 |
$806 |
1.9× |
| CT colonography w/dye (74262) |
$944 |
$1,574 |
5.1× |
| CT colonography w/o cntrst (74261) |
$754 |
$1,257 |
6.8× |
| CT iac w contrast (70481) |
$1,147 |
$1,912 |
6.2× |
| CT lower extremity with contrast (73701) |
$2,828 |
$4,714 |
15.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,015 |
$3,358 |
10.9× |
| CT lumbar spine with contrast (72132) |
$1,938 |
$3,230 |
5.3× |
| CT maxillofacial w contrast (70487) |
$1,211 |
$2,019 |
6.5× |
| CT maxillofacial w/o contrast (70486) |
$802 |
$1,336 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,426 |
$2,377 |
7.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,368 |
$2,280 |
7.4× |
| CT orbits w/o contrast (70480) |
$1,073 |
$1,789 |
9.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$279 |
$465 |
3.0× |
| CT thoracic spine w/contrast (72129) |
$1,938 |
$3,230 |
10.5× |
| CT thoracic spine w/o contrast (72128) |
$1,057 |
$1,762 |
9.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,015 |
$3,358 |
10.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,051 |
$1,751 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,688 |
$2,814 |
9.1× |
| Cta Abdomen (74175) |
$1,236 |
$2,060 |
6.7× |
| CTA abdomen pelvis (74174) |
$2,923 |
$4,871 |
7.9× |
| CTA chest (71275) |
$1,971 |
$3,285 |
10.7× |
| Cta Head (70496) |
$1,219 |
$2,032 |
6.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,292 |
$3,820 |
6.2× |
| CTA lwr ext w&w/o contrast (73706) |
$862 |
$1,436 |
4.7× |
| Cta Neck (70498) |
$1,573 |
$2,621 |
8.5× |
| Cta Pelvis (72191) |
$1,275 |
$2,125 |
6.9× |
| Cystography minimum 3 views rs&i (74430) |
$496 |
$826 |
1.3× |
| Esophagus (74220) |
$329 |
$549 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$365 |
$609 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$227 |
$379 |
0.9× |
| Foot 2 views (73620) |
$180.50 |
$300.50 |
2.0× |
| Forearm 2 views (73090) |
$155 |
$258 |
1.7× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$785 |
$1,308 |
1.4× |
| Hand 2 views (73120) |
$140 |
$234 |
1.3× |
| Hand 3 views (73130) |
$191 |
$318 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$960 |
$1,600 |
2.3× |
| Ht muscle image spect sing (78451) |
$2,109 |
$3,515 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$145 |
$242 |
1.6× |
| Hysterosalpingogram (74740) |
$496 |
$826 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$875 |
$1,458 |
1.5× |
| Knee 3 views (73562) |
$208 |
$346 |
2.3× |
| Lung Ventilation Imaging (78579) |
$655 |
$1,091 |
1.6× |
| MRA head w & w/o contrast (70546) |
$2,302 |
$3,836 |
6.3× |
| MRA head w/o contrast (70544) |
$1,504 |
$2,506 |
6.0× |
| MRA head with contrast (70545) |
$1,611 |
$2,685 |
4.4× |
| MRA neck w contrast (70548) |
$1,693 |
$2,822 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,776 |
$2,960 |
4.8× |
| MRA neck w/o contrast (70547) |
$1,611 |
$2,685 |
6.4× |
| MRI abdomen w contrast (74182) |
$1,823 |
$3,038 |
5.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,309 |
$3,848 |
6.3× |
| MRI abdomen w/o contrast (74181) |
$1,482 |
$2,470 |
5.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,891 |
$3,152 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,760 |
$2,934 |
2.1× |
| MRI c-spine with contrast (72142) |
$2,119 |
$3,532 |
5.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,449 |
$4,082 |
6.7× |
| MRI chest w/o contrast (71550) |
$1,504 |
$2,506 |
6.0× |
| MRI chest with contrast (71551) |
$1,611 |
$2,685 |
1.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,611 |
$2,685 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,683 |
$2,805 |
4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,354 |
$2,257 |
5.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,611 |
$2,685 |
6.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,419 |
$4,031 |
6.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,015 |
$3,358 |
5.5× |
| MRI pelvis w contrast (72196) |
$1,773 |
$2,955 |
4.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,876 |
$3,127 |
5.1× |
| MRI pelvis w/o contrast (72195) |
$1,670 |
$2,783 |
6.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,910 |
$3,183 |
5.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,137 |
$3,562 |
5.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,390 |
$3,984 |
6.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,119 |
$3,532 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,390 |
$3,984 |
6.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,119 |
$3,532 |
5.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,390 |
$3,984 |
6.5× |
| MRI tmj (70336) |
$1,250 |
$2,084 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,611 |
$2,685 |
6.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,635 |
$2,725 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,535 |
$2,558 |
6.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,734 |
$4,557 |
2.0× |
| Neck soft tissue (70360) |
$185 |
$309 |
2.0× |
| Nm adrenal scan (78075) |
$2,008 |
$3,346 |
1.5× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$785 |
$1,308 |
1.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$449 |
$749 |
4.1× |
| Osseous survey infant (77076) |
$252 |
$420 |
2.3× |
| Osseous survey limited (77074) |
$233 |
$389 |
2.1× |
| Parathyrd planar w/wo subtrj (78071) |
$682 |
$1,137 |
1.6× |
| Parathyroid imaging (78070) |
$682 |
$1,137 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$139 |
$231 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,822 |
$3,037 |
5.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,058 |
$1,763 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$496 |
$826 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$271 |
$451 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$325 |
$541 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$188 |
$314 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$367 |
$612 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$274 |
$457 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$127 |
$211 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$178 |
$297 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$335 |
$559 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$457 |
$762 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$368 |
$613 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$178 |
$297 |
1.9× |
| Radiological examination surgical specimen (76098) |
$842 |
$1,403 |
1.5× |
| Ribs bilateral 3 views (71110) |
$218 |
$363 |
2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,039 |
$1,731 |
2.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,039 |
$1,731 |
1.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,302 |
$2,170 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$173 |
$288 |
1.6× |
| Scanogram (77073) |
$326 |
$544 |
3.0× |
| Scapula complete (73010) |
$169 |
$281 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$360 |
$600 |
15.4× |
| Sella turcica (70240) |
$107 |
$179 |
1.2× |
| Small bowel series (74250) |
$324 |
$540 |
1.8× |
| Spine thoracic 3 views (72072) |
$283 |
$472 |
2.6× |
| Testicular Imaging With Vascular Flow (78761) |
$631 |
$1,052 |
1.5× |
| Thoracolumbar 2 views (72080) |
$202 |
$337 |
2.2× |
| Thyroid uptake measurement (78012) |
$386 |
$643 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$739 |
$1,232 |
1.8× |
| Tmj unilateral (70328) |
$197 |
$328 |
2.1× |
| Tomogram (76100) |
$346 |
$576 |
3.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,039 |
$1,731 |
1.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$705 |
$1,175 |
1.7× |
| Ultrasound elastography first target lesion (76982) |
$112 |
$186 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$376 |
$627 |
3.4× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$670 |
$1,117 |
1.6× |
| Unlisted Ultrasound Procedure (76999) |
$259 |
$432 |
2.8× |
| Upper Extremity Infant (73092) |
$112 |
$186 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$386 |
$644 |
1.5× |
| Urethrocystography voiding (74455) |
$424 |
$706 |
1.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$661 |
$1,101 |
3.6× |
| Us abdl aorta screen aaa (76706) |
$448 |
$746 |
4.1× |
| Us breast unilateral complete (76641) |
$232 |
$386 |
2.1× |
| Us breast unilateral limited (76642) |
$157 |
$261 |
1.7× |
| Us chest (76604) |
$239 |
$398 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$353 |
$589 |
3.2× |
| Us elastography parenchyma (76981) |
$131 |
$219 |
1.2× |
| Us kidney transplant (76776) |
$342 |
$570 |
3.1× |
| Us ob detailed single fetus (76811) |
$685.50 |
$1,142 |
2.7× |
| Us ob transvaginal (76817) |
$321 |
$535 |
2.9× |
| Us pelvic non ob complete (76856) |
$548 |
$914 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$314 |
$524 |
2.8× |
| Us pregnancy ltd (76815) |
$281 |
$468 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$528 |
$880 |
4.8× |
| Us retroperitoneal complete (76770) |
$411 |
$685 |
3.7× |
| Us retroperitoneal limited (76775) |
$342 |
$570 |
3.1× |
| Us scrotum and contents (76870) |
$329 |
$549 |
3.0× |
| Us soft tissue head/neck (76536) |
$352 |
$587 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$322 |
$536 |
2.9× |
| Wrist 2 views (73100) |
$174 |
$290 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$323 |
$538 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$191 |
$319 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$194 |
$323 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$644 |
$1,074 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$157 |
$262 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$195 |
$325 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$242 |
$404 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$286 |
$477 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$371 |
$618 |
3.4× |
| X-ray exam of femur 1 (73551) |
$151 |
$251 |
1.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$324 |
$540 |
1.8× |
| X-ray eye for foreign body (70030) |
$184 |
$306 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$229 |
$381 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$172 |
$286 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$188 |
$314 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$126 |
$210 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$131 |
$218 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$209 |
$349 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$119 |
$199 |
1.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$185 |
$308 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$191 |
$318 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$414 |
$690 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$161 |
$269 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$248 |
$414 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$176 |
$294 |
1.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$411 |
$685 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$191 |
$318 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$194 |
$323 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$304 |
$506 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$195 |
$325 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$201 |
$335 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$195 |
$325 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$287 |
$479 |
3.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$151 |
$251 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$321 |
$535 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$215 |
$359 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$149 |
$248 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$197 |
$329 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$166 |
$276 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$181 |
$301 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$340 |
$566 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$115 |
$191 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$174 |
$290 |
1.9× |
| Xr arthrogram ankle (73615) |
$590 |
$984 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$343 |
$572 |
3.1× |
| Xr chest 4+ views (71048) |
$164 |
$274 |
1.5× |
| Xr Cholecystography Oral Contrast (74290) |
$182 |
$303 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$146 |
$243 |
1.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$306 |
$510 |
2.8× |
| Xr optic foramina (70190) |
$148 |
$247 |
1.6× |
| Xr shoulder 1 view (73020) |
$164 |
$274 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$289 |
$482 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$188 |
$314 |
2.0× |
| Xr tmj bilateral (70330) |
$245 |
$408 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$136 |
$227 |
1.5× |