| Angiography extremity unilateral rs&i (75710) |
$4,724 |
$5,905 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$4,798.40 |
$5,998 |
1.7× |
| Arthrogram hip (73525) |
$713.60 |
$892 |
2.3× |
| Arthrogram shoulder (73040) |
$752.80 |
$941 |
2.5× |
| Arthrography knee lt (73580) |
$752.80 |
$941 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$298.40 |
$373 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$789.20 |
$986.50 |
2.3× |
| Bone age studies (77072) |
$273.60 |
$342 |
3.0× |
| Bone Imaging 3 Phase (78315) |
$780 |
$975 |
2.2× |
| Bone survey complete (77075) |
$627.20 |
$784 |
6.8× |
| Cervical spine 2 or 3 views (72040) |
$321.60 |
$402 |
4.2× |
| Chest 1 view (71045) |
$204.80 |
$256 |
2.7× |
| Clavicle complete (73000) |
$189.60 |
$237 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$447.20 |
$559 |
4.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,132 |
$2,665 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,592.80 |
$1,991 |
7.6× |
| CT abdomen w contrast (74160) |
$2,580.80 |
$3,226 |
16.8× |
| CT abdomen w wo contrast (74170) |
$2,533.20 |
$3,166.50 |
16.5× |
| CT abdomen w/o contrast (74150) |
$1,776 |
$2,220 |
19.4× |
| CT angio hrt w/3d image (75574) |
$3,204.80 |
$4,006 |
10.5× |
| CT angiography upper extremity lt (73206) |
$2,671.20 |
$3,339 |
17.4× |
| CT c-spine w/o contrast (72125) |
$1,999.20 |
$2,499 |
21.8× |
| CT cervical spine with contrast (72126) |
$2,235.60 |
$2,794.50 |
7.3× |
| CT chest w/wo contrast (71270) |
$2,334 |
$2,917.50 |
15.2× |
| CT chest with contrast (71260) |
$2,270.40 |
$2,838 |
14.8× |
| CT colonography screening (74263) |
$1,449.20 |
$1,811.50 |
6.9× |
| CT head/brain with contrast (70460) |
$2,060.80 |
$2,576 |
13.4× |
| CT head/brain without and with contrast (70470) |
$2,209.60 |
$2,762 |
14.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,934.40 |
$2,418 |
6.3× |
| CT iac w contrast (70481) |
$2,108.80 |
$2,636 |
13.7× |
| CT lower ext w/o (73700) |
$1,737.60 |
$2,172 |
19.0× |
| CT lower extremity w wo contrast (73702) |
$2,529.60 |
$3,162 |
16.5× |
| CT lower extremity with contrast (73701) |
$2,053.60 |
$2,567 |
13.4× |
| CT lumbar spine w/o contrast (72131) |
$1,922.40 |
$2,403 |
21.0× |
| CT lumbar spine with contrast (72132) |
$2,288 |
$2,860 |
7.5× |
| CT maxillofacial w contrast (70487) |
$1,892 |
$2,365 |
12.3× |
| CT maxillofacial w/o contrast (70486) |
$1,474.40 |
$1,843 |
16.1× |
| CT neck soft tissue w contrast (70491) |
$2,203.20 |
$2,754 |
14.3× |
| CT orbits w/o contrast (70480) |
$1,760.80 |
$2,201 |
19.2× |
| CT pelvis w & w/o contrast (72194) |
$2,416.80 |
$3,021 |
15.7× |
| CT pelvis w/o contrast (72192) |
$1,842.40 |
$2,303 |
20.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,267.20 |
$2,834 |
14.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,540 |
$1,925 |
16.8× |
| CT thoracic spine w/contrast (72129) |
$2,384.80 |
$2,981 |
15.5× |
| CT thoracic spine w/o contrast (72128) |
$1,796 |
$2,245 |
19.6× |
| CT thorax w/o contrast (71250) |
$2,018.40 |
$2,523 |
22.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,723.20 |
$2,154 |
18.8× |
| CT upper extremity with contrast (73201) |
$2,002.40 |
$2,503 |
6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,913.60 |
$3,642 |
19.0× |
| Cta Abdomen (74175) |
$2,209.60 |
$2,762 |
14.4× |
| CTA abdomen pelvis (74174) |
$4,036.80 |
$5,046 |
13.2× |
| CTA chest (71275) |
$2,678.40 |
$3,348 |
17.4× |
| Cta Head (70496) |
$2,208 |
$2,760 |
14.4× |
| CTA lwr ext w&w/o contrast (73706) |
$3,644.80 |
$4,556 |
23.7× |
| Cta Neck (70498) |
$2,176.80 |
$2,721 |
14.2× |
| Cta Pelvis (72191) |
$2,156.80 |
$2,696 |
14.0× |
| Cystography minimum 3 views rs&i (74430) |
$561.60 |
$702 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$487.20 |
$609 |
5.3× |
| Esophagus (74220) |
$536 |
$670 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$636.80 |
$796 |
7.0× |
| Fluoroscopy up to 1 hr (76000) |
$549.20 |
$686.50 |
2.6× |
| Forearm 2 views (73090) |
$257.60 |
$322 |
3.4× |
| Gated Heart Planar Single (78472) |
$564 |
$705 |
1.6× |
| Hand 3 views (73130) |
$272.80 |
$341 |
3.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,389.60 |
$1,737 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,389.60 |
$1,737 |
4.0× |
| Humerus Min 2 Views Left (73060) |
$252 |
$315 |
3.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$417.60 |
$522 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$722.40 |
$903 |
1.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$204.80 |
$256 |
0.4× |
| Liver & spleen imaging static only (78215) |
$408 |
$510 |
1.2× |
| Lung Ventilation Imaging (78579) |
$629.60 |
$787 |
1.8× |
| Lymphoscintigraphy (78195) |
$1,700 |
$2,125 |
3.6× |
| Meckels Diverticulum (78290) |
$237.60 |
$297 |
0.7× |
| MRA head w & w/o contrast (70546) |
$3,510.40 |
$4,388 |
11.5× |
| MRA head w/o contrast (70544) |
$2,606 |
$3,257.50 |
12.5× |
| MRA head with contrast (70545) |
$2,865.60 |
$3,582 |
9.4× |
| MRA neck w contrast (70548) |
$2,641.60 |
$3,302 |
8.6× |
| MRA neck w/o contrast (70547) |
$2,641.60 |
$3,302 |
12.6× |
| MRI abdomen w contrast (74182) |
$3,251.20 |
$4,064 |
10.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,857.60 |
$4,822 |
12.6× |
| MRI abdomen w/o contrast (74181) |
$2,717.60 |
$3,397 |
13.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,813.60 |
$3,517 |
4.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,792 |
$3,490 |
4.1× |
| MRI c-spine with contrast (72142) |
$3,486.40 |
$4,358 |
11.4× |
| MRI cervical spine w/o contrast (72141) |
$2,569.60 |
$3,212 |
12.3× |
| MRI chest w/o & w/contrast material (71552) |
$3,485.60 |
$4,357 |
11.4× |
| MRI chest w/o contrast (71550) |
$2,427.60 |
$3,034.50 |
11.6× |
| MRI chest with contrast (71551) |
$2,892.80 |
$3,616 |
4.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,460.80 |
$3,076 |
8.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,053.60 |
$3,817 |
10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,552.80 |
$3,191 |
12.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,748.80 |
$3,436 |
13.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,852 |
$4,815 |
12.6× |
| MRI pelvis w contrast (72196) |
$2,577.60 |
$3,222 |
8.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,540.80 |
$4,426 |
11.6× |
| MRI pelvis w/o contrast (72195) |
$2,492.80 |
$3,116 |
11.9× |
| MRI scan of arm joint before and after contrast (73223) |
$3,480.80 |
$4,351 |
11.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,632.80 |
$4,541 |
11.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,490.40 |
$4,363 |
11.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,425.60 |
$4,282 |
11.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,538.40 |
$4,423 |
11.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,632.80 |
$4,541 |
11.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,837.60 |
$4,797 |
12.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,748 |
$3,435 |
13.1× |
| MRI tmj (70336) |
$2,460.80 |
$3,076 |
11.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,315.20 |
$2,894 |
11.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,251.20 |
$4,064 |
10.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,322.40 |
$2,903 |
11.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,809.60 |
$4,762 |
3.4× |
| Neck soft tissue (70360) |
$221.60 |
$277 |
2.9× |
| Nm gastric emptying study (78264) |
$780 |
$975 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$1,172 |
$1,465 |
5.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$505.60 |
$632 |
5.5× |
| Parathyroid imaging (78070) |
$254.40 |
$318 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$244.80 |
$306 |
2.7× |
| Pr heart first pass single,planar (78481) |
$204.80 |
$256 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,496 |
$4,370 |
11.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$398.40 |
$498 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,215.20 |
$1,519 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$347.20 |
$434 |
4.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$367.20 |
$459 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$162.40 |
$203 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$338.40 |
$423 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$302 |
$377.50 |
4.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$272 |
$340 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$691.20 |
$864 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$519.20 |
$649 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$266.40 |
$333 |
3.5× |
| Radiological examination surgical specimen (76098) |
$192 |
$240 |
0.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$794.40 |
$993 |
0.7× |
| Sacroiliac Joints < 3 Views (72200) |
$290.40 |
$363 |
3.2× |
| Scanogram (77073) |
$338.40 |
$423 |
3.7× |
| Scapula complete (73010) |
$253.60 |
$317 |
2.8× |
| Screening digital breast tomosynthesis (77063) |
$104 |
$130 |
4.4× |
| Spine thoracic 3 views (72072) |
$380.80 |
$476 |
4.2× |
| Testicular Imaging With Vascular Flow (78761) |
$204.80 |
$256 |
0.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$505.60 |
$632 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$325.60 |
$407 |
0.9× |
| Thyroid uptake measurement (78012) |
$238.80 |
$298.50 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$967.20 |
$1,209 |
2.8× |
| Tmj unilateral (70328) |
$244 |
$305 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$652.80 |
$816 |
7.1× |
| Upper Extremity Infant (73092) |
$257.60 |
$322 |
2.8× |
| Urethrocystography voiding (74455) |
$867.60 |
$1,084.50 |
4.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$836.80 |
$1,046 |
5.4× |
| Us breast unilateral limited (76642) |
$532 |
$665 |
7.0× |
| Us chest (76604) |
$560 |
$700 |
6.1× |
| Us ob transvaginal (76817) |
$685.60 |
$857 |
7.5× |
| Us pelvic non ob complete (76856) |
$654.40 |
$818 |
7.1× |
| Us pregnancy ltd (76815) |
$388 |
$485 |
4.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$520.80 |
$651 |
5.7× |
| Us retroperitoneal complete (76770) |
$693.60 |
$867 |
7.6× |
| Us scrotum and contents (76870) |
$748.80 |
$936 |
8.2× |
| Us soft tissue head/neck (76536) |
$613.20 |
$766.50 |
6.7× |
| Us xtr non-vasc lmtd (76882) |
$582.40 |
$728 |
6.4× |
| Venogram extremity bilateral (75822) |
$2,112 |
$2,640 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$1,665.60 |
$2,082 |
1.2× |
| Wrist 2 views (73100) |
$197.60 |
$247 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$444.80 |
$556 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$171.20 |
$214 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$276.80 |
$346 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$866.40 |
$1,083 |
5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$212 |
$265 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$291.20 |
$364 |
3.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$259.60 |
$324.50 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$249.60 |
$312 |
3.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$196 |
$245 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$326.40 |
$408 |
3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$363.20 |
$454 |
4.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$281.60 |
$352 |
3.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$146.40 |
$183 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$238.80 |
$298.50 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$464 |
$580 |
5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$288 |
$360 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$272.80 |
$341 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$335.20 |
$419 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$385.60 |
$482 |
4.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$324 |
$405 |
4.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$301.60 |
$377 |
4.0× |
| Xr c-spine 6 or more views (72052) |
$272.80 |
$341 |
3.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$162.40 |
$203 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$432.80 |
$541 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$259.20 |
$324 |
3.4× |
| Xray knee 1 or 2 views rt (73560) |
$208.80 |
$261 |
2.7× |