| Abdomen 2 views (74019) |
$61.10 |
$244.40 |
0.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$236.60 |
$946.40 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,317.68 |
$5,270.72 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,317.68 |
$5,270.72 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,195.18 |
$8,780.72 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,448.94 |
$9,795.76 |
0.5× |
| Ankle 2 views (73600) |
$95.91 |
$383.62 |
1.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$255.84 |
$1,023.36 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,317.68 |
$5,270.72 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,317.68 |
$5,270.72 |
0.4× |
| Arthrogram hip (73525) |
$189.54 |
$758.16 |
0.6× |
| Arthrogram shoulder (73040) |
$200.20 |
$800.80 |
0.6× |
| Arthrography knee lt (73580) |
$189.54 |
$758.16 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$652.08 |
$2,608.32 |
1.7× |
| Bone age studies (77072) |
$54.60 |
$218.40 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$552.24 |
$2,208.96 |
1.5× |
| Bone survey complete (77075) |
$150.02 |
$600.08 |
1.5× |
| Brain image w/flow 4 + views (78606) |
$400.40 |
$1,601.60 |
0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$583.70 |
$2,334.80 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$89.96 |
$359.84 |
1.1× |
| Chest 1 view (71045) |
$44.72 |
$178.88 |
0.5× |
| Chest 3 views (71047) |
$40.04 |
$160.16 |
0.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$99.32 |
$397.28 |
0.6× |
| Clavicle complete (73000) |
$73.01 |
$292.04 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$384.28 |
$1,537.12 |
3.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$384.28 |
$1,537.12 |
1.2× |
| CT abdomen and pelvis without contrast (74176) |
$384.28 |
$1,537.12 |
1.7× |
| CT abdomen w contrast (74160) |
$384.28 |
$1,537.12 |
2.3× |
| CT abdomen w wo contrast (74170) |
$384.28 |
$1,537.12 |
2.3× |
| CT abdomen w/o contrast (74150) |
$384.28 |
$1,537.12 |
3.9× |
| CT angio hrt w/3d image (75574) |
$384.28 |
$1,537.12 |
1.2× |
| CT angiography upper extremity lt (73206) |
$384.28 |
$1,537.12 |
2.3× |
| CT c-spine w/o contrast (72125) |
$384.28 |
$1,537.11 |
3.9× |
| CT cervical spine with contrast (72126) |
$384.28 |
$1,537.12 |
1.2× |
| CT chest w/wo contrast (71270) |
$384.28 |
$1,537.12 |
2.3× |
| CT chest with contrast (71260) |
$384.28 |
$1,537.11 |
2.3× |
| CT head/brain with contrast (70460) |
$384.28 |
$1,537.12 |
2.3× |
| CT head/brain without and with contrast (70470) |
$384.28 |
$1,537.12 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$248.02 |
$992.06 |
3.0× |
| CT iac w contrast (70481) |
$384.28 |
$1,537.12 |
2.3× |
| CT lower ext w/o (73700) |
$384.28 |
$1,537.12 |
3.9× |
| CT lower extremity with contrast (73701) |
$384.28 |
$1,537.12 |
2.3× |
| CT lumbar spine w & w/o contrast (72133) |
$384.28 |
$1,537.12 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$384.28 |
$1,537.12 |
3.9× |
| CT lumbar spine with contrast (72132) |
$384.28 |
$1,537.12 |
1.2× |
| CT maxillofacial w contrast (70487) |
$384.28 |
$1,537.12 |
2.3× |
| CT maxillofacial w/o contrast (70486) |
$384.28 |
$1,537.12 |
3.9× |
| CT neck soft tissue w contrast (70491) |
$384.28 |
$1,537.12 |
2.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$384.28 |
$1,537.12 |
2.3× |
| CT orbits w/o contrast (70480) |
$384.28 |
$1,537.12 |
3.9× |
| CT pelvis w & w/o contrast (72194) |
$384.28 |
$1,537.12 |
2.3× |
| CT pelvis w/o contrast (72192) |
$384.28 |
$1,537.12 |
3.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$384.28 |
$1,537.12 |
2.3× |
| CT soft tissue neck w/o contrast (70490) |
$384.28 |
$1,537.12 |
3.9× |
| CT thoracic spine w/contrast (72129) |
$384.28 |
$1,537.12 |
2.3× |
| CT thoracic spine w/o contrast (72128) |
$384.28 |
$1,537.12 |
3.9× |
| CT thorax w/o contrast (71250) |
$384.28 |
$1,537.12 |
3.9× |
| CT upper extremity w/o contrast rt (73200) |
$384.27 |
$1,537.06 |
3.9× |
| CT upper extremity with contrast (73201) |
$384.28 |
$1,537.12 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$384.28 |
$1,537.12 |
2.3× |
| Cta Abdomen (74175) |
$384.28 |
$1,537.12 |
2.3× |
| CTA abdomen pelvis (74174) |
$384.28 |
$1,537.12 |
1.2× |
| CTA chest (71275) |
$384.28 |
$1,537.11 |
2.3× |
| Cta Head (70496) |
$384.27 |
$1,537.09 |
2.3× |
| CTA lwr ext w&w/o contrast (73706) |
$384.28 |
$1,537.12 |
2.3× |
| Cta Neck (70498) |
$384.27 |
$1,537.09 |
2.3× |
| Cta Pelvis (72191) |
$384.28 |
$1,537.12 |
2.3× |
| Cystography minimum 3 views rs&i (74430) |
$226.98 |
$907.92 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$103.74 |
$414.96 |
1.1× |
| Esophagus (74220) |
$114.92 |
$459.68 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$96.98 |
$387.92 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$105.82 |
$423.28 |
0.5× |
| Foot 2 views (73620) |
$60.58 |
$242.32 |
0.7× |
| Forearm 2 views (73090) |
$74.36 |
$297.45 |
0.9× |
| Gated Heart Planar Single (78472) |
$424.06 |
$1,696.24 |
1.1× |
| Hand 2 views (73120) |
$68.16 |
$272.64 |
0.7× |
| Hand 3 views (73130) |
$70.13 |
$280.51 |
0.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$652.08 |
$2,608.32 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$388.96 |
$1,555.84 |
1.0× |
| Ht muscle image spect sing (78451) |
$523.12 |
$2,092.48 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$72.28 |
$289.12 |
0.9× |
| Hysterosalpingogram (74740) |
$304.46 |
$1,217.84 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$251.42 |
$1,005.68 |
0.5× |
| Knee 3 views (73562) |
$98.18 |
$392.71 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$206.96 |
$827.84 |
0.4× |
| Lymphoscintigraphy (78195) |
$342.16 |
$1,368.64 |
0.7× |
| Meckels Diverticulum (78290) |
$170.56 |
$682.24 |
0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$15.86 |
$63.44 |
0.6× |
| MRA head w & w/o contrast (70546) |
$583.62 |
$2,334.49 |
1.8× |
| MRA head w/o contrast (70544) |
$583.70 |
$2,334.80 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$583.70 |
$2,334.80 |
1.8× |
| MRA neck w/o contrast (70547) |
$583.70 |
$2,334.80 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$583.70 |
$2,334.80 |
1.8× |
| MRI abdomen w/o contrast (74181) |
$583.70 |
$2,334.80 |
2.6× |
| MRI any jnt lwr ext with con lt (73722) |
$583.70 |
$2,334.80 |
0.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$583.70 |
$2,334.80 |
0.8× |
| MRI c-spine with contrast (72142) |
$583.70 |
$2,334.80 |
1.8× |
| MRI cardiac w/o contrast (75557) |
$583.70 |
$2,334.80 |
2.6× |
| MRI cervical spine w/o contrast (72141) |
$583.70 |
$2,334.80 |
2.6× |
| MRI chest w/o & w/contrast material (71552) |
$583.70 |
$2,334.80 |
1.8× |
| MRI chest w/o contrast (71550) |
$583.70 |
$2,334.80 |
2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$583.70 |
$2,334.80 |
1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$583.70 |
$2,334.80 |
2.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$583.70 |
$2,334.80 |
2.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$583.70 |
$2,334.80 |
1.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$583.70 |
$2,334.80 |
1.8× |
| MRI pelvis w/o contrast (72195) |
$583.70 |
$2,334.80 |
2.6× |
| MRI scan of arm joint before and after contrast (73223) |
$583.70 |
$2,334.80 |
1.8× |
| MRI scan of leg joint before and after contrast (73723) |
$583.70 |
$2,334.80 |
1.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$583.70 |
$2,334.80 |
1.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$583.70 |
$2,334.80 |
1.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$583.70 |
$2,334.80 |
1.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$583.70 |
$2,334.80 |
1.8× |
| MRI thoracic spine w/o contrast (72146) |
$583.70 |
$2,334.80 |
2.6× |
| MRI upper ext joint w/o contrast (73221) |
$583.70 |
$2,334.80 |
2.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$583.70 |
$2,334.80 |
1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$583.70 |
$2,334.80 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$782.86 |
$3,131.44 |
0.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,358.76 |
$5,435.04 |
0.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$717.60 |
$2,870.40 |
0.9× |
| Neck soft tissue (70360) |
$43.94 |
$175.76 |
0.5× |
| Nm gastric emptying study (78264) |
$600.60 |
$2,402.40 |
1.6× |
| Osseous survey limited (77074) |
$108.16 |
$432.64 |
1.1× |
| Parathyroid imaging (78070) |
$236.60 |
$946.40 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$84.76 |
$339.04 |
0.9× |
| Perineogram (74775) |
$154.70 |
$618.80 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$583.70 |
$2,334.80 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$170.56 |
$682.24 |
0.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$547.04 |
$2,188.16 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$225.16 |
$900.64 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$54.60 |
$218.40 |
0.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$54.60 |
$218.40 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$101.14 |
$404.56 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$46.54 |
$186.16 |
0.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$45.24 |
$180.96 |
0.6× |
| Radiologic exam colon single contrast study (74270) |
$179.66 |
$718.64 |
1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$106.60 |
$426.40 |
0.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$158.08 |
$632.32 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$96.98 |
$387.92 |
0.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$46.37 |
$185.49 |
0.6× |
| Radiological examination surgical specimen (76098) |
$248.56 |
$994.24 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,317.68 |
$5,270.72 |
0.4× |
| Ribs bilateral 3 views (71110) |
$88.40 |
$353.60 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$693.42 |
$2,773.68 |
1.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$523.12 |
$2,092.48 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$85.80 |
$343.20 |
0.9× |
| Scanogram (77073) |
$68.90 |
$275.60 |
0.7× |
| Scapula complete (73010) |
$77.22 |
$308.88 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$67.08 |
$268.32 |
2.9× |
| Small bowel series (74250) |
$162.24 |
$648.96 |
1.0× |
| Spine thoracic 3 views (72072) |
$92.56 |
$370.24 |
0.9× |
| Therapeutic Enema (74283) |
$172.90 |
$691.60 |
1.0× |
| Thoracolumbar 2 views (72080) |
$76.18 |
$304.72 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$151.06 |
$604.24 |
0.4× |
| Tomogram (76100) |
$88.40 |
$353.60 |
0.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$236.60 |
$946.40 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$61.62 |
$246.48 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$226.20 |
$904.80 |
1.0× |
| Urethrocystography voiding (74455) |
$154.70 |
$618.80 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$224.38 |
$897.52 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$54.08 |
$216.32 |
0.6× |
| Us breast unilateral complete (76641) |
$85.02 |
$340.08 |
0.9× |
| Us breast unilateral limited (76642) |
$61.43 |
$245.73 |
0.8× |
| Us chest (76604) |
$150.54 |
$602.16 |
1.5× |
| Us elastography parenchyma (76981) |
$52.26 |
$209.04 |
0.5× |
| Us kidney transplant (76776) |
$412.62 |
$1,650.48 |
4.2× |
| Us ob transvaginal (76817) |
$157.04 |
$628.16 |
1.6× |
| Us pelvic non ob complete (76856) |
$169.26 |
$677.04 |
1.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$118.04 |
$472.16 |
1.2× |
| Us pregnancy ltd (76815) |
$127.14 |
$508.56 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$96.98 |
$387.92 |
1.0× |
| Us retroperitoneal limited (76775) |
$52.26 |
$209.04 |
0.5× |
| Us scrotum and contents (76870) |
$174.72 |
$698.88 |
1.8× |
| Us soft tissue head/neck (76536) |
$174.20 |
$696.80 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$105.30 |
$421.20 |
1.1× |
| Venogram extremity bilateral (75822) |
$954.46 |
$3,817.84 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,317.68 |
$5,270.72 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$608.66 |
$2,434.64 |
0.4× |
| Venography Renal Bilateral (75833) |
$1,317.68 |
$5,270.72 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,317.68 |
$5,270.72 |
0.4× |
| Wrist 2 views (73100) |
$51.86 |
$207.43 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$152.10 |
$608.39 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$103.69 |
$414.77 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$188.76 |
$755.04 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$61.52 |
$246.08 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$66.04 |
$264.16 |
0.8× |
| X-ray exam hip uni 1 view (73501) |
$46.28 |
$185.12 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$47.58 |
$190.30 |
0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$60.06 |
$240.24 |
0.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$104.26 |
$417.04 |
1.1× |
| X-ray exam of femur 1 (73551) |
$46.28 |
$185.12 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$77.48 |
$309.92 |
0.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$107.07 |
$428.28 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$57.91 |
$231.62 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$42.90 |
$171.60 |
0.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$100.29 |
$401.14 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$92.04 |
$368.16 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$103.74 |
$414.96 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$124.80 |
$499.20 |
1.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$83.20 |
$332.80 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$101.14 |
$404.56 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$81.90 |
$327.60 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$90.22 |
$360.88 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$82.16 |
$328.64 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$77.78 |
$311.11 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$65.78 |
$263.12 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$101.66 |
$406.64 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$98.02 |
$392.08 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$73.32 |
$293.28 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$77.48 |
$309.92 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$72.54 |
$290.16 |
0.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$95.68 |
$382.72 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$60.32 |
$241.28 |
0.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$63.80 |
$255.21 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$101.92 |
$407.68 |
1.0× |
| Xr chest 4+ views (71048) |
$55.64 |
$222.56 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$59.16 |
$236.62 |
0.7× |
| Xr shoulder 1 view (73020) |
$57.98 |
$231.92 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$95.16 |
$380.64 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$89.02 |
$356.06 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$88.77 |
$355.08 |
1.1× |