| Abdomen 2 views (74019) |
$247.20 |
$412 |
2.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$350.73 |
$584.55 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,698 |
$2,830 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,698 |
$2,830 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,655.40 |
$2,759 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$1,830 |
$3,050 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,864.70 |
$4,774.50 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,022.69 |
$3,371.15 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,801.41 |
$3,002.35 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$2,916 |
$4,860 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,916 |
$4,860 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,708.70 |
$4,514.50 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,665 |
$2,775 |
0.6× |
| Ankle 2 views (73600) |
$90.24 |
$150.40 |
1.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$228 |
$380 |
0.7× |
| Aortogram thoracic (75605) |
$2,813.40 |
$4,689 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,698 |
$2,830 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,698 |
$2,830 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,655.40 |
$2,759 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$1,655.40 |
$2,759 |
0.6× |
| Arthrogram elbow (73085) |
$499.29 |
$832.15 |
1.6× |
| Arthrogram hip (73525) |
$229.20 |
$382 |
0.7× |
| Arthrogram shoulder (73040) |
$294.87 |
$491.45 |
0.9× |
| Arthrogram wrist (73115) |
$585.15 |
$975.25 |
1.9× |
| Arthrography knee lt (73580) |
$229.20 |
$382 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$243 |
$405 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$643.02 |
$1,071.70 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$843.21 |
$1,405.35 |
2.4× |
| Bone age studies (77072) |
$132.18 |
$220.30 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$881.40 |
$1,469 |
2.5× |
| Bone survey complete (77075) |
$531.36 |
$885.60 |
5.7× |
| Brain image w/flow 4 + views (78606) |
$598 |
$996.67 |
1.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$286.20 |
$477 |
0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,272.87 |
$7,121.45 |
3.3× |
| Brain Imaging Vascular Flow Only (78610) |
$598 |
$996.67 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$180.36 |
$300.60 |
2.3× |
| Chest 1 view (71045) |
$146.40 |
$244 |
1.9× |
| Chest 3 views (71047) |
$241.26 |
$402.10 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$290.91 |
$484.85 |
1.9× |
| Clavicle complete (73000) |
$157.02 |
$261.70 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$173.40 |
$289 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,648.13 |
$4,413.55 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,085 |
$3,475 |
9.8× |
| CT abdomen w contrast (74160) |
$1,265.31 |
$2,108.85 |
8.1× |
| CT abdomen w wo contrast (74170) |
$1,371.72 |
$2,286.20 |
8.8× |
| CT abdomen w/o contrast (74150) |
$1,107.93 |
$1,846.55 |
11.9× |
| CT angio hrt w/3d image (75574) |
$482.58 |
$804.30 |
1.5× |
| CT angiography upper extremity lt (73206) |
$1,652.61 |
$2,754.35 |
10.6× |
| CT c-spine w/o contrast (72125) |
$982.77 |
$1,637.95 |
10.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,690.35 |
$2,817.25 |
10.8× |
| CT cervical spine with contrast (72126) |
$1,045.80 |
$1,743 |
3.4× |
| CT chest w/wo contrast (71270) |
$1,546.86 |
$2,578.10 |
9.9× |
| CT chest with contrast (71260) |
$1,163.49 |
$1,939.15 |
7.4× |
| CT head/brain with contrast (70460) |
$980.46 |
$1,634.10 |
6.3× |
| CT head/brain without and with contrast (70470) |
$1,316.76 |
$2,194.60 |
8.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$476.13 |
$793.55 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$397.80 |
$663 |
5.1× |
| CT iac w contrast (70481) |
$1,017.18 |
$1,695.30 |
6.5× |
| CT lower ext w/o (73700) |
$906.45 |
$1,510.75 |
9.7× |
| CT lower extremity w wo contrast (73702) |
$1,000.68 |
$1,667.80 |
6.4× |
| CT lower extremity with contrast (73701) |
$926.13 |
$1,543.55 |
5.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,496.97 |
$2,494.95 |
9.6× |
| CT lumbar spine w/o contrast (72131) |
$1,182.78 |
$1,971.30 |
12.7× |
| CT lumbar spine with contrast (72132) |
$1,182.78 |
$1,971.30 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,071.54 |
$1,785.90 |
6.8× |
| CT maxillofacial w/o contrast (70486) |
$1,071.54 |
$1,785.90 |
11.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,336.89 |
$2,228.15 |
8.5× |
| CT neck soft tissue w contrast (70491) |
$944.43 |
$1,574.05 |
6.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,652.61 |
$2,754.35 |
10.6× |
| CT orbits w/o contrast (70480) |
$1,017.18 |
$1,695.30 |
10.9× |
| CT pelvis w & w/o contrast (72194) |
$1,276.41 |
$2,127.35 |
8.1× |
| CT pelvis w/o contrast (72192) |
$977.07 |
$1,628.45 |
10.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,288.98 |
$2,148.30 |
8.2× |
| CT soft tissue neck w/o contrast (70490) |
$944.43 |
$1,574.05 |
10.1× |
| CT thoracic spine w/contrast (72129) |
$1,161.87 |
$1,936.45 |
7.4× |
| CT thoracic spine w/o contrast (72128) |
$1,161.87 |
$1,936.45 |
12.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,673.28 |
$2,788.80 |
10.7× |
| CT thorax w/o contrast (71250) |
$1,015.41 |
$1,692.35 |
10.9× |
| CT unlisted procedure (76497) |
$79.20 |
$132 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$821.94 |
$1,369.90 |
5.2× |
| CT upper extremity w/o contrast rt (73200) |
$657.93 |
$1,096.55 |
7.0× |
| CT upper extremity with contrast (73201) |
$657.93 |
$1,096.55 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,478.99 |
$4,131.65 |
15.8× |
| Cta Abdomen (74175) |
$1,652.61 |
$2,754.35 |
10.6× |
| CTA abdomen pelvis (74174) |
$3,304.80 |
$5,508 |
10.6× |
| CTA chest (71275) |
$1,652.61 |
$2,754.35 |
10.6× |
| Cta Head (70496) |
$1,652.61 |
$2,754.35 |
10.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,652.61 |
$2,754.35 |
10.6× |
| Cta Neck (70498) |
$1,652.61 |
$2,754.35 |
10.6× |
| Cta Pelvis (72191) |
$1,652.61 |
$2,754.35 |
10.6× |
| Cystography minimum 3 views rs&i (74430) |
$202.20 |
$337 |
0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$269.67 |
$449.45 |
2.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$212.16 |
$353.60 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$122.40 |
$204 |
1.3× |
| Echoencephalography real time imaging (76506) |
$372 |
$620 |
4.0× |
| Esophagus (74220) |
$276.42 |
$460.70 |
1.8× |
| Fetal biophysical profile non-stress testing (76818) |
$453.15 |
$755.25 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$362.52 |
$604.20 |
3.9× |
| Fluoroscopy up to 1 hr (76000) |
$288.93 |
$481.55 |
1.4× |
| Foot 2 views (73620) |
$101.79 |
$169.65 |
1.3× |
| Forearm 2 views (73090) |
$160.47 |
$267.45 |
2.1× |
| Gated Heart Planar Single (78472) |
$249.99 |
$416.65 |
0.7× |
| Hand 2 views (73120) |
$132.66 |
$221.10 |
1.4× |
| Hand 3 views (73130) |
$170.10 |
$283.50 |
2.2× |
| Heart Infarct Image (78466) |
$320.46 |
$534.10 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,655.40 |
$2,759 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$685.38 |
$1,142.30 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$685.38 |
$1,142.30 |
1.9× |
| Ht muscle image spect sing (78451) |
$1,042.80 |
$1,738 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$163.08 |
$271.80 |
2.1× |
| Hysterosalpingogram (74740) |
$359.64 |
$599.40 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$585 |
$975 |
1.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$528.15 |
$880.25 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$535.11 |
$891.85 |
1.1× |
| Knee 3 views (73562) |
$49.80 |
$83 |
0.6× |
| Liver & spleen imaging static only (78215) |
$215.64 |
$359.40 |
0.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$214.20 |
$357 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$355.17 |
$591.95 |
0.7× |
| Lung Ventilation Imaging (78579) |
$211.20 |
$352 |
0.6× |
| Lymphoscintigraphy (78195) |
$646.41 |
$1,077.35 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$173.40 |
$289 |
0.8× |
| Meckels Diverticulum (78290) |
$291.78 |
$486.30 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$36.60 |
$61 |
1.4× |
| MRA head w & w/o contrast (70546) |
$2,012.01 |
$3,353.35 |
6.5× |
| MRA head w/o contrast (70544) |
$1,797.96 |
$2,996.60 |
8.4× |
| MRA head with contrast (70545) |
$1,765.44 |
$2,942.40 |
5.7× |
| MRA neck w contrast (70548) |
$1,797.96 |
$2,996.60 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,012.01 |
$3,353.35 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,797.96 |
$2,996.60 |
8.4× |
| MRI abdomen w contrast (74182) |
$1,563 |
$2,605 |
5.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,149.29 |
$3,582.15 |
6.9× |
| MRI abdomen w/o contrast (74181) |
$1,563 |
$2,605 |
7.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,404.12 |
$2,340.20 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,404.12 |
$2,340.20 |
2.0× |
| MRI breast w/o contrast bilateral (77047) |
$612.60 |
$1,021 |
2.9× |
| MRI breast w/o contrast unilat (77046) |
$574.35 |
$957.25 |
2.7× |
| MRI c-spine with contrast (72142) |
$1,651.68 |
$2,752.80 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$1,202.07 |
$2,003.45 |
5.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,618.11 |
$2,696.85 |
5.2× |
| MRI chest w/o contrast (71550) |
$1,404.12 |
$2,340.20 |
6.6× |
| MRI chest with contrast (71551) |
$1,404.12 |
$2,340.20 |
2.0× |
| MRI fetal sngl/1st gestation (74712) |
$307.80 |
$513 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,404.12 |
$2,340.20 |
4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,404.12 |
$2,340.20 |
4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,404.12 |
$2,340.20 |
6.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,514.22 |
$2,523.70 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,676.31 |
$2,793.85 |
5.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,514.22 |
$2,523.70 |
4.9× |
| MRI pelvis w contrast (72196) |
$1,404.12 |
$2,340.20 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,618.11 |
$2,696.85 |
5.2× |
| MRI pelvis w/o contrast (72195) |
$1,404.12 |
$2,340.20 |
6.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,474.44 |
$2,457.40 |
4.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,711.47 |
$2,852.45 |
5.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,937.07 |
$3,228.45 |
6.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,651.68 |
$2,752.80 |
5.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,149.29 |
$3,582.15 |
6.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,651.68 |
$2,752.80 |
5.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,149.29 |
$3,582.15 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,542.36 |
$2,570.60 |
7.2× |
| MRI tmj (70336) |
$1,404.12 |
$2,340.20 |
6.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,404.12 |
$2,340.20 |
6.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,797.96 |
$2,996.60 |
5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,404.12 |
$2,340.20 |
6.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,086.60 |
$1,811 |
0.9× |
| Neck soft tissue (70360) |
$145.53 |
$242.55 |
1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$221.98 |
$369.96 |
0.6× |
| Nm bone marrow wb (78104) |
$402.36 |
$670.60 |
1.1× |
| Nm gastric emptying study (78264) |
$743.28 |
$1,238.80 |
2.1× |
| Nm gastroesophageal reflux study (78262) |
$211.20 |
$352 |
0.6× |
| Nuclear medicine of heart pumping function (78473) |
$249.99 |
$416.65 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$585 |
$975 |
1.6× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$535.80 |
$893 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$214.08 |
$356.80 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$296.58 |
$494.30 |
1.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$216.99 |
$361.65 |
2.3× |
| Osseous survey infant (77076) |
$154.35 |
$257.25 |
1.7× |
| Osseous survey limited (77074) |
$145.56 |
$242.60 |
1.6× |
| Parathyroid imaging (78070) |
$308.19 |
$513.65 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$163.32 |
$272.20 |
1.7× |
| Peritoneogram rs&i (74190) |
$374.40 |
$624 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$4,272.87 |
$7,121.45 |
3.3× |
| PET imaging for CT attenuation whole body (78816) |
$4,272.87 |
$7,121.45 |
3.3× |
| Pr heart first pass single,planar (78481) |
$277.20 |
$462 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,404.12 |
$2,340.20 |
4.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,655.40 |
$2,759 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,632 |
$2,720 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$718.89 |
$1,198.15 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$472.50 |
$787.50 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$318 |
$530 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$78 |
$130 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$266.34 |
$443.90 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$152.40 |
$254 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$68.67 |
$114.45 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$244.80 |
$408 |
2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$216.57 |
$360.95 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$169.62 |
$282.70 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$166.23 |
$277.05 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$170.40 |
$284 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$396.39 |
$660.65 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$241.20 |
$402 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$426.57 |
$710.95 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$284.01 |
$473.35 |
1.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$180.09 |
$300.15 |
2.3× |
| Radiopharm Dacryocystography (78660) |
$214.08 |
$356.80 |
0.6× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$342 |
$570 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,698 |
$2,830 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,655.40 |
$2,759 |
0.6× |
| Ribs bilateral 3 views (71110) |
$346.32 |
$577.20 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$419.13 |
$698.55 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$727.20 |
$1,212 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$840 |
$1,400 |
1.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$296.58 |
$494.30 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$296.58 |
$494.30 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$128.40 |
$214 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$677.76 |
$1,129.60 |
3.2× |
| Salivary gland imaging serial images (78231) |
$211.20 |
$352 |
0.6× |
| Scanogram (77073) |
$161.91 |
$269.85 |
1.7× |
| Scapula complete (73010) |
$161.31 |
$268.85 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$36 |
$60 |
1.5× |
| Sella turcica (70240) |
$120.84 |
$201.40 |
1.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$362.04 |
$603.40 |
3.9× |
| Small bowel series (74250) |
$310.98 |
$518.30 |
2.0× |
| Spine thoracic 3 views (72072) |
$242.55 |
$404.25 |
2.6× |
| Testicular Imaging With Vascular Flow (78761) |
$216.60 |
$361 |
0.6× |
| Thoracolumbar 2 views (72080) |
$81.18 |
$135.30 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$536.16 |
$893.60 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$461.94 |
$769.90 |
1.3× |
| Thyroid uptake measurement (78012) |
$211.20 |
$352 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$537 |
$895 |
1.5× |
| Tmj unilateral (70328) |
$142.35 |
$237.25 |
1.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$840 |
$1,400 |
1.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$280.47 |
$467.45 |
0.8× |
| Ultrasound elastography first target lesion (76982) |
$145.80 |
$243 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$363.99 |
$606.65 |
3.9× |
| Umbilical-artery Doppler (OB) (76820) |
$269.67 |
$449.45 |
2.9× |
| Upper Extremity Infant (73092) |
$136.08 |
$226.80 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$325.20 |
$542 |
1.5× |
| Urethrocystography voiding (74455) |
$382.41 |
$637.35 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$443.61 |
$739.35 |
2.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$566.61 |
$944.35 |
3.6× |
| Us abdl aorta screen aaa (76706) |
$138.60 |
$231 |
1.5× |
| Us breast unilateral complete (76641) |
$261.69 |
$436.15 |
2.8× |
| Us breast unilateral limited (76642) |
$261.69 |
$436.15 |
3.4× |
| Us chest (76604) |
$265.05 |
$441.75 |
2.8× |
| Us compl joint r-t w/image documentation (76881) |
$154.80 |
$258 |
1.7× |
| Us elastography parenchyma (76981) |
$276 |
$460 |
3.0× |
| Us guided compression repair (76936) |
$374.58 |
$624.30 |
1.9× |
| Us infant hips dynamic (76885) |
$252.90 |
$421.50 |
3.3× |
| Us infant hips limited static (76886) |
$134.85 |
$224.75 |
1.7× |
| Us kidney transplant (76776) |
$376.32 |
$627.20 |
4.0× |
| Us ob detailed single fetus (76811) |
$453.15 |
$755.25 |
2.1× |
| Us ob transvaginal (76817) |
$414.63 |
$691.05 |
4.4× |
| Us pelvic non ob complete (76856) |
$438.42 |
$730.70 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$438.42 |
$730.70 |
4.7× |
| Us pregnancy ltd (76815) |
$122.85 |
$204.75 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$440.37 |
$733.95 |
4.7× |
| Us retroperitoneal complete (76770) |
$398.79 |
$664.65 |
4.3× |
| Us retroperitoneal limited (76775) |
$269.67 |
$449.45 |
2.9× |
| Us scrotum and contents (76870) |
$399.27 |
$665.45 |
4.3× |
| Us soft tissue head/neck (76536) |
$460.68 |
$767.80 |
4.9× |
| Us spinal canal and contents (76800) |
$334.11 |
$556.85 |
3.6× |
| Us transrectal (76872) |
$409.38 |
$682.30 |
4.4× |
| Us transrectal prostate volume (76873) |
$211.14 |
$351.90 |
2.3× |
| Us xtr non-vasc lmtd (76882) |
$154.71 |
$257.85 |
1.7× |
| Venogram extremity bilateral (75822) |
$862.20 |
$1,437 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,676.70 |
$2,794.50 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$829.20 |
$1,382 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$838.20 |
$1,397 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,655.40 |
$2,759 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$1,698 |
$2,830 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,830 |
$3,050 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,493.40 |
$7,489 |
0.9× |
| Wrist 2 views (73100) |
$104.01 |
$173.35 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$295.32 |
$492.20 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$183.96 |
$306.60 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$183.99 |
$306.65 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$494.91 |
$824.85 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$122.31 |
$203.85 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$161.79 |
$269.65 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$244.80 |
$408 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$366.03 |
$610.05 |
4.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$204.84 |
$341.40 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$128.40 |
$214 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$273.93 |
$456.55 |
2.9× |
| X-ray eye for foreign body (70030) |
$105.60 |
$176 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$244.50 |
$407.50 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$162.57 |
$270.95 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$172.26 |
$287.10 |
2.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,074 |
$1,790 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$145.80 |
$243 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$105.60 |
$176 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$193.77 |
$322.95 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$91.83 |
$153.05 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$151.11 |
$251.85 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$175.05 |
$291.75 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$401.40 |
$669 |
4.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$241.50 |
$402.50 |
2.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$172.77 |
$287.95 |
2.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$151.11 |
$251.85 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$219.21 |
$365.35 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$389.85 |
$649.75 |
4.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$377.58 |
$629.30 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$207.39 |
$345.65 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$230.82 |
$384.70 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$364.32 |
$607.20 |
3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$154.38 |
$257.30 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$177.99 |
$296.65 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$177.84 |
$296.40 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$291.60 |
$486 |
3.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$46.80 |
$78 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$267.69 |
$446.15 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$164.01 |
$273.35 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$116.67 |
$194.45 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$105.60 |
$176 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$173.22 |
$288.70 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$199.53 |
$332.55 |
2.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$138.06 |
$230.10 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$166.17 |
$276.95 |
2.1× |
| Xr arthrogram ankle (73615) |
$406.47 |
$677.45 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$304.26 |
$507.10 |
3.3× |
| Xr chest 4+ views (71048) |
$301.59 |
$502.65 |
3.2× |
| Xr finger(s) 2+ views (73140) |
$170.10 |
$283.50 |
2.2× |
| Xr optic foramina (70190) |
$159.48 |
$265.80 |
2.1× |
| Xr shoulder 1 view (73020) |
$120.90 |
$201.50 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$304.26 |
$507.10 |
3.3× |
| Xr tibia/fibula 2 views (73590) |
$196.14 |
$326.90 |
2.5× |
| Xr tmj bilateral (70330) |
$159 |
$265 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$131.16 |
$218.60 |
1.7× |