| Abdomen 2 views (74019) |
$372.75 |
$497 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$5,424 |
$7,232 |
1.4× |
| Ankle 2 views (73600) |
$200.25 |
$267 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,206 |
$1,608 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,679.25 |
$2,239 |
3.5× |
| Cervical spine 2 or 3 views (72040) |
$370.50 |
$494 |
3.6× |
| Chest 1 view (71045) |
$216 |
$288 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$885.75 |
$1,181 |
4.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$634.50 |
$846 |
5.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,262 |
$3,016 |
5.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,098 |
$1,464 |
3.8× |
| CT abdomen w contrast (74160) |
$1,701.75 |
$2,269 |
8.1× |
| CT abdomen w wo contrast (74170) |
$2,641.50 |
$3,522 |
12.6× |
| CT abdomen w/o contrast (74150) |
$1,384.50 |
$1,846 |
11.1× |
| CT angiography upper extremity lt (73206) |
$2,304 |
$3,072 |
11.0× |
| CT c-spine w/contrast (72126) |
$1,732.50 |
$2,310 |
4.1× |
| CT c-spine w/o contrast (72125) |
$1,459.50 |
$1,946 |
11.6× |
| CT chest w contrast (71260) |
$1,728 |
$2,304 |
8.2× |
| CT colonography screening (74263) |
$3,850.50 |
$5,134 |
13.5× |
| CT colonography w/dye (74262) |
$3,697.50 |
$4,930 |
17.6× |
| CT head/brain with contrast (70460) |
$1,392.75 |
$1,857 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,784.25 |
$2,379 |
8.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$608.25 |
$811 |
1.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$199.50 |
$266 |
1.9× |
| CT lower ext w/o (73700) |
$1,395.38 |
$1,860.50 |
11.1× |
| CT lower extremity w/contrast material (73701) |
$1,644 |
$2,192 |
7.8× |
| CT lumbar spine w/contrast (72132) |
$1,752.75 |
$2,337 |
4.2× |
| CT lumbar spine w/o contrast (72131) |
$1,460.25 |
$1,947 |
11.7× |
| CT maxillofacial w contrast (70487) |
$1,857 |
$2,476 |
8.8× |
| CT maxillofacial wo contrast (70486) |
$1,521.75 |
$2,029 |
12.1× |
| CT orbits w/o contrast (70480) |
$1,285.88 |
$1,714.50 |
10.3× |
| CT pelvis w/o contrast (72192) |
$1,370.25 |
$1,827 |
10.9× |
| CT pelvis w/wo contrast (72194) |
$2,216.25 |
$2,955 |
10.5× |
| CT soft tissue neck w contrast (70491) |
$1,542 |
$2,056 |
7.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,479 |
$1,972 |
11.8× |
| CT thoracic spine w/contrast (72129) |
$1,725 |
$2,300 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$1,475.25 |
$1,967 |
11.8× |
| CT thorax w/o contrast (71250) |
$1,464.75 |
$1,953 |
11.7× |
| CT upper ext wo (73200) |
$1,362.75 |
$1,817 |
10.9× |
| CT upper extremity with contrast (73201) |
$1,617 |
$2,156 |
3.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,904 |
$3,872 |
13.8× |
| Cta Abdomen (74175) |
$2,632.50 |
$3,510 |
12.5× |
| CTA abdomen pelvis (74174) |
$2,763 |
$3,684 |
6.6× |
| CTA chest (71275) |
$2,010.75 |
$2,681 |
9.6× |
| Cta Head (70496) |
$3,653.25 |
$4,871 |
17.4× |
| Cta Neck (70498) |
$3,670.50 |
$4,894 |
17.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$423.75 |
$565 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$250.50 |
$334 |
2.4× |
| Esophagus (74220) |
$911.25 |
$1,215 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$392.25 |
$523 |
3.1× |
| Forearm 2 views (73090) |
$263.25 |
$351 |
2.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,658.25 |
$2,211 |
3.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,066.25 |
$2,755 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,126.50 |
$1,502 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,407 |
$1,876 |
2.2× |
| Knee 3 views (73562) |
$349.50 |
$466 |
3.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,237.50 |
$5,650 |
10.1× |
| MRA head w/o contrast (70544) |
$3,067.50 |
$4,090 |
10.7× |
| MRA neck w contrast (70548) |
$3,197.25 |
$4,263 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,632 |
$6,176 |
11.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,191 |
$5,588 |
10.0× |
| MRI abdomen w/o contrast (74181) |
$2,649 |
$3,532 |
9.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,905.25 |
$5,207 |
9.3× |
| MRI breast w/o contrast bilateral (77047) |
$3,528.75 |
$4,705 |
12.3× |
| MRI breast wo contrast unilateral (77046) |
$3,516 |
$4,688 |
12.3× |
| MRI c-spine with contrast (72142) |
$3,496.50 |
$4,662 |
8.4× |
| MRI cervical spine w/o contrast (72141) |
$2,812.50 |
$3,750 |
9.8× |
| MRI chest w/o & w/contrast material (71552) |
$4,919.25 |
$6,559 |
11.8× |
| MRI chest w/o contrast (71550) |
$3,551.25 |
$4,735 |
12.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,407.25 |
$4,543 |
8.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,089.25 |
$4,119 |
10.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,089.25 |
$4,119 |
10.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,236.25 |
$4,315 |
7.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,231.50 |
$5,642 |
10.1× |
| MRI pelvis w/o contrast (72195) |
$3,150.75 |
$4,201 |
11.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,057.50 |
$5,410 |
9.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,999.75 |
$5,333 |
9.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,883.75 |
$3,845 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,726.75 |
$4,969 |
8.9× |
| MRI temporomandibular joint (70336) |
$2,745 |
$3,660 |
9.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,810.25 |
$3,747 |
9.8× |
| MRI up ext w/o contrast (73218) |
$3,204 |
$4,272 |
11.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,293.50 |
$3,058 |
8.0× |
| MRI, joint upper extrem combo (73223) |
$2,802 |
$3,736 |
6.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,138.75 |
$4,185 |
2.0× |
| Myocardial spect single study at rest or stress (78451) |
$3,159.75 |
$4,213 |
2.0× |
| Nm gastric emptying study (78264) |
$1,426.50 |
$1,902 |
3.0× |
| Ob us nuchal meas 1 gest (76813) |
$539.25 |
$719 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$218.25 |
$291 |
1.7× |
| Peritoneogram after injection (74190) |
$1,959 |
$2,612 |
3.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$314.25 |
$419 |
3.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$193.50 |
$258 |
1.9× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$348.75 |
$465 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$450 |
$600 |
3.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$487.50 |
$650 |
3.9× |
| Radex fingr minimum 2 views (73140) |
$309 |
$412 |
3.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$309.75 |
$413 |
3.0× |
| Radex Hand Minimum 3 Views (73130) |
$310.50 |
$414 |
3.0× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$361.50 |
$482 |
2.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$274.50 |
$366 |
2.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$394.50 |
$526 |
3.1× |
| Radex Humerus Minimum 2 Views (73060) |
$282.75 |
$377 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$278.25 |
$371 |
2.7× |
| Radex Kne Compl 4/More Views (73564) |
$403.50 |
$538 |
3.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$250.50 |
$334 |
2.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$288 |
$384 |
2.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$345.75 |
$461 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$473.25 |
$631 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$294 |
$392 |
2.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$356.25 |
$475 |
3.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$189.75 |
$253 |
1.8× |
| Radiologic exam chest 2 views (71046) |
$294 |
$392 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$1,187.25 |
$1,583 |
5.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$615.75 |
$821 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,293 |
$1,724 |
6.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,069.50 |
$1,426 |
5.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$261 |
$348 |
2.5× |
| Radiological examination surgical specimen (76098) |
$838.50 |
$1,118 |
1.3× |
| Ribs bilateral 3 views (71110) |
$391.50 |
$522 |
3.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,965.25 |
$5,287 |
2.6× |
| Sacroiliac Joints < 3 Views (72200) |
$289.50 |
$386 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$139.50 |
$186 |
6.0× |
| Small bowel series (74250) |
$1,101.75 |
$1,469 |
5.2× |
| Spine thoracic 3 views (72072) |
$369.75 |
$493 |
3.0× |
| Thoracolumbar 2 views (72080) |
$279 |
$372 |
2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,134 |
$1,512 |
2.4× |
| Ultrasound Exam Aaa Screen (76706) |
$287.25 |
$383 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$295.50 |
$394 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$399.75 |
$533 |
3.2× |
| Us breast unilateral limited (76642) |
$233.25 |
$311 |
2.2× |
| Us chest (76604) |
$317.25 |
$423 |
2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$238.50 |
$318 |
1.9× |
| Us ob limited (76815) |
$400.50 |
$534 |
3.2× |
| Us ob transvaginal (76817) |
$451.50 |
$602 |
3.6× |
| Us pelvic non ob complete (76856) |
$573 |
$764 |
4.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$487.50 |
$650 |
3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$563.25 |
$751 |
4.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$532.50 |
$710 |
4.3× |
| Us retroperitoneal complete (76770) |
$596.25 |
$795 |
4.8× |
| Us scrotum and contents (76870) |
$564 |
$752 |
4.5× |
| Us soft tissue head/neck (76536) |
$528 |
$704 |
4.2× |
| Us,transplanted kidney, real time/ doppler (76776) |
$586.50 |
$782 |
4.7× |
| Venogram extremity bilateral (75822) |
$1,725.75 |
$2,301 |
0.9× |
| Venogram Extremity Unilateral (75820) |
$1,533.75 |
$2,045 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,170.50 |
$2,894 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$291 |
$388 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$326.25 |
$435 |
2.6× |
| X-ray exam of femur 2/> (73552) |
$225 |
$300 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$233.25 |
$311 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$390.75 |
$521 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$509.25 |
$679 |
4.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$311.25 |
$415 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$514.50 |
$686 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$347.25 |
$463 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$281.25 |
$375 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$369 |
$492 |
3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$457.50 |
$610 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$329.25 |
$439 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$229.50 |
$306 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$319.50 |
$426 |
2.6× |
| Xr bone length studies (77073) |
$247.50 |
$330 |
2.0× |
| Xr c-spine 4 or 5 views (72050) |
$518.25 |
$691 |
4.1× |
| Xr c-spine 6 or more views (72052) |
$655.50 |
$874 |
5.2× |
| Xr chest 4+ views (71048) |
$456 |
$608 |
3.6× |