| Abdomen 2 views (74019) |
$307.80 |
$513 |
3.0× |
| Ankle 2 views (73600) |
$578.40 |
$964 |
6.8× |
| Arthrogram knee (73580) |
$767.40 |
$1,279 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,590.60 |
$2,651 |
4.1× |
| Bone &/joint imaging whole body (78306) |
$2,323.20 |
$3,872 |
6.0× |
| Bone age studies (77072) |
$737.40 |
$1,229 |
7.2× |
| Bone Imaging 3 Phase (78315) |
$1,608 |
$2,680 |
4.1× |
| Bone survey complete (77075) |
$1,092 |
$1,820 |
10.7× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$367.20 |
$612 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$591.60 |
$986 |
7.0× |
| Chest 1 view (71045) |
$243.60 |
$406 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$620.40 |
$1,034 |
3.6× |
| Clavicle complete (73000) |
$622.20 |
$1,037 |
7.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$313.20 |
$522 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,493.80 |
$5,823 |
10.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,201.40 |
$3,669 |
9.5× |
| CT abdomen w contrast (74160) |
$2,604 |
$4,340 |
15.2× |
| CT abdomen w wo contrast (74170) |
$2,323.20 |
$3,872 |
13.6× |
| CT abdomen w/o contrast (74150) |
$1,969.20 |
$3,282 |
19.3× |
| CT c-spine w/o contrast (72125) |
$1,830.60 |
$3,051 |
17.9× |
| CT chest w contrast (71260) |
$1,986.60 |
$3,311 |
11.6× |
| CT head/brain with contrast (70460) |
$2,964 |
$4,940 |
17.3× |
| CT head/brain without and with contrast (70470) |
$2,741.40 |
$4,569 |
16.0× |
| CT iac w contrast (70481) |
$816 |
$1,360 |
4.8× |
| CT lower ext w/o (73700) |
$1,528.20 |
$2,547 |
15.0× |
| CT lower extremity w wo contrast (73702) |
$2,674.80 |
$4,458 |
15.6× |
| CT lower extremity w/contrast material (73701) |
$2,298 |
$3,830 |
13.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,086.60 |
$1,811 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$1,447.80 |
$2,413 |
14.2× |
| CT maxillofacial w contrast (70487) |
$2,730.60 |
$4,551 |
16.0× |
| CT maxillofacial wo contrast (70486) |
$1,481.40 |
$2,469 |
14.5× |
| CT orbits w/o contrast (70480) |
$3,354 |
$5,590 |
32.9× |
| CT pelvis w/o contrast (72192) |
$1,330.20 |
$2,217 |
13.0× |
| CT soft tissue neck w contrast (70491) |
$2,194.80 |
$3,658 |
12.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,852.20 |
$3,087 |
18.2× |
| CT thoracic spine w/o contrast (72128) |
$1,689 |
$2,815 |
16.6× |
| CT thorax w/o contrast (71250) |
$1,629.60 |
$2,716 |
16.0× |
| CT upper ext wo (73200) |
$1,824.60 |
$3,041 |
17.9× |
| CT upper extremity with contrast (73201) |
$3,019.80 |
$5,033 |
8.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,298.20 |
$5,497 |
19.3× |
| Cta Abdomen (74175) |
$1,766.40 |
$2,944 |
10.3× |
| CTA abdomen pelvis (74174) |
$3,399 |
$5,665 |
10.0× |
| CTA chest (71275) |
$2,503.80 |
$4,173 |
14.6× |
| Cta Head (70496) |
$2,505.60 |
$4,176 |
14.6× |
| Cta Neck (70498) |
$4,071 |
$6,785 |
23.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$898.20 |
$1,497 |
8.8× |
| Esophagus (74220) |
$1,231.80 |
$2,053 |
7.2× |
| Facial bones min 3 views (70150) |
$597 |
$995 |
5.9× |
| Fluoroscopy up to 1 hr (76000) |
$769.80 |
$1,283 |
3.3× |
| Foot 2 views (73620) |
$385.80 |
$643 |
4.5× |
| Forearm 2 views (73090) |
$408 |
$680 |
4.8× |
| Hand 2 views (73120) |
$481.20 |
$802 |
4.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,641.40 |
$6,069 |
6.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$930 |
$1,550 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,209.80 |
$3,683 |
4.2× |
| Knee 3 views (73562) |
$645 |
$1,075 |
7.6× |
| Mr safety determination physician/other qhp (76016) |
$166.20 |
$277 |
2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$46.20 |
$77 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$173.40 |
$289 |
1.9× |
| Mr safety implt pos&/immoblj (76019) |
$112.20 |
$187 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$456.60 |
$761 |
2.0× |
| MRA head w/o contrast (70544) |
$2,284.80 |
$3,808 |
9.8× |
| MRA neck w contrast (70548) |
$753 |
$1,255 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,678.80 |
$7,798 |
13.7× |
| MRA neck w/o contrast (70547) |
$2,695.80 |
$4,493 |
11.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,352.80 |
$5,588 |
9.8× |
| MRI abdomen w/o contrast (74181) |
$2,527.20 |
$4,212 |
10.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,688.40 |
$7,814 |
13.8× |
| MRI c-spine with contrast (72142) |
$1,557 |
$2,595 |
4.6× |
| MRI cervical spine w/o contrast (72141) |
$2,087.40 |
$3,479 |
9.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,426.20 |
$7,377 |
13.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,424 |
$4,040 |
10.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,426.20 |
$7,377 |
13.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,834.60 |
$6,391 |
11.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,340.20 |
$5,567 |
9.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,340.20 |
$5,567 |
9.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,525 |
$5,875 |
10.4× |
| MRI temporomandibular joint (70336) |
$2,728.20 |
$4,547 |
11.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,289.60 |
$3,816 |
9.8× |
| MRI up ext w/o contrast (73218) |
$2,928.60 |
$4,881 |
12.6× |
| MRI upper ext joint w/o contrast (73221) |
$2,204.40 |
$3,674 |
9.5× |
| Myocardial Spect Multiple Studies (78452) |
$5,660.40 |
$9,434 |
4.5× |
| Myocardial spect single study at rest or stress (78451) |
$4,153.20 |
$6,922 |
3.3× |
| Neck soft tissue (70360) |
$647.40 |
$1,079 |
7.6× |
| Nm gastric emptying study (78264) |
$3,115.20 |
$5,192 |
8.0× |
| Parathyroid Planar Imaging (78070) |
$1,595.40 |
$2,659 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$603.60 |
$1,006 |
5.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$579.60 |
$966 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$588 |
$980 |
1.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$569.40 |
$949 |
6.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$543.60 |
$906 |
6.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$762.60 |
$1,271 |
9.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$697.20 |
$1,162 |
8.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$253.20 |
$422 |
2.5× |
| Radex fingr minimum 2 views (73140) |
$614.40 |
$1,024 |
7.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$576 |
$960 |
6.8× |
| Radex Hand Minimum 3 Views (73130) |
$712.80 |
$1,188 |
8.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$325.20 |
$542 |
3.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$1,144.80 |
$1,908 |
11.2× |
| Radex Humerus Minimum 2 Views (73060) |
$594.60 |
$991 |
7.0× |
| Radex Kne 1/2 Views (73560) |
$445.80 |
$743 |
5.3× |
| Radex Kne Compl 4/More Views (73564) |
$1,069.80 |
$1,783 |
10.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$612.60 |
$1,021 |
6.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$462.60 |
$771 |
5.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$759.60 |
$1,266 |
8.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$102 |
$170 |
1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$558.60 |
$931 |
6.6× |
| Radex Toe Minimum 2 Views (73660) |
$430.80 |
$718 |
5.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$662.40 |
$1,104 |
7.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$620.40 |
$1,034 |
7.3× |
| Radiologic exam chest 2 views (71046) |
$485.40 |
$809 |
5.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$831.60 |
$1,386 |
4.9× |
| Radiologic examination femur 1 view (73551) |
$544.20 |
$907 |
6.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$809.40 |
$1,349 |
9.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$463.80 |
$773 |
0.9× |
| Scapula (73010) |
$579 |
$965 |
5.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$107.40 |
$179 |
4.6× |
| Shoulder 1 view (73020) |
$508.20 |
$847 |
6.0× |
| Spine thoracic 3 views (72072) |
$735.60 |
$1,226 |
7.2× |
| Thoracolumbar 2 views (72080) |
$95.40 |
$159 |
1.1× |
| Thyroid uptake measurement (78012) |
$305.40 |
$509 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,419 |
$2,365 |
3.6× |
| Ultrasound Exam Aaa Screen (76706) |
$1,010.40 |
$1,684 |
9.9× |
| Ultrasound, abdomen limited (76705) |
$868.20 |
$1,447 |
8.5× |
| Us breast unilateral limited (76642) |
$572.40 |
$954 |
6.7× |
| Us chest (76604) |
$868.80 |
$1,448 |
8.5× |
| Us compl joint r-t w/image documentation (76881) |
$696 |
$1,160 |
6.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$615.60 |
$1,026 |
6.0× |
| Us ob limited (76815) |
$600.60 |
$1,001 |
5.9× |
| Us ob transvaginal (76817) |
$1,213.80 |
$2,023 |
11.9× |
| Us pelvic non ob complete (76856) |
$1,611 |
$2,685 |
15.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$759.60 |
$1,266 |
7.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$890.40 |
$1,484 |
8.7× |
| Us retroperitoneal complete (76770) |
$1,407.60 |
$2,346 |
13.8× |
| Us retroperitoneal limited (76775) |
$786 |
$1,310 |
7.7× |
| Us scrotum and contents (76870) |
$1,098 |
$1,830 |
10.8× |
| Us soft tissue head/neck (76536) |
$945.60 |
$1,576 |
9.3× |
| Us spinal canal and contents (76800) |
$964.20 |
$1,607 |
9.5× |
| Wrist 2 views (73100) |
$426 |
$710 |
5.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$718.80 |
$1,198 |
7.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$345.60 |
$576 |
4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$487.20 |
$812 |
5.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,163.40 |
$1,939 |
11.4× |
| X-ray exam of femur 2/> (73552) |
$776.40 |
$1,294 |
9.1× |
| X-ray eye for foreign body (70030) |
$492 |
$820 |
5.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$154.80 |
$258 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$402.60 |
$671 |
4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$868.20 |
$1,447 |
8.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$758.40 |
$1,264 |
7.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$656.40 |
$1,094 |
6.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$448.80 |
$748 |
5.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$924 |
$1,540 |
9.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$696.60 |
$1,161 |
6.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$576.60 |
$961 |
5.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$776.40 |
$1,294 |
9.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$995.40 |
$1,659 |
11.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$727.80 |
$1,213 |
7.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$571.80 |
$953 |
5.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$442.20 |
$737 |
5.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$448.20 |
$747 |
5.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$924 |
$1,540 |
9.1× |
| Xr c-spine 4 or 5 views (72050) |
$1,011.60 |
$1,686 |
9.9× |
| Xr c-spine 6 or more views (72052) |
$827.40 |
$1,379 |
8.1× |