| Abdomen 2 views (74019) |
$258 |
$322.50 |
2.6× |
| Ankle 2 views (73600) |
$214.20 |
$267.75 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,322.60 |
$1,653.25 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$1,525.40 |
$1,906.75 |
4.0× |
| Bone survey complete (77075) |
$447.20 |
$559 |
4.5× |
| Cervical spine 2 or 3 views (72040) |
$297 |
$371.25 |
3.6× |
| Chest 1 view (71045) |
$156 |
$195 |
1.9× |
| Clavicle complete (73000) |
$149.80 |
$187.25 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$356.40 |
$445.50 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,821 |
$4,776.25 |
11.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,950.80 |
$3,688.50 |
12.9× |
| CT abdomen w contrast (74160) |
$2,164 |
$2,705 |
12.9× |
| CT abdomen w wo contrast (74170) |
$2,075.40 |
$2,594.25 |
12.4× |
| CT abdomen w/o contrast (74150) |
$1,528.80 |
$1,911 |
15.3× |
| CT angiography upper extremity lt (73206) |
$2,766.60 |
$3,458.25 |
16.5× |
| CT c-spine w/o contrast (72125) |
$1,334.20 |
$1,667.75 |
13.4× |
| CT chest with contrast (71260) |
$1,597.40 |
$1,996.75 |
9.5× |
| CT head/brain without and with contrast (70470) |
$2,037 |
$2,546.25 |
12.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$322.80 |
$403.50 |
3.9× |
| CT iac w contrast (70481) |
$1,777.40 |
$2,221.75 |
10.6× |
| CT lower ext w/o (73700) |
$1,252.20 |
$1,565.25 |
12.5× |
| CT lower extremity w wo contrast (73702) |
$1,421.60 |
$1,777 |
8.5× |
| CT lower extremity with contrast (73701) |
$1,327.20 |
$1,659 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$1,450.60 |
$1,813.25 |
14.5× |
| CT lumbar spine with contrast (72132) |
$1,681.60 |
$2,102 |
5.0× |
| CT maxillofacial w contrast (70487) |
$1,572.80 |
$1,966 |
9.4× |
| CT maxillofacial w/o contrast (70486) |
$1,233 |
$1,541.25 |
12.3× |
| CT neck soft tissue w contrast (70491) |
$1,867.40 |
$2,334.25 |
11.1× |
| CT orbits w/o contrast (70480) |
$1,332.40 |
$1,665.50 |
13.3× |
| CT pelvis w/o contrast (72192) |
$1,422.80 |
$1,778.50 |
14.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,968.80 |
$2,461 |
11.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,332.40 |
$1,665.50 |
13.3× |
| CT thoracic spine w/o contrast (72128) |
$1,334.20 |
$1,667.75 |
13.4× |
| CT thorax w/o contrast (71250) |
$1,334.20 |
$1,667.75 |
13.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,386 |
$1,732.50 |
13.9× |
| CT upper extremity with contrast (73201) |
$1,319.20 |
$1,649 |
4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,339 |
$2,923.75 |
14.0× |
| Cta Abdomen (74175) |
$2,766.60 |
$3,458.25 |
16.5× |
| CTA abdomen pelvis (74174) |
$3,218.40 |
$4,023 |
9.7× |
| CTA chest (71275) |
$2,766.60 |
$3,458.25 |
16.5× |
| Cta Head (70496) |
$2,766.60 |
$3,458.25 |
16.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,572.40 |
$3,215.50 |
15.3× |
| Cta Neck (70498) |
$2,766.60 |
$3,458.25 |
16.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$335 |
$418.75 |
3.4× |
| Esophagus (74220) |
$399 |
$498.75 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$913.60 |
$1,142 |
9.1× |
| Forearm 2 views (73090) |
$228.80 |
$286 |
2.8× |
| Hand 3 views (73130) |
$233.60 |
$292 |
2.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,175.20 |
$1,469 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$920.20 |
$1,150.25 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$192.80 |
$241 |
2.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$196.40 |
$245.50 |
2.0× |
| Knee 3 views (73562) |
$287.20 |
$359 |
3.5× |
| Meckels Diverticulum (78290) |
$838.80 |
$1,048.50 |
2.2× |
| MRA head w/o contrast (70544) |
$2,533.60 |
$3,167 |
11.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,031.40 |
$3,789.25 |
9.1× |
| MRI abdomen w/o contrast (74181) |
$2,346.80 |
$2,933.50 |
10.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,826.20 |
$3,532.75 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$2,547.40 |
$3,184.25 |
11.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,783.80 |
$2,229.75 |
7.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,675.40 |
$3,344.25 |
8.0× |
| MRI pelvis w/o contrast (72195) |
$1,868.80 |
$2,336 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,308 |
$2,885 |
6.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,056.20 |
$3,820.25 |
9.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,130.40 |
$5,163 |
12.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,176.40 |
$5,220.50 |
12.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,487.20 |
$3,109 |
10.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,961.40 |
$2,451.75 |
8.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,308 |
$2,885 |
6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,522.40 |
$3,153 |
11.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,113 |
$2,641.25 |
1.7× |
| Neck soft tissue (70360) |
$228.80 |
$286 |
2.8× |
| Nm gastric emptying study (78264) |
$1,130.60 |
$1,413.25 |
3.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$568.40 |
$710.50 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$175.20 |
$219 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,307 |
$2,883.75 |
6.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,123 |
$3,903.75 |
6.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$175.60 |
$219.50 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$330 |
$412.50 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$199.80 |
$249.75 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$185.90 |
$232.38 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$166 |
$207.50 |
2.0× |
| Radiological examination surgical specimen (76098) |
$140.40 |
$175.50 |
0.3× |
| Ribs bilateral 3 views (71110) |
$234.20 |
$292.75 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$106.80 |
$133.50 |
4.6× |
| Small bowel series (74250) |
$319.60 |
$399.50 |
1.9× |
| Spine thoracic 3 views (72072) |
$374.60 |
$468.25 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$593.60 |
$742 |
5.9× |
| Urethrocystography retrograde rs&i (74450) |
$447.20 |
$559 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$264 |
$330 |
2.6× |
| Us breast unilateral limited (76642) |
$228.80 |
$286 |
2.8× |
| Us ob transvaginal (76817) |
$411 |
$513.75 |
4.1× |
| Us pelvic non ob complete (76856) |
$564.20 |
$705.25 |
5.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$313.20 |
$391.50 |
3.1× |
| Us pregnancy ltd (76815) |
$373.80 |
$467.25 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$369.40 |
$461.75 |
3.7× |
| Us retroperitoneal complete (76770) |
$557 |
$696.25 |
5.6× |
| Us retroperitoneal limited (76775) |
$410.50 |
$513.12 |
4.1× |
| Us scrotum and contents (76870) |
$492.60 |
$615.75 |
4.9× |
| Us soft tissue head/neck (76536) |
$530.40 |
$663 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$655.80 |
$819.75 |
6.6× |
| Wrist 2 views (73100) |
$100 |
$125 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$326 |
$407.50 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$153.60 |
$192 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$267.60 |
$334.50 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$126.80 |
$158.50 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$238.60 |
$298.25 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$145.20 |
$181.50 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$245 |
$306.25 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$238.60 |
$298.25 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$140.40 |
$175.50 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$297 |
$371.25 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$199.80 |
$249.75 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$330.80 |
$413.50 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$333.60 |
$417 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$264 |
$330 |
2.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$147.80 |
$184.75 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$240.40 |
$300.50 |
2.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$243.40 |
$304.25 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$179.40 |
$224.25 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$272.40 |
$340.50 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$267.20 |
$334 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$147.80 |
$184.75 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$233.60 |
$292 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$243.40 |
$304.25 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$228 |
$285 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160 |
$200 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$149.80 |
$187.25 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$165.60 |
$207 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$179.40 |
$224.25 |
2.2× |
| Xr c-spine 6 or more views (72052) |
$343.60 |
$429.50 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$194.80 |
$243.50 |
2.3× |
| Xr shoulder 1 view (73020) |
$181.60 |
$227 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$394.20 |
$492.75 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$238.60 |
$298.25 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$219.20 |
$274 |
2.6× |