| Abdomen 2 views (74019) |
$204.88 |
$394 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$938.60 |
$1,805 |
2.7× |
| Ankle 2 views (73600) |
$123.76 |
$238 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$123.76 |
$238 |
1.6× |
| Chest 1 view (71045) |
$123.76 |
$238 |
1.6× |
| Clavicle complete (73000) |
$123.76 |
$238 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$115.44 |
$222 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,565.72 |
$3,011 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,281.28 |
$2,464 |
6.2× |
| CT abdomen w contrast (74160) |
$875.16 |
$1,683 |
5.8× |
| CT abdomen w wo contrast (74170) |
$1,003.08 |
$1,929 |
6.6× |
| CT abdomen w/o contrast (74150) |
$875.16 |
$1,683 |
9.7× |
| CT c-spine w/o contrast (72125) |
$960.44 |
$1,847 |
10.7× |
| CT cervical spine with contrast (72126) |
$982.28 |
$1,889 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,003.08 |
$1,929 |
6.6× |
| CT chest with contrast (71260) |
$982.28 |
$1,889 |
6.5× |
| CT head/brain with contrast (70460) |
$713.96 |
$1,373 |
4.7× |
| CT head/brain without and with contrast (70470) |
$848.12 |
$1,631 |
5.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$139.88 |
$269 |
1.9× |
| CT lower ext w/o (73700) |
$833.56 |
$1,603 |
9.2× |
| CT lower extremity w wo contrast (73702) |
$853.84 |
$1,642 |
5.6× |
| CT lower extremity with contrast (73701) |
$833.56 |
$1,603 |
5.5× |
| CT lumbar spine w/o contrast (72131) |
$960.44 |
$1,847 |
10.7× |
| CT lumbar spine with contrast (72132) |
$1,774.24 |
$3,412 |
5.9× |
| CT maxillofacial w contrast (70487) |
$714.48 |
$1,374 |
4.7× |
| CT maxillofacial w/o contrast (70486) |
$640.12 |
$1,231 |
7.1× |
| CT maxillofacial w/wo contrast (70488) |
$848.12 |
$1,631 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$982.28 |
$1,889 |
6.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,005.12 |
$3,856 |
13.3× |
| CT orbits w/o contrast (70480) |
$524.16 |
$1,008 |
5.8× |
| CT pelvis w & w/o contrast (72194) |
$1,067.04 |
$2,052 |
7.1× |
| CT pelvis w/o contrast (72192) |
$1,250.60 |
$2,405 |
13.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$420.68 |
$809 |
5.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$853.84 |
$1,642 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$939.12 |
$1,806 |
10.4× |
| CT thoracic spine w/o contrast (72128) |
$960.44 |
$1,847 |
10.7× |
| CT thorax w/o contrast (71250) |
$960.44 |
$1,847 |
10.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$853.84 |
$1,642 |
5.6× |
| CT upper extremity w/o contrast rt (73200) |
$833.56 |
$1,603 |
9.2× |
| CT upper extremity with contrast (73201) |
$833.56 |
$1,603 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,088.88 |
$2,094 |
7.2× |
| CTA abdomen pelvis (74174) |
$1,565.72 |
$3,011 |
5.2× |
| CTA chest (71275) |
$982.28 |
$1,889 |
6.5× |
| Cta Head (70496) |
$2,182.96 |
$4,198 |
14.4× |
| Cta Neck (70498) |
$2,182.96 |
$4,198 |
14.4× |
| Echoencephalography real time imaging (76506) |
$273 |
$525 |
3.0× |
| Foot 2 views (73620) |
$82.16 |
$158 |
1.1× |
| Forearm 2 views (73090) |
$111.54 |
$214.50 |
1.5× |
| Hand 2 views (73120) |
$90.74 |
$174.50 |
1.0× |
| Hand 3 views (73130) |
$123.76 |
$238 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$125.06 |
$240.50 |
1.7× |
| Knee 3 views (73562) |
$109.20 |
$210 |
1.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$211.64 |
$407 |
0.7× |
| MRA head w/o contrast (70544) |
$1,070.68 |
$2,059 |
5.2× |
| MRA neck w contrast (70548) |
$1,070.68 |
$2,059 |
3.6× |
| MRA neck w/o contrast (70547) |
$1,070.68 |
$2,059 |
5.2× |
| MRI abdomen w contrast (74182) |
$1,070.68 |
$2,059 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,419.60 |
$2,730 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$992.68 |
$1,909 |
4.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,231.84 |
$4,292 |
3.3× |
| MRI c-spine with contrast (72142) |
$1,070.68 |
$2,059 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$992.68 |
$1,909 |
4.8× |
| MRI chest w/o contrast (71550) |
$992.68 |
$1,909 |
4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,393.60 |
$2,680 |
4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,138.80 |
$2,190 |
5.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,223.52 |
$4,276 |
10.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,423.24 |
$2,737 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$992.68 |
$1,909 |
4.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,563.60 |
$4,930 |
8.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,419.60 |
$2,730 |
4.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,254.16 |
$6,258 |
10.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,070.68 |
$2,059 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,348.88 |
$2,594 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,070.68 |
$2,059 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,834 |
$5,450 |
9.4× |
| MRI thoracic spine w/o contrast (72146) |
$992.68 |
$1,909 |
4.8× |
| MRI upper ext joint w/o contrast (73221) |
$992.68 |
$1,909 |
4.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,241.20 |
$4,310 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,931.80 |
$3,715 |
9.4× |
| Neck soft tissue (70360) |
$123.76 |
$238 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$337.48 |
$649 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$123.76 |
$238 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,113.28 |
$4,064 |
7.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$199.68 |
$384 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$123.76 |
$238 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$200.20 |
$385 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$204.88 |
$394 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$177.84 |
$342 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$231.40 |
$445 |
3.1× |
| Ribs bilateral 3 views (71110) |
$202.28 |
$389 |
2.2× |
| Sacroiliac Joints < 3 Views (72200) |
$99.32 |
$191 |
1.1× |
| Scanogram (77073) |
$193.44 |
$372 |
2.1× |
| Scapula complete (73010) |
$182.78 |
$351.50 |
2.0× |
| Spine thoracic 3 views (72072) |
$123.76 |
$238 |
1.4× |
| Thoracolumbar 2 views (72080) |
$258.44 |
$497 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$361.92 |
$696 |
4.0× |
| Upper Extremity Infant (73092) |
$123.76 |
$238 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$192.40 |
$370 |
1.3× |
| Us abdl aorta screen aaa (76706) |
$126.36 |
$243 |
1.4× |
| Us breast unilateral complete (76641) |
$173.68 |
$334 |
1.9× |
| Us breast unilateral limited (76642) |
$173.68 |
$334 |
2.3× |
| Us chest (76604) |
$268.84 |
$517 |
3.0× |
| Us ob transvaginal (76817) |
$278.20 |
$535 |
3.1× |
| Us pelvic non ob complete (76856) |
$273 |
$525 |
3.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$331.76 |
$638 |
3.7× |
| Us pregnancy ltd (76815) |
$518.44 |
$997 |
5.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$278.20 |
$535 |
3.1× |
| Us retroperitoneal complete (76770) |
$273 |
$525 |
3.0× |
| Us retroperitoneal limited (76775) |
$379.60 |
$730 |
4.2× |
| Us scrotum and contents (76870) |
$273 |
$525 |
3.0× |
| Us soft tissue head/neck (76536) |
$273 |
$525 |
3.0× |
| Us xtr non-vasc lmtd (76882) |
$253.24 |
$487 |
2.8× |
| Wrist 2 views (73100) |
$123.76 |
$238 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$127.40 |
$245 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$166.40 |
$320 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$123.76 |
$238 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$111.54 |
$214.50 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$123.76 |
$238 |
1.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$328.12 |
$631 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$123.76 |
$238 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$199.68 |
$384 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$295.88 |
$569 |
3.3× |
| X-ray exam of femur 1 (73551) |
$123.76 |
$238 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$123.76 |
$238 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$267.28 |
$514 |
3.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$123.76 |
$238 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$123.76 |
$238 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$209.04 |
$402 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$123.76 |
$238 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$231.40 |
$445 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$123.76 |
$238 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$267.28 |
$514 |
3.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$142.48 |
$274 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$123.76 |
$238 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$241.80 |
$465 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$131.04 |
$252 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$160.16 |
$308 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$202.80 |
$390 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$171.08 |
$329 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$177.84 |
$342 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$241.80 |
$465 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$123.76 |
$238 |
1.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$123.76 |
$238 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$123.76 |
$238 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$213.20 |
$410 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$158.34 |
$304.50 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$210.60 |
$405 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$89.44 |
$172 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$123.76 |
$238 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$286 |
$550 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$123.76 |
$238 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$123.76 |
$238 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$213.20 |
$410 |
2.4× |
| Xr chest 4+ views (71048) |
$267.28 |
$514 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$123.76 |
$238 |
1.6× |
| Xr shoulder 1 view (73020) |
$123.76 |
$238 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$123.76 |
$238 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$123.76 |
$238 |
1.6× |
| Xr tmj bilateral (70330) |
$297.44 |
$572 |
4.0× |
| Xray knee 1 or 2 views rt (73560) |
$123.76 |
$238 |
1.6× |