| Abdomen 2 views (74019) |
$305.65 |
$509.41 |
2.9× |
| Ankle 2 views (73600) |
$195.03 |
$325.05 |
2.2× |
| Arthrogram elbow (73085) |
$308.17 |
$513.62 |
0.9× |
| Arthrogram hip (73525) |
$308.17 |
$513.62 |
0.9× |
| Arthrogram shoulder (73040) |
$308.17 |
$513.62 |
0.9× |
| Arthrogram wrist (73115) |
$282.02 |
$470.04 |
0.8× |
| Arthrography knee lt (73580) |
$308.17 |
$513.62 |
0.9× |
| Bone age studies (77072) |
$138.89 |
$231.49 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$313.09 |
$521.82 |
3.6× |
| Chest 1 view (71045) |
$173.20 |
$288.66 |
2.0× |
| Chest 3 views (71047) |
$216.50 |
$360.83 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$468.89 |
$781.49 |
2.7× |
| Clavicle complete (73000) |
$212.20 |
$353.66 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,770.05 |
$6,283.41 |
10.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,874.56 |
$4,790.93 |
12.0× |
| CT abdomen w contrast (74160) |
$1,848.88 |
$3,081.47 |
10.5× |
| CT abdomen w wo contrast (74170) |
$1,881.67 |
$3,136.11 |
10.7× |
| CT abdomen w/o contrast (74150) |
$1,628.18 |
$2,713.64 |
15.5× |
| CT angiography upper extremity lt (73206) |
$2,143.70 |
$3,572.84 |
12.2× |
| CT c-spine w/o contrast (72125) |
$1,448.25 |
$2,413.75 |
13.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,899.18 |
$3,165.30 |
10.8× |
| CT cervical spine with contrast (72126) |
$1,824.16 |
$3,040.27 |
5.2× |
| CT chest w/wo contrast (71270) |
$2,051.89 |
$3,419.81 |
11.6× |
| CT chest with contrast (71260) |
$1,812.77 |
$3,021.28 |
10.3× |
| CT head/brain with contrast (70460) |
$1,506.78 |
$2,511.30 |
8.6× |
| CT head/brain without and with contrast (70470) |
$1,883.63 |
$3,139.38 |
10.7× |
| CT iac w contrast (70481) |
$1,667.71 |
$2,779.52 |
9.5× |
| CT limited/localized follow up study (76380) |
$684.05 |
$1,140.09 |
7.8× |
| CT lower ext w/o (73700) |
$1,583.27 |
$2,638.78 |
15.1× |
| CT lower extremity w wo contrast (73702) |
$2,007.98 |
$3,346.64 |
11.4× |
| CT lower extremity with contrast (73701) |
$1,899.45 |
$3,165.75 |
10.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,042.69 |
$3,404.49 |
11.6× |
| CT lumbar spine w/o contrast (72131) |
$1,611.63 |
$2,686.05 |
15.3× |
| CT lumbar spine with contrast (72132) |
$1,762.19 |
$2,936.99 |
5.0× |
| CT maxillofacial w contrast (70487) |
$1,496.59 |
$2,494.32 |
8.5× |
| CT maxillofacial w/o contrast (70486) |
$1,181.76 |
$1,969.60 |
11.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,810.72 |
$3,017.87 |
10.3× |
| CT neck soft tissue w contrast (70491) |
$1,668.88 |
$2,781.46 |
9.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,777.24 |
$2,962.06 |
10.1× |
| CT orbits w/o contrast (70480) |
$1,519.35 |
$2,532.25 |
14.5× |
| CT pelvis w & w/o contrast (72194) |
$1,892.23 |
$3,153.72 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,429.30 |
$2,382.16 |
13.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,357.61 |
$2,262.69 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,244.76 |
$2,074.60 |
11.9× |
| CT thoracic spine w/contrast (72129) |
$1,800.12 |
$3,000.20 |
10.2× |
| CT thoracic spine w/o contrast (72128) |
$1,678.30 |
$2,797.16 |
16.0× |
| CT thorax w/o contrast (71250) |
$1,531.95 |
$2,553.25 |
14.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,033.72 |
$3,389.54 |
11.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,671.43 |
$2,785.71 |
15.9× |
| CT upper extremity with contrast (73201) |
$1,936.03 |
$3,226.72 |
5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,205.35 |
$3,675.59 |
12.5× |
| Cta Abdomen (74175) |
$2,285.39 |
$3,808.99 |
13.0× |
| CTA abdomen pelvis (74174) |
$4,400.50 |
$7,334.16 |
12.6× |
| CTA chest (71275) |
$1,955.61 |
$3,259.35 |
11.1× |
| Cta Head (70496) |
$2,090.14 |
$3,483.57 |
11.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,688.37 |
$2,813.95 |
9.6× |
| Cta Neck (70498) |
$2,091.02 |
$3,485.03 |
11.9× |
| Cta Pelvis (72191) |
$1,851.76 |
$3,086.26 |
10.5× |
| Cystography minimum 3 views rs&i (74430) |
$236.06 |
$393.44 |
0.7× |
| Diskography lumbar (72295) |
$1,124.76 |
$1,874.60 |
0.6× |
| Echoencephalography real time imaging (76506) |
$418.97 |
$698.29 |
4.0× |
| Esophagus (74220) |
$430.62 |
$717.70 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$529.16 |
$881.94 |
5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$418.97 |
$698.29 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$394.70 |
$657.83 |
1.6× |
| Foot 2 views (73620) |
$268.94 |
$448.23 |
3.1× |
| Forearm 2 views (73090) |
$278.88 |
$464.79 |
3.2× |
| Hand 3 views (73130) |
$296.45 |
$494.08 |
3.4× |
| Humerus Min 2 Views Left (73060) |
$271.68 |
$452.80 |
3.1× |
| Hysterosalpingogram (74740) |
$474.88 |
$791.46 |
2.0× |
| Knee 3 views (73562) |
$284.42 |
$474.04 |
3.3× |
| MRA head w & w/o contrast (70546) |
$2,661.31 |
$4,435.51 |
7.6× |
| MRA head w/o contrast (70544) |
$1,260.08 |
$2,100.13 |
5.3× |
| MRA head with contrast (70545) |
$1,356.58 |
$2,260.97 |
3.9× |
| MRA neck w contrast (70548) |
$1,772.48 |
$2,954.14 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,319.18 |
$3,865.30 |
6.6× |
| MRA neck w/o contrast (70547) |
$1,720.97 |
$2,868.28 |
7.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,514.93 |
$4,191.55 |
7.2× |
| MRI abdomen w/o contrast (74181) |
$1,852.79 |
$3,087.98 |
7.7× |
| MRI any jnt lwr ext with con lt (73722) |
$2,303.55 |
$3,839.25 |
2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,647.88 |
$2,746.47 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$2,174.77 |
$3,624.61 |
9.1× |
| MRI chest w/o contrast (71550) |
$1,335.87 |
$2,226.45 |
5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,826.68 |
$3,044.46 |
7.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,218.89 |
$2,031.48 |
5.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,224.63 |
$3,707.71 |
6.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,183.74 |
$3,639.56 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$1,587.27 |
$2,645.45 |
6.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,348.06 |
$3,913.44 |
6.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,030.30 |
$3,383.83 |
5.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,662.76 |
$4,437.93 |
7.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,962.75 |
$4,937.92 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,741.48 |
$4,569.14 |
7.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,956.16 |
$3,260.26 |
5.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,817.43 |
$4,695.71 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,149.20 |
$3,582 |
9.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,117.61 |
$3,529.35 |
8.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,846.94 |
$4,744.89 |
8.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,885.10 |
$3,141.83 |
7.9× |
| Myelogram Cervical (72240) |
$909.37 |
$1,515.61 |
1.2× |
| Myelogram Lumbar (72265) |
$1,417.35 |
$2,362.25 |
1.8× |
| Myelogram thoracic (72255) |
$1,140.19 |
$1,900.32 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,504.18 |
$2,506.97 |
1.9× |
| Neck soft tissue (70360) |
$184.08 |
$306.80 |
2.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$317.48 |
$529.14 |
3.0× |
| Osseous survey limited (77074) |
$405.32 |
$675.54 |
3.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,439.83 |
$4,066.39 |
7.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$280.98 |
$468.30 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$144.89 |
$241.49 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$299.52 |
$499.20 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$233.55 |
$389.25 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$224.51 |
$374.19 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$171.29 |
$285.49 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$179.82 |
$299.70 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$549.27 |
$915.45 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$416.83 |
$694.72 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$272.15 |
$453.59 |
3.1× |
| Ribs bilateral 3 views (71110) |
$454.84 |
$758.06 |
4.3× |
| Scanogram (77073) |
$254.42 |
$424.03 |
2.4× |
| Scapula complete (73010) |
$266.67 |
$444.45 |
2.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$813.29 |
$1,355.48 |
7.7× |
| Ultrasound, abdomen limited (76705) |
$474.11 |
$790.18 |
4.5× |
| Unlisted Ultrasound Procedure (76999) |
$321.24 |
$535.40 |
3.7× |
| Urethrocystography retrograde rs&i (74450) |
$435.18 |
$725.30 |
1.8× |
| Us breast unilateral complete (76641) |
$353.24 |
$588.74 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$592.03 |
$986.71 |
5.6× |
| Us infant hips dynamic (76885) |
$507.98 |
$846.64 |
5.8× |
| Us ob transvaginal (76817) |
$371.83 |
$619.72 |
3.5× |
| Us pelvic non ob complete (76856) |
$560.11 |
$933.52 |
5.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$439.99 |
$733.32 |
4.2× |
| Us pregnancy ltd (76815) |
$352 |
$586.66 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$479.12 |
$798.54 |
4.6× |
| Us retroperitoneal complete (76770) |
$471.02 |
$785.03 |
4.5× |
| Us scrotum and contents (76870) |
$424.19 |
$706.98 |
4.0× |
| Us soft tissue head/neck (76536) |
$447.74 |
$746.23 |
4.3× |
| Us transrectal (76872) |
$816.98 |
$1,361.64 |
7.8× |
| Us xtr non-vasc lmtd (76882) |
$293.46 |
$489.10 |
2.8× |
| Wrist 2 views (73100) |
$272.87 |
$454.79 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$424.15 |
$706.91 |
4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$199.85 |
$333.08 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$264.21 |
$440.35 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$624.61 |
$1,041.02 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$290.27 |
$483.78 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$207.34 |
$345.57 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$223.27 |
$372.12 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$306.69 |
$511.15 |
2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$408.92 |
$681.53 |
3.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$335.32 |
$558.86 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$340.21 |
$567.01 |
3.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$105.93 |
$176.55 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$332.74 |
$554.56 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$279.87 |
$466.45 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$283.76 |
$472.94 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$648.67 |
$1,081.11 |
6.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$413.28 |
$688.80 |
3.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$202.39 |
$337.32 |
2.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$295.82 |
$493.04 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$237.23 |
$395.39 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$246.55 |
$410.91 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$246.56 |
$410.94 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$242.14 |
$403.56 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$273.55 |
$455.92 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$236.62 |
$394.37 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$250.75 |
$417.91 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$291.22 |
$485.37 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$236.60 |
$394.33 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$248.86 |
$414.76 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$223.70 |
$372.83 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$250.88 |
$418.14 |
2.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$396.33 |
$660.55 |
3.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$191.76 |
$319.60 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$275.82 |
$459.70 |
3.2× |
| Xr arthrogram ankle (73615) |
$282.02 |
$470.04 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$441.92 |
$736.53 |
4.2× |
| Xr Cholecystography Oral Contrast (74290) |
$175.97 |
$293.28 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$194.83 |
$324.71 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$419.81 |
$699.69 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$273.19 |
$455.32 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$219.02 |
$365.04 |
2.5× |