| Abdomen 2 views (74019) |
$417.20 |
$596 |
4.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$592.20 |
$846 |
1.6× |
| Ankle 2 views (73600) |
$71.75 |
$102.50 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$307.30 |
$439 |
1.0× |
| Arthrogram shoulder (73040) |
$436.80 |
$624 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$860.30 |
$1,229 |
2.4× |
| Bone age studies (77072) |
$92.75 |
$132.50 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$830.90 |
$1,187 |
2.3× |
| Bone survey complete (77075) |
$249.20 |
$356 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$149.80 |
$214 |
1.9× |
| Chest 1 view (71045) |
$77.35 |
$110.50 |
1.0× |
| Chest 3 views (71047) |
$209.30 |
$299 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$145.60 |
$208 |
0.9× |
| Clavicle complete (73000) |
$80.15 |
$114.50 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$588 |
$840 |
6.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,448.60 |
$3,498 |
7.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,493.10 |
$2,133 |
6.9× |
| CT abdomen w contrast (74160) |
$1,183.70 |
$1,691 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,246.70 |
$1,781 |
7.8× |
| CT abdomen w/o contrast (74150) |
$771.40 |
$1,102 |
8.1× |
| CT angiography upper extremity lt (73206) |
$249.90 |
$357 |
1.6× |
| CT c-spine w/o contrast (72125) |
$789.60 |
$1,128 |
8.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,830.50 |
$2,615 |
11.5× |
| CT cervical spine with contrast (72126) |
$1,015.70 |
$1,451 |
3.2× |
| CT chest w/wo contrast (71270) |
$1,379.70 |
$1,971 |
8.7× |
| CT chest with contrast (71260) |
$1,149.40 |
$1,642 |
7.2× |
| CT head/brain with contrast (70460) |
$763.70 |
$1,091 |
4.8× |
| CT head/brain without and with contrast (70470) |
$1,142.40 |
$1,632 |
7.2× |
| CT iac w contrast (70481) |
$975.10 |
$1,393 |
6.1× |
| CT limited/localized follow up study (76380) |
$213.50 |
$305 |
2.7× |
| CT lower ext w/o (73700) |
$417.20 |
$596 |
4.4× |
| CT lower extremity w wo contrast (73702) |
$1,013.60 |
$1,448 |
6.4× |
| CT lower extremity with contrast (73701) |
$921.20 |
$1,316 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,830.50 |
$2,615 |
11.5× |
| CT lumbar spine w/o contrast (72131) |
$789.60 |
$1,128 |
8.3× |
| CT lumbar spine with contrast (72132) |
$1,015.70 |
$1,451 |
3.2× |
| CT maxillofacial w contrast (70487) |
$830.20 |
$1,186 |
5.2× |
| CT maxillofacial w/o contrast (70486) |
$709.10 |
$1,013 |
7.5× |
| CT maxillofacial w/wo contrast (70488) |
$845.60 |
$1,208 |
5.3× |
| CT neck soft tissue w contrast (70491) |
$798 |
$1,140 |
5.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,115.80 |
$1,594 |
7.0× |
| CT orbits w/o contrast (70480) |
$666.40 |
$952 |
7.0× |
| CT pelvis w & w/o contrast (72194) |
$1,264.90 |
$1,807 |
8.0× |
| CT pelvis w/o contrast (72192) |
$722.40 |
$1,032 |
7.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,254.40 |
$1,792 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$666.40 |
$952 |
7.0× |
| CT thoracic spine w/contrast (72129) |
$1,015.70 |
$1,451 |
6.4× |
| CT thoracic spine w/o contrast (72128) |
$789.60 |
$1,128 |
8.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,830.50 |
$2,615 |
11.5× |
| CT thorax w/o contrast (71250) |
$763 |
$1,090 |
8.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$737.10 |
$1,053 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$612.50 |
$875 |
6.5× |
| CT upper extremity with contrast (73201) |
$697.90 |
$997 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$374.50 |
$535 |
2.4× |
| CTA abdomen pelvis (74174) |
$1,878.80 |
$2,684 |
5.9× |
| CTA chest (71275) |
$840.35 |
$1,200.50 |
5.3× |
| Cta Head (70496) |
$374.50 |
$535 |
2.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$747.60 |
$1,068 |
2.4× |
| Cta Neck (70498) |
$374.50 |
$535 |
2.4× |
| Cystography minimum 3 views rs&i (74430) |
$307.30 |
$439 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$265.30 |
$379 |
2.8× |
| Esophagus (74220) |
$147.70 |
$211 |
0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$321.30 |
$459 |
3.4× |
| Foot 2 views (73620) |
$74.20 |
$106 |
0.9× |
| Forearm 2 views (73090) |
$83.30 |
$119 |
1.1× |
| Hand 2 views (73120) |
$74.55 |
$106.50 |
0.8× |
| Hand 3 views (73130) |
$87.15 |
$124.50 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$665.70 |
$951 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$86.45 |
$123.50 |
1.1× |
| Hysterosalpingogram (74740) |
$306.60 |
$438 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$851.20 |
$1,216 |
1.7× |
| Knee 3 views (73562) |
$158.90 |
$227 |
2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$849.80 |
$1,214 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$879.90 |
$1,257 |
1.8× |
| Lung perfusion differential (78597) |
$734.30 |
$1,049 |
2.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$95.90 |
$137 |
1.2× |
| Meckels Diverticulum (78290) |
$664.30 |
$949 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,617.70 |
$2,311 |
5.1× |
| MRA head w/o contrast (70544) |
$1,131.90 |
$1,617 |
5.2× |
| MRA neck w/o contrast (70547) |
$430.50 |
$615 |
2.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,628.20 |
$2,326 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$945 |
$1,350 |
4.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$934.85 |
$1,335.50 |
1.3× |
| MRI cervical spine w/o contrast (72141) |
$1,131.90 |
$1,617 |
5.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,078 |
$1,540 |
3.4× |
| MRI chest w/o contrast (71550) |
$498.40 |
$712 |
2.3× |
| MRI chest with contrast (71551) |
$848.40 |
$1,212 |
1.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$763.70 |
$1,091 |
3.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$847 |
$1,210 |
3.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,830.50 |
$2,615 |
5.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,663.20 |
$2,376 |
5.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,157.10 |
$1,653 |
3.7× |
| MRI pelvis w/o contrast (72195) |
$453.60 |
$648 |
2.1× |
| MRI scan of arm joint before and after contrast (73223) |
$750.40 |
$1,072 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,271.90 |
$1,817 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,804.60 |
$2,578 |
5.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,804.60 |
$2,578 |
5.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,804.60 |
$2,578 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,131.90 |
$1,617 |
5.2× |
| MRI upper ext joint w/o contrast (73221) |
$763.70 |
$1,091 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$976.50 |
$1,395 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$637 |
$910 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$1,128.40 |
$1,612 |
1.0× |
| Neck soft tissue (70360) |
$84.35 |
$120.50 |
1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$734.30 |
$1,049 |
2.0× |
| Nm gastric emptying study (78264) |
$458.50 |
$655 |
1.3× |
| Nuclear medicine of heart pumping function (78473) |
$904.40 |
$1,292 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,273.30 |
$1,819 |
3.5× |
| Parathyroid imaging (78070) |
$1,273.30 |
$1,819 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$85.05 |
$121.50 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,400 |
$2,000 |
4.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$363.30 |
$519 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$112 |
$160 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$121.10 |
$173 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$96.60 |
$138 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$132.30 |
$189 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$140 |
$200 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$226.80 |
$324 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$140 |
$200 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$921.20 |
$1,316 |
5.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$253.40 |
$362 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$89.25 |
$127.50 |
1.1× |
| Radiological examination surgical specimen (76098) |
$591.50 |
$845 |
1.2× |
| Ribs bilateral 3 views (71110) |
$132.30 |
$189 |
1.4× |
| Scapula complete (73010) |
$79.80 |
$114 |
0.8× |
| Sella turcica (70240) |
$106.40 |
$152 |
1.4× |
| Small bowel series (74250) |
$186.90 |
$267 |
1.2× |
| Spine thoracic 3 views (72072) |
$101.85 |
$145.50 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$812.70 |
$1,161 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$287.70 |
$411 |
3.0× |
| Unlisted Ultrasound Procedure (76999) |
$106.40 |
$152 |
1.4× |
| Upper Extremity Infant (73092) |
$224 |
$320 |
2.4× |
| Urethrocystography voiding (74455) |
$597.10 |
$853 |
2.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$368.20 |
$526 |
2.3× |
| Us breast unilateral complete (76641) |
$224.70 |
$321 |
2.4× |
| Us breast unilateral limited (76642) |
$265.30 |
$379 |
3.4× |
| Us chest (76604) |
$117.60 |
$168 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$265.30 |
$379 |
2.8× |
| Us ob transvaginal (76817) |
$373.10 |
$533 |
3.9× |
| Us pelvic non ob complete (76856) |
$320.60 |
$458 |
3.4× |
| Us pregnancy ltd (76815) |
$160.30 |
$229 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$373.10 |
$533 |
3.9× |
| Us scrotum and contents (76870) |
$249.20 |
$356 |
2.6× |
| Us soft tissue head/neck (76536) |
$249.20 |
$356 |
2.6× |
| Us xtr non-vasc lmtd (76882) |
$240.80 |
$344 |
2.5× |
| Wrist 2 views (73100) |
$76.30 |
$109 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$174.30 |
$249 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$77 |
$110 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$88.20 |
$126 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$921.20 |
$1,316 |
5.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$139.65 |
$199.50 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$143.85 |
$205.50 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$68.25 |
$97.50 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$89.60 |
$128 |
1.1× |
| X-ray exam hip uni 4/> views (73503) |
$99.40 |
$142 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$95.20 |
$136 |
1.0× |
| X-ray exam of femur 1 (73551) |
$77.70 |
$111 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$156.80 |
$224 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$85.75 |
$122.50 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$86.80 |
$124 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$247.10 |
$353 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$94.15 |
$134.50 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$64.05 |
$91.50 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$129.50 |
$185 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$201.95 |
$288.50 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$134.75 |
$192.50 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$102.90 |
$147 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$132.30 |
$189 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$107.45 |
$153.50 |
1.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$554.40 |
$792 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$116.90 |
$167 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$168 |
$240 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$155.40 |
$222 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$104.30 |
$149 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$97.30 |
$139 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$204.40 |
$292 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$155.40 |
$222 |
2.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$106.40 |
$152 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$182 |
$260 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$134.40 |
$192 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$80.50 |
$115 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$79.45 |
$113.50 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$71.75 |
$102.50 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$85.40 |
$122 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$61.60 |
$88 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$91.35 |
$130.50 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$174.30 |
$249 |
1.8× |
| Xr chest 4+ views (71048) |
$214.20 |
$306 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$81.90 |
$117 |
1.0× |
| Xr internal auditory meati complete (70134) |
$363.30 |
$519 |
0.7× |
| Xr optic foramina (70190) |
$81.90 |
$117 |
1.0× |
| Xr shoulder 1 view (73020) |
$79.45 |
$113.50 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$156.45 |
$223.50 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$86.80 |
$124 |
1.1× |
| Xr tmj bilateral (70330) |
$98.70 |
$141 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$143.15 |
$204.50 |
1.8× |