| Abdomen 1 View (74018) |
$102.99 |
$442 |
1.1× |
| Abdomen 2 views (74019) |
$125.59 |
$539 |
1.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$411.92 |
$1,943 |
1.0× |
| Adrenal Cortex & Medulla Img (78075) |
$523.64 |
$2,470 |
0.4× |
| Angio pulmonary bilat (75743) |
$1,295.91 |
$5,610 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,943.40 |
$8,413 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,875.49 |
$8,119 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,153.38 |
$4,993 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,137.21 |
$4,923 |
0.3× |
| Ankle 2 views (73600) |
$78.99 |
$339 |
0.9× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,175.56 |
$5,089 |
0.2× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$1,786.09 |
$7,732 |
0.3× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$1,388.77 |
$6,012 |
0.2× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$1,350.20 |
$5,845 |
0.2× |
| Arthrogram hip (73525) |
$330.05 |
$1,240 |
0.9× |
| Arthrogram Wrist (73115) |
$290.13 |
$1,090 |
0.8× |
| Bone age studies (77072) |
$77.59 |
$333 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$883.83 |
$4,169 |
2.1× |
| Bone Imaging Limited Area (78300) |
$384.99 |
$1,816 |
0.9× |
| Bone Imaging Whole Body (78306) |
$768.50 |
$3,625 |
1.8× |
| Bone marrow imaging limited area (78102) |
$337.08 |
$1,590 |
0.8× |
| Bone survey infant (77076) |
$245.35 |
$1,053 |
2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$490.57 |
$2,314 |
0.8× |
| Cat Scan Follow-Up Study (76380) |
$86.73 |
$586 |
0.9× |
| Cerebrospinal Fluid Scan (78630) |
$351.71 |
$1,659 |
0.6× |
| Chest 1 view (71045) |
$63.92 |
$272 |
0.7× |
| Chest 2 views (71046) |
$77.08 |
$328 |
0.8× |
| Chest 3 views (71047) |
$86.01 |
$366 |
0.9× |
| Chest 4 or more views (71048) |
$104.10 |
$443 |
0.9× |
| Clavicle complete (73000) |
$74.56 |
$320 |
0.8× |
| Contrast Exam Abdominl Aorta (75625) |
$1,137.21 |
$4,923 |
0.3× |
| Contrast X-Ray Bladder (74430) |
$237.19 |
$1,018 |
0.6× |
| Contrast X-Ray Of Elbow (73085) |
$293.05 |
$1,101 |
0.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$293.05 |
$1,101 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$665 |
$3,800 |
1.8× |
| CT abdomen and pelvis without contrast (74176) |
$443.28 |
$2,533 |
1.7× |
| CT abdomen w contrast (74160) |
$389.38 |
$2,225 |
2.1× |
| CT abdomen w wo contrast (74170) |
$467.25 |
$2,670 |
2.5× |
| CT abdomen w/o contrast (74150) |
$311.50 |
$1,780 |
2.8× |
| CT Angio Abdomen and Pelvis (74174) |
$698.25 |
$3,990 |
1.9× |
| CT Angio Chest (71275) |
$647.15 |
$3,698 |
3.5× |
| CT Angio Head (70496) |
$453.30 |
$2,561 |
2.4× |
| CT angio hrt w/3d image (75574) |
$371.33 |
$2,509 |
1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$449.92 |
$2,571 |
2.4× |
| CT Angio Neck (70498) |
$414.18 |
$2,340 |
2.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$474.78 |
$2,713 |
2.5× |
| CT cervical spine w/ contrast (72126) |
$578.02 |
$3,303 |
1.6× |
| CT cervical spine w/o contrast (72125) |
$462.35 |
$2,642 |
4.1× |
| CT cervical spine w/wo cont (72127) |
$693.52 |
$3,963 |
3.7× |
| CT chest w contrast (71260) |
$513.45 |
$2,934 |
2.7× |
| CT chest w/wo contrast (71270) |
$616.18 |
$3,521 |
3.3× |
| CT head/brain with contrast (70460) |
$359.84 |
$2,033 |
1.9× |
| CT head/brain without and with contrast (70470) |
$431.70 |
$2,439 |
2.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$337.88 |
$2,283 |
0.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$383.02 |
$2,588 |
4.1× |
| CT hrt w/3d image congen (75573) |
$353.57 |
$2,389 |
0.9× |
| CT iac w contrast (70481) |
$421.61 |
$2,382 |
2.3× |
| CT l-spine w&w/o contrast (72133) |
$680.75 |
$3,890 |
3.6× |
| CT lower ext w/o (73700) |
$285.60 |
$1,632 |
2.6× |
| CT lower extremity w/contrast material (73701) |
$357 |
$2,040 |
1.9× |
| CT lumbar spine w contrast (72132) |
$567.35 |
$3,242 |
1.5× |
| CT lumbar spine w/o contrast (72131) |
$453.78 |
$2,593 |
4.1× |
| CT maxillofacial w contrast (70487) |
$337.01 |
$1,904 |
1.8× |
| CT maxillofacial wo contrast (70486) |
$269.57 |
$1,523 |
2.4× |
| CT neck tissue combo (70492) |
$394.36 |
$2,228 |
2.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$505.87 |
$2,858 |
2.7× |
| CT orbits w/o contrast (70480) |
$337.18 |
$1,905 |
3.0× |
| CT pelvis w&w/o contrast (72194) |
$513.80 |
$2,936 |
2.7× |
| CT pelvis w/o contrast (72192) |
$342.47 |
$1,957 |
3.1× |
| CT scan of leg combo (73702) |
$428.40 |
$2,448 |
2.3× |
| CT scans face/jaw combo (70488) |
$404.44 |
$2,285 |
2.2× |
| CT soft tissue neck w contrast (70491) |
$328.69 |
$1,857 |
1.8× |
| CT soft tissue neck w/o contrast (70490) |
$262.84 |
$1,485 |
2.4× |
| CT thoracic spine w contrast (72129) |
$575.57 |
$3,289 |
3.1× |
| CT thoracic spine w/o contrast (72128) |
$460.42 |
$2,631 |
4.1× |
| CT thoracic spine w/wo cont (72130) |
$690.72 |
$3,947 |
3.7× |
| CT thorax w/o contrast (71250) |
$410.72 |
$2,347 |
3.7× |
| CT upper ext wo (73200) |
$301.35 |
$1,722 |
2.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$452.02 |
$2,583 |
2.4× |
| CT upper extremity with contrast (73201) |
$376.78 |
$2,153 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$362.01 |
$2,446 |
1.9× |
| Cta Abdomen (74175) |
$490.70 |
$2,804 |
2.6× |
| CTA pelvis (72191) |
$539.52 |
$3,083 |
2.9× |
| Diskography lumbar (72295) |
$836.94 |
$3,592 |
0.4× |
| Dxa Bone Density Axial (77080) |
$102.99 |
$442 |
0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$62.91 |
$270 |
0.7× |
| Echo exam uterus (76831) |
$237.36 |
$688 |
0.9× |
| Echo Guide For Artery Repair (76936) |
$215.97 |
$626 |
0.9× |
| Esophagram (74220) |
$124.42 |
$534 |
0.7× |
| Fetal Biophys Profile W/Nst (76818) |
$335.68 |
$973 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$219.42 |
$636 |
2.0× |
| Fluoroscopy up to 1 hr (76000) |
$160.30 |
$688 |
0.6× |
| Follow-Up Angiography (75898) |
$500.81 |
$2,168 |
0.1× |
| Foot 2 views (73620) |
$72.70 |
$312 |
0.8× |
| Forearm 2 views (73090) |
$75.73 |
$325 |
0.8× |
| Gastric emptying imaging study (78264) |
$396.02 |
$1,868 |
0.9× |
| Gastroesophageal Reflux Exam (78262) |
$412.34 |
$1,945 |
1.0× |
| Gated Heart Planar Single (78472) |
$556.71 |
$2,626 |
1.3× |
| Hand 2 views (73120) |
$75.96 |
$326 |
0.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,147.06 |
$4,923 |
0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,157.54 |
$4,968 |
0.3× |
| Hepatobil Syst Image W/Drug (78227) |
$382.24 |
$1,803 |
0.7× |
| Hepatobiliary System Imaging (78226) |
$311.22 |
$1,468 |
0.7× |
| Ht Musc Image Planar Mult (78454) |
$909.69 |
$4,291 |
0.7× |
| Ht Muscle Image Spect Sing (78451) |
$754.93 |
$3,561 |
0.5× |
| Hysterosalpingogram (74740) |
$160.30 |
$688 |
0.6× |
| Infant hip ultrasound, limited static exam (76886) |
$141.79 |
$411 |
1.5× |
| Infusion Ivp (74410) |
$544.99 |
$2,339 |
2.9× |
| Joint Survey Single View (77077) |
$83.18 |
$357 |
0.7× |
| K Flow/Funct Image Multiple (78709) |
$577.06 |
$2,722 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$369.94 |
$1,745 |
0.6× |
| K Flow/Funct Image W/O Drug (78707) |
$488.24 |
$2,303 |
0.8× |
| Knee 3 Views (73562) |
$93.20 |
$400 |
1.0× |
| Liver & Spleen Imaging Static Only (78215) |
$310.37 |
$1,464 |
0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$273.06 |
$1,288 |
0.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$390.50 |
$1,842 |
0.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$393.26 |
$1,855 |
0.7× |
| Lung Ventilation Imaging (78579) |
$261.18 |
$1,232 |
0.6× |
| Lymph System Imaging (78195) |
$456.65 |
$2,154 |
0.8× |
Magnetic Image Jaw Joint (70336)
range across 3 matching MRF lines |
$244.94–$367.48 |
$1,655–$2,483 |
varies |
| Mammary ductogram or galactogram single (77053) |
$186.17 |
$799 |
0.7× |
| Meckels Divert Exam (78290) |
$376.30 |
$1,775 |
0.9× |
| Mr safety determination physician/other qhp (76016) |
$31.46 |
$135 |
0.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$9.32 |
$40 |
0.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$48.23 |
$207 |
0.5× |
| Mr safety implt pos&/immoblj (76019) |
$67.57 |
$290 |
1.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$126.75 |
$544 |
0.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$403.99 |
$3,258 |
1.1× |
| MRA head w/o contrast (70544) |
$269.33 |
$2,172 |
1.1× |
| MRA head with contrast (70545) |
$336.66 |
$2,715 |
0.9× |
| MRA neck w contrast (70548) |
$277.64 |
$2,239 |
0.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$333.19 |
$2,687 |
0.9× |
| MRA neck w/o contrast (70547) |
$222.08 |
$1,791 |
0.9× |
| MRI abdomen w contrast (74182) |
$390.42 |
$2,638 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$312.28 |
$2,110 |
1.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$440.15 |
$2,974 |
0.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$528.21 |
$3,569 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$450.66 |
$3,045 |
0.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$431.57 |
$2,916 |
1.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$287.71 |
$1,944 |
1.1× |
| MRI cervical spine w contrast (72142) |
$376.62 |
$3,013 |
1.0× |
| MRI cervical spine w/o cont (72141) |
$301.25 |
$2,410 |
1.2× |
| MRI chest w/o contrast (71550) |
$252.78 |
$1,708 |
1.0× |
| MRI chest with contrast (71551) |
$315.98 |
$2,135 |
0.4× |
| MRI chest wo w contrast (71552) |
$379.18 |
$2,562 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$386.13 |
$2,609 |
1.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$463.39 |
$3,131 |
1.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$308.88 |
$2,087 |
1.2× |
| MRI lumbar spine w contrast (72149) |
$377.75 |
$3,022 |
1.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$451.88 |
$3,615 |
1.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$362.05 |
$2,034 |
1.4× |
| MRI orbit face neck w contrast (70542) |
$452.65 |
$2,543 |
1.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$543.08 |
$3,051 |
1.5× |
| MRI pelvis w contrast (72196) |
$367.48 |
$2,483 |
1.0× |
| MRI pelvis w/o & w contrast (72197) |
$440.89 |
$2,979 |
1.2× |
| MRI pelvis w/o contrast (72195) |
$293.93 |
$1,986 |
1.2× |
| MRI thoracic spine w/o contrast (72146) |
$300.50 |
$2,404 |
1.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$306.06 |
$2,068 |
0.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$244.79 |
$1,654 |
1.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$367.19 |
$2,481 |
1.0× |
| MRI, abdomen, combo (74183) |
$468.42 |
$3,165 |
1.3× |
| MRI, dorsal spine combo (72157) |
$450.75 |
$3,606 |
1.2× |
| MRI, dorsal spine contrast (72147) |
$375.62 |
$3,005 |
1.0× |
| MRI, joint upper extrem (73221) |
$360.53 |
$2,436 |
1.4× |
| MRI, joint upper extrem combo (73223) |
$540.79 |
$3,654 |
1.5× |
| MRI, lumbar spine combo (72158) |
$453.25 |
$3,626 |
1.2× |
| Myelogram cervical (72240) |
$498.39 |
$2,139 |
0.6× |
| Myelogram Lumbar (72265) |
$498.39 |
$2,139 |
0.6× |
| Myelography thoracic (72255) |
$498.85 |
$2,141 |
0.6× |
| Myelograpy 2/more regions rs&i (72270) |
$629.80 |
$2,703 |
0.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$754.93 |
$3,561 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$909.69 |
$4,291 |
0.7× |
| N-invas est c ffr sw aly CTA (75580) |
$735.13 |
$4,566 |
0.8× |
| Neck soft tissue (70360) |
$72 |
$309 |
0.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$140.77 |
$664 |
0.3× |
| Nuclear Rx Oral Admin (79005) |
$477.51 |
$1,794 |
1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$576.85 |
$2,721 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$411.92 |
$1,943 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$470.43 |
$2,219 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$82.95 |
$356 |
0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,147.06 |
$4,923 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$330.93 |
$1,561 |
0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$167.53 |
$719 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$247.45 |
$1,062 |
0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$86.91 |
$373 |
0.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$66.87 |
$287 |
0.7× |
| Radex elbow complete minimum 3 views (73080) |
$85.74 |
$368 |
0.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$81.78 |
$351 |
0.7× |
| Radex fingr minimum 2 views (73140) |
$60.58 |
$260 |
0.7× |
| Radex foot complete minimum 3 views (73630) |
$85.74 |
$368 |
0.9× |
| Radex Hand Minimum 3 Views (73130) |
$83.88 |
$360 |
0.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$109.74 |
$471 |
1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$194.79 |
$836 |
1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$70.13 |
$301 |
0.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$67.34 |
$289 |
0.7× |
| Radex shoulder complete minimum 2 views (73030) |
$90.40 |
$388 |
1.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$66.40 |
$285 |
0.7× |
| Radex Spine 1 View Specify Level (72020) |
$56.62 |
$243 |
0.6× |
| Radex Sternum Minimum 2 Views (71120) |
$77.36 |
$332 |
0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$91.57 |
$393 |
1.0× |
| Radex Toe Minimum 2 Views (73660) |
$58.48 |
$251 |
0.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$121.86 |
$523 |
1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$82.48 |
$354 |
0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$189.66 |
$814 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$90.64 |
$389 |
0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$144.93 |
$622 |
1.3× |
| Radiologic exam colon double contrast study (74280) |
$243.25 |
$1,044 |
1.3× |
| Radiologic exam colon single contrast study (74270) |
$218.55 |
$938 |
1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$133.04 |
$571 |
0.7× |
| Radiologic exam knee complete 4/more views (73564) |
$104.38 |
$448 |
0.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$102.75 |
$441 |
0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$127.92 |
$549 |
0.7× |
| Radiologic exam swallow function contrast study (74230) |
$144.23 |
$619 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$143.30 |
$615 |
0.8× |
| Radiologic examination femur 1 view (73551) |
$56.39 |
$242 |
0.6× |
| Radiologic examination femur minimum 2 views (73552) |
$86.21 |
$370 |
0.9× |
| Radiologic examination knee 1/2 views (73560) |
$79.22 |
$340 |
0.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$54.76 |
$235 |
0.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$73.63 |
$316 |
0.8× |
| Renal Cyst Study (74470) |
$326.67 |
$1,402 |
0.6× |
| Ribs bilateral 3 views (71110) |
$78.99 |
$339 |
0.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$231.08 |
$1,090 |
0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$254.61 |
$1,201 |
0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$740.09 |
$3,491 |
1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$347.89 |
$1,641 |
0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$436.72 |
$2,060 |
0.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$799.45 |
$3,771 |
0.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,036.26 |
$4,888 |
0.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$540.81 |
$2,551 |
0.4× |
| Rp Therapy Intravenous Administration (79101) |
$499.33 |
$1,876 |
2.0× |
| Scapula (73010) |
$84.58 |
$363 |
0.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$16.64 |
$52 |
0.7× |
| Shoulder 1 view (73020) |
$65.01 |
$279 |
0.7× |
| Shoulder Arthrography (73040) |
$293.05 |
$1,101 |
0.8× |
| Skull less than 4 views (70250) |
$78.75 |
$338 |
0.7× |
| Sternoclavicular joints (71130) |
$98.56 |
$423 |
1.1× |
| Thoracic spine 2 views (72070) |
$75.96 |
$326 |
0.7× |
| Thoracic spine 3 views (72072) |
$87.61 |
$376 |
0.8× |
| Thoracolumbar 2 views (72080) |
$79.69 |
$342 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$224.93 |
$1,061 |
0.5× |
| Thyroid Met Imaging Body (78018) |
$548.23 |
$2,586 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$351.50 |
$1,658 |
0.8× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$111.43–$167.32 |
$323–$485 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$137.31 |
$398 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$227.01 |
$658 |
2.0× |
| Upper gi w/o kub (74240) |
$141.20 |
$606 |
0.8× |
| Urethrocystogram voiding (74455) |
$160.30 |
$688 |
0.6× |
| Urethrocystography retrograde (74450) |
$247.45 |
$1,062 |
1.0× |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
$144.90–$217.35 |
$420–$630 |
varies |
| Us chest (76604) |
$152.14 |
$441 |
1.4× |
| Us complete joint (76881) |
$161.46 |
$468 |
1.4× |
| Us exam, pelvic, limited (76857) |
$225.63 |
$654 |
2.0× |
| Us head (76506) |
$255.99 |
$742 |
2.3× |
| Us kidney transplant (76776) |
$192.51 |
$558 |
1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$116.26 |
$337 |
1.0× |
| Us ob detailed single fetus (76811) |
$301.18 |
$873 |
1.2× |
| Us ob limited 1 or more fetuses (76815) |
$174.22 |
$505 |
1.6× |
| Us ob transvaginal (76817) |
$198.03 |
$574 |
1.8× |
| Us pelvic non ob complete (76856) |
$267.03 |
$774 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$184.57 |
$535 |
1.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$175.26 |
$508 |
1.6× |
| Us retroperitoneal complete (76770) |
$234.26 |
$679 |
2.1× |
| Us retroperitoneal limited (76775) |
$151.11 |
$438 |
1.4× |
| Us scrotum and contents (76870) |
$246.33 |
$714 |
2.2× |
| Us spinal canal and contents (76800) |
$270.48 |
$784 |
2.4× |
| Us thyroid (76536) |
$203.89 |
$591 |
1.8× |
| Vein X-Ray Chest (75827) |
$298.71 |
$1,282 |
0.2× |
| Venogram Sinus/Jugular (75860) |
$955.07 |
$4,099 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,147.06 |
$4,923 |
0.3× |
| Venography extremity bilateral rs&i (75822) |
$531.71 |
$2,282 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$454.35 |
$1,950 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,023.57 |
$4,393 |
0.3× |
| Venography Renal Unilateral (75831) |
$852.78 |
$3,660 |
0.3× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$1,085.31 |
$4,658 |
0.2× |
| Wrist 2 views (73100) |
$69.20 |
$297 |
0.7× |
| X-ray antegrade pyelogram tube (74425) |
$315.25 |
$1,353 |
0.8× |
| X-Ray Aorta Leg Arteries (75630) |
$1,337.95 |
$5,792 |
0.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$78.99 |
$339 |
0.9× |
| X-Ray Exam Breast Specimen (76098) |
$119.76 |
$514 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$83.88 |
$360 |
0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$137.47 |
$590 |
1.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$159.37 |
$684 |
1.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$60.81 |
$261 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$73.86 |
$317 |
0.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$91.57 |
$393 |
0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$75.96 |
$326 |
0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$87.84 |
$377 |
0.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$103.45 |
$444 |
0.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$138.87 |
$596 |
1.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$86.21 |
$370 |
0.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$124.89 |
$536 |
1.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$77.12 |
$331 |
0.7× |
| X-ray eye for foreign body (70030) |
$56.39 |
$242 |
0.6× |
| X-ray humerus (73060) |
$82.02 |
$352 |
0.9× |
| X-ray IV pyelogram+tomography (74415) |
$636.09 |
$2,730 |
3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$79.69 |
$342 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$92.27 |
$396 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$102.75 |
$441 |
0.9× |
| X-ray nose-rectum child f.b. (76010) |
$78.75 |
$338 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$107.65 |
$462 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$84.35 |
$362 |
0.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$75.96 |
$326 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$84.58 |
$363 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$78.99 |
$339 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$100.19 |
$430 |
0.9× |
| X-ray thoracic spine 4 vw (72074) |
$93.90 |
$403 |
0.8× |
| X-Ray Tmj Unilat (70328) |
$74.56 |
$320 |
0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$256.53 |
$1,101 |
0.7× |
| X-Rays Bone Length Studies (77073) |
$89.24 |
$383 |
0.8× |
| X-Rays Bone Survey Complete (77075) |
$127.92 |
$549 |
1.1× |
| Xr c-spine 4 or 5 views (72050) |
$93.67 |
$402 |
0.8× |
| Xr facial bones less than 3 views (70140) |
$74.09 |
$318 |
0.8× |
| Xr orbits complete 4 views (70200) |
$100.89 |
$433 |
0.9× |