| Abdomen 2 views (74019) |
$368 |
$368 |
3.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,906 |
$1,906 |
4.6× |
| Arthrogram hip (73525) |
$853 |
$853 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,920 |
$1,920 |
4.6× |
| Bone age studies (77072) |
$184 |
$184 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,122 |
$2,122 |
5.1× |
| Cervical spine 2 or 3 views (72040) |
$351 |
$351 |
3.9× |
| Chest 1 view (71045) |
$249 |
$249 |
2.8× |
| Chest 3 views (71047) |
$372 |
$372 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$421 |
$421 |
2.3× |
| Clavicle complete (73000) |
$275 |
$275 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,706 |
$1,706 |
15.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,418 |
$5,418 |
15.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,913 |
$3,913 |
15.8× |
| CT abdomen w contrast (74160) |
$2,609 |
$2,609 |
14.3× |
| CT abdomen w wo contrast (74170) |
$3,111 |
$3,111 |
17.1× |
| CT abdomen w/o contrast (74150) |
$2,308 |
$2,308 |
21.3× |
| CT angio hrt w/3d image (75574) |
$1,204 |
$1,204 |
3.3× |
| CT c-spine w/o contrast (72125) |
$2,433 |
$2,433 |
22.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,659 |
$2,659 |
14.6× |
| CT chest w/wo contrast (71270) |
$2,910 |
$2,910 |
16.0× |
| CT chest with contrast (71260) |
$2,600 |
$2,600 |
14.3× |
| CT head/brain with contrast (70460) |
$2,308 |
$2,308 |
12.7× |
| CT head/brain without and with contrast (70470) |
$2,609 |
$2,609 |
14.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$100 |
$100 |
1.1× |
| CT iac w contrast (70481) |
$2,483 |
$2,483 |
13.6× |
| CT lower ext w/o (73700) |
$2,207 |
$2,207 |
20.3× |
| CT lower extremity w wo contrast (73702) |
$3,010 |
$3,010 |
16.5× |
| CT lower extremity with contrast (73701) |
$2,408 |
$2,408 |
13.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,900 |
$2,900 |
15.9× |
| CT lumbar spine w/o contrast (72131) |
$2,408 |
$2,408 |
22.2× |
| CT lumbar spine with contrast (72132) |
$2,659 |
$2,659 |
7.3× |
| CT maxillofacial w contrast (70487) |
$2,207 |
$2,207 |
12.1× |
| CT maxillofacial w/o contrast (70486) |
$1,906 |
$1,906 |
17.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,408 |
$2,408 |
13.2× |
| CT neck soft tissue w contrast (70491) |
$2,408 |
$2,408 |
13.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,609 |
$2,609 |
14.3× |
| CT orbits w/o contrast (70480) |
$2,308 |
$2,308 |
21.3× |
| CT pelvis w & w/o contrast (72194) |
$2,910 |
$2,910 |
16.0× |
| CT pelvis w/o contrast (72192) |
$2,308 |
$2,308 |
21.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,709 |
$2,709 |
14.9× |
| CT soft tissue neck w/o contrast (70490) |
$2,107 |
$2,107 |
19.4× |
| CT thoracic spine w/o contrast (72128) |
$2,408 |
$2,408 |
22.2× |
| CT thoracic spine w/wo contrast (72130) |
$2,640 |
$2,640 |
14.5× |
| CT thorax w/o contrast (71250) |
$2,308 |
$2,308 |
21.3× |
| CT upper extremity w/o contrast rt (73200) |
$2,107 |
$2,107 |
19.4× |
| CT upper extremity with contrast (73201) |
$2,308 |
$2,308 |
6.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,562 |
$3,562 |
19.6× |
| Cta Abdomen (74175) |
$3,311 |
$3,311 |
18.2× |
| CTA abdomen pelvis (74174) |
$5,418 |
$5,418 |
15.0× |
| CTA chest (71275) |
$3,311 |
$3,311 |
18.2× |
| Cta Head (70496) |
$3,010 |
$3,010 |
16.5× |
| Cta Neck (70498) |
$3,010 |
$3,010 |
16.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$452 |
$452 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$153 |
$153 |
1.7× |
| Dxa bone density study axial skeleton (77085) |
$350 |
$350 |
3.2× |
| Echoencephalography real time imaging (76506) |
$321 |
$321 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$485 |
$485 |
4.5× |
| Fluoroscopy up to 1 hr (76000) |
$652 |
$652 |
2.6× |
| Foot 2 views (73620) |
$308 |
$308 |
3.4× |
| Forearm 2 views (73090) |
$209 |
$209 |
2.3× |
| Gated Heart Planar Single (78472) |
$1,204 |
$1,204 |
2.9× |
| Hand 3 views (73130) |
$235 |
$235 |
2.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,906 |
$1,906 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,806 |
$1,806 |
4.4× |
| Ht muscle image spect sing (78451) |
$3,612 |
$3,612 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$230 |
$230 |
2.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,806 |
$1,806 |
3.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,605 |
$1,605 |
2.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,107 |
$2,107 |
3.7× |
| Knee 3 views (73562) |
$333 |
$333 |
3.7× |
| Lymphoscintigraphy (78195) |
$1,806 |
$1,806 |
3.2× |
| MRA head w/o contrast (70544) |
$3,415 |
$3,415 |
13.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,815 |
$3,815 |
10.5× |
| MRA neck w/o contrast (70547) |
$2,710 |
$2,710 |
10.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,115 |
$4,115 |
11.4× |
| MRI abdomen w/o contrast (74181) |
$3,210 |
$3,210 |
13.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,415 |
$3,415 |
4.2× |
| MRI bone marrow blood supply (77084) |
$1,605 |
$1,605 |
6.5× |
| MRI breast w/o contrast bilateral (77047) |
$2,510 |
$2,510 |
10.1× |
| MRI breast w/o contrast unilat (77046) |
$1,255 |
$1,255 |
5.1× |
| MRI c-spine with contrast (72142) |
$3,660 |
$3,660 |
10.1× |
| MRI cervical spine w/o contrast (72141) |
$3,415 |
$3,415 |
13.8× |
| MRI chest w/o & w/contrast material (71552) |
$4,015 |
$4,015 |
11.1× |
| MRI chest w/o contrast (71550) |
$3,515 |
$3,515 |
14.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,010 |
$2,010 |
5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,710 |
$2,710 |
10.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,815 |
$3,815 |
10.5× |
| MRI pelvis w contrast (72196) |
$3,660 |
$3,660 |
10.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,115 |
$4,115 |
11.4× |
| MRI pelvis w/o contrast (72195) |
$3,110 |
$3,110 |
12.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,815 |
$3,815 |
10.5× |
| MRI scan of leg joint before and after contrast (73723) |
$3,615 |
$3,615 |
10.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,315 |
$4,315 |
11.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,510 |
$3,510 |
9.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,215 |
$4,215 |
11.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,715 |
$3,715 |
10.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,165 |
$4,165 |
11.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,460 |
$3,460 |
14.0× |
| MRI tmj (70336) |
$2,510 |
$2,510 |
10.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,610 |
$2,610 |
10.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,415 |
$3,415 |
9.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,710 |
$2,710 |
10.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,214 |
$4,214 |
3.1× |
| Neck soft tissue (70360) |
$217 |
$217 |
2.4× |
| Nm bone marrow multiple (78103) |
$370 |
$370 |
0.9× |
| Nm bone marrow wb (78104) |
$403 |
$403 |
1.0× |
| Nm gastric emptying study (78264) |
$1,906 |
$1,906 |
4.6× |
| Nuclear Rx Oral Admin (79005) |
$1,202 |
$1,202 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$351 |
$351 |
3.2× |
| Parathyroid imaging (78070) |
$1,304 |
$1,304 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$326 |
$326 |
3.0× |
| PET image w/CT, skull-thigh (78815) |
$6,262 |
$6,262 |
4.2× |
| PET imaging for CT attenuation whole body (78816) |
$7,676 |
$7,676 |
5.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,310 |
$3,310 |
9.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$898 |
$898 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,308 |
$2,308 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,644 |
$2,644 |
4.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$308 |
$308 |
3.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$331 |
$331 |
3.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$477 |
$477 |
4.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$276 |
$276 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$278 |
$278 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$449 |
$449 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$328 |
$328 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$328 |
$328 |
3.6× |
| Radiological examination surgical specimen (76098) |
$143 |
$143 |
0.3× |
| Ribs bilateral 3 views (71110) |
$342 |
$342 |
3.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,906 |
$1,906 |
3.4× |
| Rp Therapy Intravenous Administration (79101) |
$633 |
$633 |
2.6× |
| Scapula complete (73010) |
$228 |
$228 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$85 |
$85 |
3.6× |
| Spine thoracic 3 views (72072) |
$433 |
$433 |
4.0× |
| Thoracolumbar 2 views (72080) |
$262 |
$262 |
2.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,206 |
$2,206 |
3.9× |
| Thyroid uptake measurement (78012) |
$754 |
$754 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,405 |
$1,405 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$702 |
$702 |
6.5× |
| Umbilical-artery Doppler (OB) (76820) |
$261 |
$261 |
2.4× |
| Unlisted Ultrasound Procedure (76999) |
$502 |
$502 |
5.6× |
| Us abdl aorta screen aaa (76706) |
$548 |
$548 |
5.0× |
| Us breast unilateral complete (76641) |
$575 |
$575 |
5.3× |
| Us breast unilateral limited (76642) |
$387 |
$387 |
4.3× |
| Us chest (76604) |
$502 |
$502 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$702 |
$702 |
6.5× |
| Us infant hips limited static (76886) |
$814 |
$814 |
9.0× |
| Us kidney transplant (76776) |
$770 |
$770 |
7.1× |
| Us ob detailed single fetus (76811) |
$502 |
$502 |
2.0× |
| Us ob transvaginal (76817) |
$577 |
$577 |
5.3× |
| Us pelvic non ob complete (76856) |
$803 |
$803 |
7.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$502 |
$502 |
4.6× |
| Us pregnancy ltd (76815) |
$425 |
$425 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$700 |
$700 |
6.4× |
| Us retroperitoneal complete (76770) |
$759 |
$759 |
7.0× |
| Us retroperitoneal limited (76775) |
$529 |
$529 |
4.9× |
| Us scrotum and contents (76870) |
$702 |
$702 |
6.5× |
| Us soft tissue head/neck (76536) |
$552 |
$552 |
5.1× |
| Us spinal canal and contents (76800) |
$727 |
$727 |
6.7× |
| Us transrectal (76872) |
$652 |
$652 |
6.0× |
| Us xtr non-vasc lmtd (76882) |
$472 |
$472 |
4.3× |
| Vertebral fracture assessment via dxa (77086) |
$100 |
$100 |
1.1× |
| Wrist 2 views (73100) |
$178 |
$178 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$383 |
$383 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$217 |
$217 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$315 |
$315 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$196 |
$196 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$241 |
$241 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$226 |
$226 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$306 |
$306 |
3.4× |
| X-ray exam of femur 1 (73551) |
$165 |
$165 |
1.8× |
| X-ray eye for foreign body (70030) |
$188 |
$188 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$327 |
$327 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$303 |
$303 |
3.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$175 |
$175 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$376 |
$376 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$180 |
$180 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$161 |
$161 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$408 |
$408 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$627 |
$627 |
5.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$361 |
$361 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$217 |
$217 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$370 |
$370 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$376 |
$376 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$227 |
$227 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$401 |
$401 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$420 |
$420 |
3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$252 |
$252 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$222 |
$222 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$328 |
$328 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$273 |
$273 |
3.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$184 |
$184 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$335 |
$335 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$203 |
$203 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$195 |
$195 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$241 |
$241 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$376 |
$376 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$165 |
$165 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$230 |
$230 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$419 |
$419 |
3.9× |
| Xr chest 4+ views (71048) |
$429 |
$429 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$214 |
$214 |
2.4× |
| Xr shoulder 1 view (73020) |
$166 |
$166 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$484 |
$484 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$326 |
$326 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$222 |
$222 |
2.5× |