| Abdomen 2 views (74019) |
$111.78 |
$159.68 |
1.1× |
| Ankle 2 views (73600) |
$188.91 |
$269.87 |
2.2× |
| Bone age studies (77072) |
$55.02 |
$78.60 |
0.5× |
| Bone survey complete (77075) |
$239.48 |
$342.11 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$117.32 |
$167.60 |
1.4× |
| Chest 1 view (71045) |
$112.12 |
$160.18 |
1.3× |
| Chest xray 3 views (71047) |
$60.48 |
$86.41 |
0.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$227.28 |
$324.68 |
1.3× |
| Clavicle complete (73000) |
$32.61 |
$46.59 |
0.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$674.02 |
$962.90 |
6.6× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$253.97 |
$362.82 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,846.63 |
$2,638.04 |
5.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,296.21 |
$1,851.72 |
5.6× |
| CT abdomen w contrast (74160) |
$943.28 |
$1,347.55 |
5.5× |
| CT abdomen w wo contrast (74170) |
$943.47 |
$1,347.82 |
5.5× |
| CT abdomen w/o contrast (74150) |
$532.14 |
$760.20 |
5.2× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,009.95 |
$1,442.78 |
5.9× |
| CT angiography upper extremity lt (73206) |
$1,000.37 |
$1,429.10 |
5.8× |
| CT c-spine w/o contrast (72125) |
$678.84 |
$969.77 |
6.7× |
| CT chest w contrast (71260) |
$900.98 |
$1,287.10 |
5.3× |
| CT chest w/wo contrast (71270) |
$265.42 |
$379.17 |
1.6× |
| CT head/brain with contrast (70460) |
$929.18 |
$1,327.39 |
5.4× |
| CT head/brain without and with contrast (70470) |
$1,359.86 |
$1,942.66 |
7.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$69.30 |
$99 |
0.8× |
| CT iac w contrast (70481) |
$923.86 |
$1,319.79 |
5.4× |
| CT lower ext w/o (73700) |
$518.86 |
$741.22 |
5.1× |
| CT lower extremity w/contrast material (73701) |
$969.94 |
$1,385.64 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$672.66 |
$960.94 |
6.6× |
| CT maxillofacial w contrast (70487) |
$639.49 |
$913.56 |
3.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,222.17 |
$1,745.95 |
7.1× |
| CT maxillofacial wo contrast (70486) |
$526.94 |
$752.78 |
5.2× |
| CT orbits w/o contrast (70480) |
$786.08 |
$1,122.97 |
7.7× |
| CT pelvis w/o contrast (72192) |
$680.88 |
$972.68 |
6.7× |
| CT pelvis w/wo contrast (72194) |
$1,041.23 |
$1,487.46 |
6.1× |
| CT scan of arm combo (73202) |
$784.95 |
$1,121.36 |
4.6× |
| CT soft tissue neck w contrast (70491) |
$953.56 |
$1,362.24 |
5.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,063.71 |
$1,519.58 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$540.36 |
$771.94 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$672.66 |
$960.94 |
6.6× |
| CT thorax w/o contrast (71250) |
$674.02 |
$962.90 |
6.6× |
| CT upper ext wo (73200) |
$581.06 |
$830.08 |
5.7× |
| CT upper extremity with contrast (73201) |
$902.74 |
$1,289.62 |
2.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,042.82 |
$1,489.74 |
6.1× |
| Cta Abdomen (74175) |
$1,003.58 |
$1,433.69 |
5.9× |
| CTA abdomen pelvis (74174) |
$1,447.63 |
$2,068.04 |
4.3× |
| CTA chest (71275) |
$940.53 |
$1,343.62 |
5.5× |
| Cta Head (70496) |
$1,013.24 |
$1,447.48 |
5.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,013.24 |
$1,447.48 |
3.0× |
| Cta Neck (70498) |
$1,013.24 |
$1,447.48 |
5.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$533 |
$761.43 |
5.2× |
| Esophagus (74220) |
$208.18 |
$281.84 |
1.2× |
| Facial bones min 3 views (70150) |
$111.09 |
$158.70 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$273.86 |
$365.14 |
1.2× |
| Foot 2 views (73620) |
$109.42 |
$156.30 |
1.3× |
| Forearm 2 views (73090) |
$32.61 |
$46.59 |
0.4× |
| Hand 2 views (73120) |
$110.76 |
$158.23 |
1.1× |
| Knee 3 views (73562) |
$191.80 |
$274 |
2.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$952.06 |
$1,360.08 |
1.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,307.01 |
$1,867.16 |
3.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,535.98 |
$2,194.24 |
4.5× |
| MRA head w/o contrast (70544) |
$910.69 |
$1,300.98 |
3.9× |
| MRA head with contrast (70545) |
$1,360.18 |
$1,943.11 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,954.58 |
$2,792.26 |
5.7× |
| MRA neck w/o contrast (70547) |
$941.12 |
$1,344.44 |
4.0× |
| MRI abdomen w contrast (74182) |
$1,316.64 |
$1,880.90 |
3.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,479.50 |
$3,542.13 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$935.23 |
$1,336.04 |
4.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,307.55 |
$1,867.92 |
1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,535.98 |
$2,194.24 |
4.5× |
| MRI c-spine with contrast (72142) |
$1,322.10 |
$1,888.72 |
3.9× |
| MRI cervical spine w/o contrast (72141) |
$1,203.24 |
$1,718.90 |
5.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,546.26 |
$2,208.93 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,083.49 |
$1,547.84 |
4.7× |
| MRI chest with contrast (71551) |
$1,316.64 |
$1,880.90 |
1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,307.01 |
$1,867.16 |
3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,535.30 |
$2,193.28 |
4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,649.72 |
$2,356.74 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$924.94 |
$1,321.33 |
4.0× |
| MRI orbit face neck w contrast (70542) |
$1,306.34 |
$1,866.20 |
3.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,535.30 |
$2,193.28 |
4.5× |
| MRI pelvis w/contrast (72196) |
$1,317.31 |
$1,881.87 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,479.50 |
$3,542.13 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$1,050.47 |
$1,500.67 |
4.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,165.08 |
$1,664.40 |
3.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,327.68 |
$1,896.68 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,575.61 |
$3,679.44 |
7.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,322.10 |
$1,888.72 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,550.08 |
$2,214.40 |
4.6× |
| MRI temporomandibular joint (70336) |
$936.60 |
$1,338 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,319.72 |
$1,885.32 |
5.7× |
| MRI up ext w/o contrast (73218) |
$925.06 |
$1,321.52 |
4.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,192.11 |
$1,703.01 |
5.1× |
| MRI, joint upper extrem combo (73223) |
$2,463.54 |
$3,519.34 |
7.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,258.16 |
$6,083.08 |
3.4× |
| Neck soft tissue (70360) |
$99 |
$141.44 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$112.51 |
$160.73 |
1.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$34 |
$48.57 |
0.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$110.08 |
$157.26 |
1.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$34 |
$48.57 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$165.88 |
$236.98 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$108.52 |
$155.02 |
1.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$110.76 |
$158.23 |
1.3× |
| Radex Hand Minimum 3 Views (73130) |
$111.46 |
$159.22 |
1.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$171.74 |
$245.34 |
2.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$171.32 |
$244.74 |
1.7× |
| Radex Humerus Minimum 2 Views (73060) |
$34 |
$48.57 |
0.4× |
| Radex Kne 1/2 Views (73560) |
$112.51 |
$160.73 |
1.3× |
| Radex Kne Compl 4/More Views (73564) |
$46.17 |
$65.95 |
0.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$160.62 |
$229.46 |
1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$102.87 |
$146.96 |
1.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$38.85 |
$55.50 |
0.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$99.70 |
$142.42 |
1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$168.70 |
$241 |
2.0× |
| Radex Toe Minimum 2 Views (73660) |
$25.76 |
$36.80 |
0.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$34 |
$48.57 |
0.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$112.63 |
$160.90 |
1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$111.78 |
$159.68 |
1.1× |
| Radiologic exam chest 2 views (71046) |
$105.86 |
$151.23 |
1.2× |
| Radiologic exam colon single contrast study (74270) |
$467.30 |
$623.07 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$466.54 |
$623.07 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$300.95 |
$407.68 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$111.46 |
$159.22 |
1.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$115.46 |
$164.94 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$107.97 |
$154.24 |
1.1× |
| Scapula (73010) |
$37.46 |
$53.52 |
0.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$80.85 |
$115.50 |
3.5× |
| Shoulder 1 view (73020) |
$29.88 |
$42.68 |
0.4× |
| Thoracolumbar 2 views (72080) |
$117.32 |
$167.60 |
1.4× |
| Ultrasound Exam Aaa Screen (76706) |
$332.50 |
$475 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$112.96 |
$161.37 |
1.1× |
| Unlisted ultrasound procedure (76999) |
$138.95 |
$198.50 |
1.6× |
| Us breast unilateral limited (76642) |
$287.98 |
$411.40 |
3.4× |
| Us chest (76604) |
$221.53 |
$316.48 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$462 |
$660 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$282.86 |
$404.09 |
2.8× |
| Us pelvic non ob complete (76856) |
$281.26 |
$401.80 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$241.36 |
$344.80 |
2.4× |
| Us retroperitoneal complete (76770) |
$278.66 |
$398.08 |
2.7× |
| Us retroperitoneal limited (76775) |
$266.98 |
$381.40 |
2.6× |
| Us scrotum and contents (76870) |
$277 |
$395.72 |
2.7× |
| Us soft tissue head/neck (76536) |
$281.26 |
$401.80 |
2.8× |
| Wrist 2 views (73100) |
$34.77 |
$49.67 |
0.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$166.78 |
$238.26 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$104.18 |
$148.83 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$410.23 |
$557.16 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$31.23 |
$44.61 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$116.63 |
$166.62 |
1.4× |
| X-ray exam of femur 2/> (73552) |
$112.51 |
$160.73 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$105.58 |
$150.83 |
1.2× |
| X-ray IV pyelogram (ivp) (74400) |
$447.57 |
$639.38 |
2.6× |
| X-ray leg, infant (73592) |
$106.60 |
$152.28 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$45.74 |
$65.34 |
0.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$182.68 |
$260.98 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$54.56 |
$77.94 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$98.95 |
$141.36 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$120.36 |
$171.95 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$125.86 |
$179.79 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$112.82 |
$161.17 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$111.46 |
$159.22 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$110.42 |
$157.74 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$116.14 |
$165.91 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$174.22 |
$248.88 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$114.19 |
$163.12 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$112.76 |
$161.08 |
1.1× |
| Xr bone length studies (77073) |
$90.69 |
$129.56 |
0.9× |
| Xr c-spine 4 or 5 views (72050) |
$265.66 |
$379.52 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$359.24 |
$513.19 |
3.5× |
| Xr chest 4+ views (71048) |
$120.33 |
$171.90 |
1.2× |