| Abdomen 2 views (74019) |
$70.99 |
$177.46 |
0.7× |
| Ankle 2 views (73600) |
$83.43 |
$208.56 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$243.62 |
$609.05 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$249.23 |
$623.06 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$555.62 |
$1,389.05 |
1.5× |
| Bone age studies (77072) |
$90.18 |
$225.43 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$547 |
$1,367.48 |
1.5× |
| Bone survey complete (77075) |
$688.39 |
$1,720.96 |
7.2× |
| Cervical spine 2 or 3 views (72040) |
$169.79 |
$424.46 |
2.1× |
| Chest 1 view (71045) |
$123.41 |
$308.52 |
1.5× |
| Clavicle complete (73000) |
$108.32 |
$270.78 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$117.89 |
$294.71 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,406.36 |
$6,015.89 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,818.42 |
$4,546.04 |
8.3× |
| CT abdomen w contrast (74160) |
$811.40 |
$2,028.48 |
5.0× |
| CT abdomen w wo contrast (74170) |
$1,107.26 |
$2,768.15 |
6.9× |
| CT abdomen w/o contrast (74150) |
$1,093.31 |
$2,733.27 |
11.4× |
| CT c-spine w/o contrast (72125) |
$1,093.31 |
$2,733.27 |
11.4× |
| CT cervical spine w&w/o contrast (72127) |
$905.45 |
$2,263.62 |
5.6× |
| CT chest w/wo contrast (71270) |
$1,157.55 |
$2,893.87 |
7.2× |
| CT chest with contrast (71260) |
$1,019.85 |
$2,549.61 |
6.3× |
| CT head/brain with contrast (70460) |
$923.93 |
$2,309.81 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,192.22 |
$2,980.55 |
7.4× |
| CT iac w contrast (70481) |
$687.50 |
$1,718.74 |
4.3× |
| CT lower ext w/o (73700) |
$1,033.64 |
$2,584.09 |
10.8× |
| CT lower extremity w wo contrast (73702) |
$1,062.52 |
$2,656.28 |
6.6× |
| CT lower extremity with contrast (73701) |
$1,057.10 |
$2,642.74 |
6.6× |
| CT lumbar spine w & w/o contrast (72133) |
$802.69 |
$2,006.72 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$1,093.31 |
$2,733.27 |
11.4× |
| CT lumbar spine with contrast (72132) |
$1,202.85 |
$3,007.11 |
3.7× |
| CT maxillofacial w contrast (70487) |
$526.39 |
$1,315.96 |
3.3× |
| CT maxillofacial w/o contrast (70486) |
$974.19 |
$2,435.46 |
10.1× |
| CT maxillofacial w/wo contrast (70488) |
$444.01 |
$1,110.02 |
2.8× |
| CT neck soft tissue w contrast (70491) |
$1,042.21 |
$2,605.51 |
6.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$755.94 |
$1,889.82 |
4.7× |
| CT orbits w/o contrast (70480) |
$1,005.69 |
$2,514.21 |
10.5× |
| CT pelvis w & w/o contrast (72194) |
$1,299.11 |
$3,247.76 |
8.1× |
| CT pelvis w/o contrast (72192) |
$957.90 |
$2,394.74 |
10.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$947.28 |
$2,368.18 |
5.9× |
| CT soft tissue neck w/o contrast (70490) |
$782.10 |
$1,955.24 |
8.1× |
| CT thoracic spine w/o contrast (72128) |
$1,182.27 |
$2,955.67 |
12.3× |
| CT thorax w/o contrast (71250) |
$994.54 |
$2,486.34 |
10.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,036.90 |
$2,592.23 |
6.4× |
| CT upper extremity w/o contrast rt (73200) |
$894.70 |
$2,236.75 |
9.3× |
| CT upper extremity with contrast (73201) |
$799.75 |
$1,999.36 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,116.55 |
$2,791.36 |
6.9× |
| Cta Abdomen (74175) |
$1,228.74 |
$3,071.83 |
7.6× |
| CTA abdomen pelvis (74174) |
$1,228.74 |
$3,071.83 |
3.8× |
| CTA chest (71275) |
$989.84 |
$2,474.58 |
6.1× |
| Cta Head (70496) |
$1,116.55 |
$2,791.36 |
6.9× |
| Cta Neck (70498) |
$750.25 |
$1,875.61 |
4.7× |
| Cystography minimum 3 views rs&i (74430) |
$570.22 |
$1,425.54 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$195.17 |
$487.91 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$63.60 |
$158.99 |
0.8× |
| Dxa bone density study axial skeleton (77085) |
$337.25 |
$843.12 |
3.5× |
| Esophagus (74220) |
$304.03 |
$760.07 |
1.9× |
| Fetal biophysical profile non-stress testing (76818) |
$106.40 |
$266 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$545.66 |
$1,364.14 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$145.57 |
$363.91 |
0.7× |
| Foot 2 views (73620) |
$91.52 |
$228.78 |
1.1× |
| Forearm 2 views (73090) |
$108.24 |
$270.59 |
1.4× |
| Gated Heart Planar Single (78472) |
$315.42 |
$788.55 |
0.9× |
| Hand 2 views (73120) |
$80.84 |
$202.10 |
0.8× |
| Hand 3 views (73130) |
$122.08 |
$305.21 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$342.66 |
$856.65 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$342.66 |
$856.65 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$171.13 |
$427.82 |
2.1× |
| Hysterosalpingogram (74740) |
$464.02 |
$1,160.04 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$424.86 |
$1,062.13 |
0.9× |
| Knee 3 views (73562) |
$129.54 |
$323.84 |
1.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$256.24 |
$640.59 |
3.2× |
| Mr safety determination physician/other qhp (76016) |
$476 |
$1,190 |
5.9× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$476 |
$1,190 |
8.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$476 |
$1,190 |
17.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$476 |
$1,190 |
5.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$476 |
$1,190 |
2.2× |
| MRA head w & w/o contrast (70546) |
$1,258.33 |
$3,145.81 |
3.9× |
| MRA head w/o contrast (70544) |
$1,298.44 |
$3,246.09 |
5.9× |
| MRA head with contrast (70545) |
$1,196.39 |
$2,990.96 |
3.7× |
| MRA neck w contrast (70548) |
$1,196.39 |
$2,990.96 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRA neck w/o contrast (70547) |
$1,298.44 |
$3,246.09 |
5.9× |
| MRI abdomen w contrast (74182) |
$1,196.39 |
$2,990.96 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRI abdomen w/o contrast (74181) |
$1,298.44 |
$3,246.09 |
5.9× |
| MRI c-spine with contrast (72142) |
$1,196.39 |
$2,990.96 |
3.7× |
| MRI cervical spine w/o contrast (72141) |
$1,298.44 |
$3,246.09 |
5.9× |
| MRI chest w/o contrast (71550) |
$1,349.55 |
$3,373.87 |
6.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,794.58 |
$4,486.46 |
5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,726.62 |
$4,316.55 |
7.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,349.55 |
$3,373.87 |
6.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRI pelvis w contrast (72196) |
$1,196.39 |
$2,990.96 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRI pelvis w/o contrast (72195) |
$524.42 |
$1,311.03 |
2.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRI scan of leg joint before and after contrast (73723) |
$2,450.50 |
$6,126.24 |
7.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,196.39 |
$2,990.96 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,633.67 |
$4,084.17 |
5.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,196.39 |
$2,990.96 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,448.26 |
$3,620.65 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,298.44 |
$3,246.09 |
5.9× |
| MRI tmj (70336) |
$679.06 |
$1,697.64 |
3.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,947.66 |
$4,869.14 |
8.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,450.50 |
$6,126.24 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,623.06 |
$4,057.62 |
7.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,864.02 |
$4,660.04 |
1.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$6,755.83 |
$16,889.57 |
8.6× |
| Neck soft tissue (70360) |
$134.54 |
$336.35 |
1.7× |
| Nm gastric emptying study (78264) |
$481.94 |
$1,204.85 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$634.39 |
$1,585.97 |
3.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$69.28 |
$173.20 |
0.7× |
| Parathyroid imaging (78070) |
$285.72 |
$714.28 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$111.79 |
$279.46 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,794.58 |
$4,486.44 |
5.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$56.22 |
$140.53 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$102.22 |
$255.53 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$78.35 |
$195.86 |
0.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$119.92 |
$299.78 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$147.82 |
$369.54 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$89.47 |
$223.67 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$111.63 |
$279.06 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$119.74 |
$299.35 |
1.5× |
| Radiologic exam colon single contrast study (74270) |
$992.74 |
$2,481.85 |
6.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$304.03 |
$760.07 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$262.80 |
$656.98 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$121.38 |
$303.43 |
1.5× |
| Radiological examination surgical specimen (76098) |
$305 |
$762.48 |
0.6× |
| Ribs bilateral 3 views (71110) |
$125.48 |
$313.70 |
1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$663.42 |
$1,658.54 |
1.8× |
| Sacroiliac Joints < 3 Views (72200) |
$91.98 |
$229.95 |
1.0× |
| Scapula complete (73010) |
$108.42 |
$271.04 |
1.1× |
| Small bowel series (74250) |
$328.59 |
$821.47 |
2.0× |
| Spine thoracic 3 views (72072) |
$171.92 |
$429.78 |
1.8× |
| Testicular Imaging With Vascular Flow (78761) |
$366.88 |
$917.19 |
1.0× |
| Thoracolumbar 2 views (72080) |
$91.41 |
$228.52 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$191.86 |
$479.65 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$285.72 |
$714.28 |
0.8× |
| Tmj unilateral (70328) |
$49.10 |
$122.75 |
0.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$502.60 |
$1,256.48 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$367.09 |
$917.72 |
3.8× |
| Upper Extremity Infant (73092) |
$77.11 |
$192.76 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$503.84 |
$1,259.59 |
2.3× |
| Urethrocystography voiding (74455) |
$570.22 |
$1,425.54 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$530.40 |
$1,326 |
3.3× |
| Us breast unilateral complete (76641) |
$222.06 |
$555.14 |
2.3× |
| Us breast unilateral limited (76642) |
$185.05 |
$462.62 |
2.3× |
| Us chest (76604) |
$311.90 |
$779.73 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$124.68 |
$311.70 |
1.3× |
| Us ob transvaginal (76817) |
$279.48 |
$698.68 |
2.9× |
| Us pelvic non ob complete (76856) |
$413.57 |
$1,033.92 |
4.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$314.66 |
$786.64 |
3.3× |
| Us pregnancy ltd (76815) |
$175.26 |
$438.13 |
1.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$339.88 |
$849.69 |
3.5× |
| Us retroperitoneal complete (76770) |
$432.81 |
$1,082.02 |
4.5× |
| Us retroperitoneal limited (76775) |
$301.08 |
$752.69 |
3.1× |
| Us scrotum and contents (76870) |
$387 |
$967.50 |
4.0× |
| Us soft tissue head/neck (76536) |
$497.88 |
$1,244.68 |
5.2× |
| Us transrectal (76872) |
$275.41 |
$688.52 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$128.12 |
$320.29 |
1.3× |
| Vertebral fracture assessment via dxa (77086) |
$209.65 |
$524.12 |
2.6× |
| Wrist 2 views (73100) |
$75.44 |
$188.58 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$299.44 |
$748.58 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$81.62 |
$204.04 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$110.47 |
$276.17 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$992.74 |
$2,481.85 |
6.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$84.34 |
$210.86 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$116.36 |
$290.90 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$50.55 |
$126.36 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$101.98 |
$254.93 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$218.25 |
$545.62 |
2.3× |
| X-ray exam of femur 1 (73551) |
$56.34 |
$140.85 |
0.7× |
| X-ray eye for foreign body (70030) |
$54.10 |
$135.25 |
0.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$247.80 |
$619.50 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$116.02 |
$290.05 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$101.09 |
$252.72 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$96.68 |
$241.68 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$109.24 |
$273.08 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$135.76 |
$339.40 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$78.75 |
$196.86 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$86.82 |
$217.05 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$145.18 |
$362.93 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$193.58 |
$483.93 |
2.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$338.38 |
$845.94 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$119.17 |
$297.92 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$186.53 |
$466.32 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$122.48 |
$306.20 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$398.41 |
$996.02 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$158.42 |
$396.05 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$290.58 |
$726.43 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$164.12 |
$410.29 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$172.27 |
$430.67 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$116.85 |
$292.11 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$105.52 |
$263.77 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$303.37 |
$758.41 |
3.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$69.14 |
$172.85 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$313.88 |
$784.69 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$109.59 |
$273.97 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$131.82 |
$329.55 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$77.79 |
$194.47 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$97.82 |
$244.54 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$104.19 |
$260.47 |
1.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$101.23 |
$253.06 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$110.35 |
$275.87 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$133.08 |
$332.70 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$235.44 |
$588.60 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$125.22 |
$313.05 |
1.6× |
| Xr shoulder 1 view (73020) |
$110.44 |
$276.10 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$280.14 |
$700.33 |
2.9× |
| Xr tibia/fibula 2 views (73590) |
$125.23 |
$313.06 |
1.6× |
| Xr tmj bilateral (70330) |
$110.78 |
$276.93 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$116.41 |
$291.02 |
1.5× |