| Abdomen 2 views (74019) |
$385.55 |
$701 |
3.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,321.65 |
$2,403 |
2.8× |
| Angiography extremity bilateral rs&i (75716) |
$7,949.70 |
$14,454 |
2.1× |
| Angiography extremity unilateral rs&i (75710) |
$7,949.70 |
$14,454 |
2.1× |
| Angiography internal mammary rs&i (75756) |
$7,949.70 |
$14,454 |
2.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$13,706 |
$24,920 |
2.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$7,949.70 |
$14,454 |
2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,949.70 |
$14,454 |
2.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$13,706 |
$24,920 |
2.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$7,949.70 |
$14,454 |
2.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$7,949.70 |
$14,454 |
2.1× |
| Ankle 2 views (73600) |
$485.38 |
$882.50 |
4.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$959.20 |
$1,744 |
2.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,949.70 |
$14,454 |
2.1× |
| Aortography abdominal serialography rs&i (75625) |
$7,949.70 |
$14,454 |
2.1× |
| Arthrogram elbow (73085) |
$959.20 |
$1,744 |
2.3× |
| Arthrogram hip (73525) |
$1,012 |
$1,840 |
2.4× |
| Arthrogram shoulder (73040) |
$1,275.45 |
$2,319 |
3.0× |
| Arthrogram wrist (73115) |
$959.20 |
$1,744 |
2.3× |
| Arthrography knee lt (73580) |
$959.20 |
$1,744 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,028.50 |
$1,870 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,098.35 |
$1,997 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$1,062.60 |
$1,932 |
2.2× |
| Bone age studies (77072) |
$319 |
$580 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,194.60 |
$2,172 |
2.5× |
| Bone Marrow Imaging Limited Area (78102) |
$1,028.50 |
$1,870 |
2.1× |
| Bone survey complete (77075) |
$980.65 |
$1,783 |
7.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,028.66 |
$1,870.28 |
2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,052.40 |
$7,368 |
2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,607.10 |
$2,922 |
3.8× |
| Cervical spine 2 or 3 views (72040) |
$308.55 |
$561 |
3.0× |
| Chest 1 view (71045) |
$238.70 |
$434 |
2.3× |
| Chest 3 views (71047) |
$334.95 |
$609 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$554.40 |
$1,008 |
2.6× |
| Clavicle complete (73000) |
$531.85 |
$967 |
5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$479.60 |
$872 |
3.8× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$463.65 |
$843 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,158.20 |
$3,924 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,566.95 |
$2,849 |
5.5× |
| CT abdomen w contrast (74160) |
$1,554.85 |
$2,827 |
7.4× |
| CT abdomen w wo contrast (74170) |
$1,718.20 |
$3,124 |
8.2× |
| CT abdomen w/o contrast (74150) |
$915.20 |
$1,664 |
7.3× |
| CT angio hrt w/3d image (75574) |
$1,663.75 |
$3,025 |
4.0× |
| CT angiography upper extremity lt (73206) |
$1,568.88 |
$2,852.50 |
7.5× |
| CT c-spine w/o contrast (72125) |
$1,028.50 |
$1,870 |
8.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,640.10 |
$2,982 |
7.8× |
| CT cervical spine with contrast (72126) |
$2,050.95 |
$3,729 |
4.9× |
| CT chest w/wo contrast (71270) |
$1,530.65 |
$2,783 |
7.3× |
| CT chest with contrast (71260) |
$1,503.70 |
$2,734 |
7.2× |
| CT colonography screening (74263) |
$766.70 |
$1,394 |
2.7× |
| CT colonography w/dye (74262) |
$766.70 |
$1,394 |
3.6× |
| CT colonography w/o cntrst (74261) |
$843.70 |
$1,534 |
6.7× |
| CT head/brain with contrast (70460) |
$1,366.20 |
$2,484 |
6.5× |
| CT head/brain without and with contrast (70470) |
$1,626.90 |
$2,958 |
7.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$232.10 |
$422 |
2.2× |
| CT iac w contrast (70481) |
$1,569.70 |
$2,854 |
7.5× |
| CT limited/localized follow up study (76380) |
$577.50 |
$1,050 |
5.5× |
| CT lower ext w/o (73700) |
$1,028.50 |
$1,870 |
8.2× |
| CT lower extremity w wo contrast (73702) |
$1,536.94 |
$2,794.43 |
7.3× |
| CT lower extremity with contrast (73701) |
$1,581.52 |
$2,875.50 |
7.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,718.20 |
$3,124 |
8.2× |
| CT lumbar spine w/o contrast (72131) |
$1,028.50 |
$1,870 |
8.2× |
| CT lumbar spine with contrast (72132) |
$1,961.30 |
$3,566 |
4.7× |
| CT maxillofacial w contrast (70487) |
$1,569.70 |
$2,854 |
7.5× |
| CT maxillofacial w/o contrast (70486) |
$1,028.50 |
$1,870 |
8.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,475.10 |
$2,682 |
7.0× |
| CT neck soft tissue w contrast (70491) |
$1,718.20 |
$3,124 |
8.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,697.85 |
$3,087 |
8.1× |
| CT orbits w/o contrast (70480) |
$1,028.50 |
$1,870 |
8.2× |
| CT pelvis w & w/o contrast (72194) |
$1,718.20 |
$3,124 |
8.2× |
| CT pelvis w/o contrast (72192) |
$922.35 |
$1,677 |
7.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,718.20 |
$3,124 |
8.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,028.50 |
$1,870 |
8.2× |
| CT thoracic spine w/contrast (72129) |
$1,023.55 |
$1,861 |
4.9× |
| CT thoracic spine w/o contrast (72128) |
$1,028.50 |
$1,870 |
8.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,422.85 |
$2,587 |
6.8× |
| CT thorax w/o contrast (71250) |
$886.05 |
$1,611 |
7.1× |
| CT unlisted procedure (76497) |
$448.25 |
$815 |
4.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,640.24 |
$2,982.25 |
7.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,028.50 |
$1,870 |
8.2× |
| CT upper extremity with contrast (73201) |
$2,830.85 |
$5,147 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,718.20 |
$3,124 |
8.2× |
| Cta Abdomen (74175) |
$1,718.20 |
$3,124 |
8.2× |
| CTA abdomen pelvis (74174) |
$1,566.95 |
$2,849 |
3.7× |
| CTA chest (71275) |
$1,218.52 |
$2,215.50 |
5.8× |
| Cta Head (70496) |
$1,411.85 |
$2,567 |
6.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,598.85 |
$2,907 |
7.6× |
| Cta Neck (70498) |
$1,411.85 |
$2,567 |
6.7× |
| Cta Pelvis (72191) |
$1,661 |
$3,020 |
7.9× |
| Cystography minimum 3 views rs&i (74430) |
$959.20 |
$1,744 |
2.3× |
| Diskogram cervical (72285) |
$4,815.25 |
$8,755 |
2.1× |
| Diskography lumbar (72295) |
$4,815.25 |
$8,755 |
2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$275 |
$500 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$275 |
$500 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$226.60 |
$412 |
2.2× |
| Echoencephalography real time imaging (76506) |
$289.85 |
$527 |
2.3× |
| Esophageal motility (78258) |
$1,028.50 |
$1,870 |
2.1× |
| Esophagus (74220) |
$683.65 |
$1,243 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$573.65 |
$1,043 |
4.6× |
| Fluoroscopy up to 1 hr (76000) |
$611.05 |
$1,111 |
2.1× |
| Foot 2 views (73620) |
$349.25 |
$635 |
3.3× |
| Forearm 2 views (73090) |
$414.15 |
$753 |
4.0× |
| Gated Heart Planar Single (78472) |
$1,321.65 |
$2,403 |
2.8× |
| Hand 2 views (73120) |
$540.38 |
$982.50 |
4.3× |
| Hand 3 views (73130) |
$447.70 |
$814 |
4.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,949.70 |
$14,454 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,348.05 |
$2,451 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,258.95 |
$2,289 |
2.6× |
| Ht muscle image spect sing (78451) |
$3,541.45 |
$6,439 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$500.50 |
$910 |
4.8× |
| Hysterosalpingogram (74740) |
$820.88 |
$1,492.50 |
2.9× |
| Kidney imaging morphology (78700) |
$1,028.50 |
$1,870 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,348.05 |
$2,451 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,348.05 |
$2,451 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,348.05 |
$2,451 |
2.1× |
| Knee 3 views (73562) |
$644.05 |
$1,171 |
6.2× |
| Liver & spleen imaging static only (78215) |
$1,369.50 |
$2,490 |
2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,082.95 |
$1,969 |
2.3× |
| Liver imaging static only (78201) |
$1,348.05 |
$2,451 |
2.1× |
| Liver imaging w/vascular flow (78202) |
$1,348.05 |
$2,451 |
2.1× |
| Lung perfusion differential (78597) |
$1,028.50 |
$1,870 |
2.1× |
| Lung Ventilation Imaging (78579) |
$1,028.50 |
$1,870 |
2.1× |
| Lymphoscintigraphy (78195) |
$1,348.05 |
$2,451 |
2.1× |
| Mammary ductogram or galactogram multiple (77054) |
$726.55 |
$1,321 |
2.5× |
| Mammary ductogram or galactogram single (77053) |
$661.10 |
$1,202 |
2.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$595.10 |
$1,082 |
5.7× |
| Meckels Diverticulum (78290) |
$1,028.50 |
$1,870 |
2.1× |
| MRA head w & w/o contrast (70546) |
$1,793.55 |
$3,261 |
4.3× |
| MRA head w/o contrast (70544) |
$1,492.70 |
$2,714 |
5.2× |
| MRA head with contrast (70545) |
$1,560.90 |
$2,838 |
3.7× |
| MRA neck w contrast (70548) |
$1,342.55 |
$2,441 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,982.75 |
$3,605 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,166.55 |
$2,121 |
4.1× |
| MRI abdomen w contrast (74182) |
$1,606 |
$2,920 |
3.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,309.45 |
$4,199 |
5.5× |
| MRI abdomen w/o contrast (74181) |
$1,284.25 |
$2,335 |
4.5× |
| MRI any jnt lwr ext with con lt (73722) |
$2,311.65 |
$4,203 |
2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,643.85 |
$4,807 |
2.8× |
| MRI bone marrow blood supply (77084) |
$611.05 |
$1,111 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$611.05 |
$1,111 |
2.1× |
| MRI breast w/o contrast unilat (77046) |
$1,771.09 |
$3,220.16 |
6.2× |
| MRI c-spine with contrast (72142) |
$1,877.15 |
$3,413 |
4.5× |
| MRI cardiac w/o contrast (75557) |
$1,361.25 |
$2,475 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,795.20 |
$3,264 |
6.3× |
| MRI chest w/o & w/contrast material (71552) |
$3,132.25 |
$5,695 |
7.5× |
| MRI chest w/o contrast (71550) |
$1,586.20 |
$2,884 |
5.5× |
| MRI chest with contrast (71551) |
$1,997.05 |
$3,631 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,856.80 |
$3,376 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,758.08 |
$3,196.50 |
4.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,893.65 |
$3,443 |
6.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,733.60 |
$3,152 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,336.95 |
$4,249 |
5.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,812.80 |
$3,296 |
4.3× |
| MRI pelvis w contrast (72196) |
$1,706.10 |
$3,102 |
4.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,309.45 |
$4,199 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$1,632.40 |
$2,968 |
5.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,806.10 |
$5,102 |
6.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,957.90 |
$5,378 |
7.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,391.30 |
$6,166 |
8.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,777.60 |
$3,232 |
4.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,558.50 |
$6,470 |
8.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,851.30 |
$3,366 |
4.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,213.10 |
$5,842 |
7.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,739.10 |
$3,162 |
6.1× |
| MRI tmj (70336) |
$1,953.60 |
$3,552 |
6.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,804.55 |
$3,281 |
6.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,830.30 |
$5,146 |
6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,887.32 |
$3,431.50 |
6.6× |
| Myelogram Cervical (72240) |
$1,997.05 |
$3,631 |
2.1× |
| Myelogram Lumbar (72265) |
$1,997.05 |
$3,631 |
2.1× |
| Myelogram thoracic (72255) |
$1,997.05 |
$3,631 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,792.25 |
$6,895 |
2.4× |
| Neck soft tissue (70360) |
$288.20 |
$524 |
2.8× |
| Nm bone marrow wb (78104) |
$1,028.50 |
$1,870 |
2.1× |
| Nm gastric emptying study (78264) |
$1,278.20 |
$2,324 |
2.7× |
| Nm gastroesophageal reflux study (78262) |
$1,028.50 |
$1,870 |
2.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$3,541.45 |
$6,439 |
2.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,028.50 |
$1,870 |
2.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,028.50 |
$1,870 |
2.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,348.05 |
$2,451 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$890.45 |
$1,619 |
3.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$275 |
$500 |
2.2× |
| Osseous survey infant (77076) |
$290.40 |
$528 |
2.3× |
| Osseous survey limited (77074) |
$453.20 |
$824 |
3.6× |
| Parathyrd planar w/wo subtrj (78071) |
$2,042.70 |
$3,714 |
4.3× |
| Parathyroid imaging (78070) |
$1,653.85 |
$3,007 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$327.80 |
$596 |
2.6× |
| PET image w/CT, skull-thigh (78815) |
$3,901.70 |
$7,094 |
2.3× |
| PET imaging CT for attenuation limited area (78814) |
$3,901.70 |
$7,094 |
2.3× |
| PET imaging for CT attenuation whole body (78816) |
$5,302 |
$9,640 |
3.1× |
| PET imaging limited area chest head/neck (78811) |
$3,541.45 |
$6,439 |
2.3× |
| Pr heart first pass single,planar (78481) |
$1,348.05 |
$2,451 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,135.82 |
$5,701.50 |
7.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,949.70 |
$14,454 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,028.50 |
$1,870 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,348.05 |
$2,451 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,376.10 |
$2,502 |
2.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$462 |
$840 |
4.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$533.50 |
$970 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$756.80 |
$1,376 |
6.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$583.55 |
$1,061 |
4.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$607.75 |
$1,105 |
4.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$533.50 |
$970 |
4.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$257.40 |
$468 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$385.55 |
$701 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$276.10 |
$502 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$810.15 |
$1,473 |
3.9× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$611.05 |
$1,111 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$586.85 |
$1,067 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$774.40 |
$1,408 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$669.35 |
$1,217 |
6.4× |
| Radiological examination surgical specimen (76098) |
$1,376.10 |
$2,502 |
2.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$7,949.70 |
$14,454 |
2.1× |
| Ribs bilateral 3 views (71110) |
$415.25 |
$755 |
3.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,016.30 |
$3,666 |
4.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,541.45 |
$6,439 |
5.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,796.10 |
$6,902 |
5.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,796.10 |
$6,902 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,305.95 |
$7,829 |
2.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,796.10 |
$6,902 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$642.40 |
$1,168 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$275 |
$500 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$699.05 |
$1,271 |
2.4× |
| Scanogram (77073) |
$400.95 |
$729 |
3.2× |
| Scapula complete (73010) |
$696.85 |
$1,267 |
5.6× |
| Screening digital breast tomosynthesis (77063) |
$84.42 |
$153.50 |
3.6× |
| Sella turcica (70240) |
$338.80 |
$616 |
3.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$275 |
$500 |
2.2× |
| Sialogram (70390) |
$656.15 |
$1,193 |
2.3× |
| Small bowel series (74250) |
$676.50 |
$1,230 |
3.2× |
| Spine thoracic 3 views (72072) |
$275 |
$500 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,474.45 |
$4,499 |
3.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,028.50 |
$1,870 |
2.1× |
| Thyroid uptake measurement (78012) |
$1,028.50 |
$1,870 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,028.50 |
$1,870 |
2.1× |
| Tmj unilateral (70328) |
$339.35 |
$617 |
3.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,541.45 |
$6,439 |
5.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,098.35 |
$1,997 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$651.20 |
$1,184 |
5.2× |
| Umbilical-artery Doppler (OB) (76820) |
$292.05 |
$531 |
2.3× |
| Upper Extremity Infant (73092) |
$315.70 |
$574 |
2.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,028.50 |
$1,870 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$611.05 |
$1,111 |
2.1× |
| Urethrocystography voiding (74455) |
$685.85 |
$1,247 |
2.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$935 |
$1,700 |
4.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,560.90 |
$2,838 |
7.4× |
| Us abdl aorta screen aaa (76706) |
$591.80 |
$1,076 |
4.7× |
| Us breast unilateral complete (76641) |
$454.85 |
$827 |
3.6× |
| Us breast unilateral limited (76642) |
$443.30 |
$806 |
4.2× |
| Us chest (76604) |
$498.85 |
$907 |
4.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$275 |
$500 |
2.2× |
| Us guided compression repair (76936) |
$782.65 |
$1,423 |
3.0× |
| Us ob detailed single fetus (76811) |
$611.05 |
$1,111 |
2.1× |
| Us ob transvaginal (76817) |
$676.50 |
$1,230 |
5.4× |
| Us pelvic non ob complete (76856) |
$598.12 |
$1,087.50 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$380.05 |
$691 |
3.0× |
| Us pregnancy ltd (76815) |
$275 |
$500 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$442.20 |
$804 |
3.5× |
| Us retroperitoneal complete (76770) |
$922.35 |
$1,677 |
7.4× |
| Us retroperitoneal limited (76775) |
$651.20 |
$1,184 |
5.2× |
| Us scrotum and contents (76870) |
$645.70 |
$1,174 |
5.2× |
| Us soft tissue head/neck (76536) |
$526.90 |
$958 |
4.2× |
| Us transrectal (76872) |
$1,028.50 |
$1,870 |
8.2× |
| Us xtr non-vasc lmtd (76882) |
$275 |
$500 |
2.2× |
| Vascular flow imaging (78445) |
$1,028.50 |
$1,870 |
2.1× |
| Venogram extremity bilateral (75822) |
$3,994.10 |
$7,262 |
2.1× |
| Venography caval inferior serialography rs&i (75825) |
$7,949.70 |
$14,454 |
2.1× |
| Venography caval superior serialography rs&i (75827) |
$3,994.10 |
$7,262 |
2.1× |
| Venography extremity unilateral rs&i (75820) |
$3,994.10 |
$7,262 |
2.1× |
| Venography Renal Bilateral (75833) |
$7,949.70 |
$14,454 |
2.1× |
| Venography renal unilateral selective rs&i (75831) |
$7,949.70 |
$14,454 |
2.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$13,706 |
$24,920 |
2.1× |
| Vertebral fracture assessment via dxa (77086) |
$226.60 |
$412 |
2.2× |
| Wrist 2 views (73100) |
$455.40 |
$828 |
4.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$763.95 |
$1,389 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$383.35 |
$697 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$468.05 |
$851 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,398.65 |
$2,543 |
6.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$408.10 |
$742 |
3.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$463.65 |
$843 |
4.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$508.75 |
$925 |
4.1× |
| X-ray exam hip uni 1 view (73501) |
$226.60 |
$412 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$402.05 |
$731 |
3.9× |
| X-ray exam hip uni 4/> views (73503) |
$365.20 |
$664 |
2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$812.90 |
$1,478 |
6.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$810.15 |
$1,473 |
6.5× |
| X-ray exam of femur 1 (73551) |
$669.35 |
$1,217 |
6.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$733.42 |
$1,333.50 |
3.5× |
| X-ray eye for foreign body (70030) |
$368.50 |
$670 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$502.70 |
$914 |
4.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$297.55 |
$541 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$479.05 |
$871 |
4.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$5,261.30 |
$9,566 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$521.12 |
$947.50 |
5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$226.60 |
$412 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$480.15 |
$873 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$263.45 |
$479 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$315.70 |
$574 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$337.15 |
$613 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$509.85 |
$927 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$344.30 |
$626 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$237.60 |
$432 |
2.3× |
| X-ray of voice box or throat (70370) |
$432.30 |
$786 |
4.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$522.50 |
$950 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$377.85 |
$687 |
3.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$2,159.30 |
$3,926 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$244.75 |
$445 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$497.20 |
$904 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$664.40 |
$1,208 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$403.70 |
$734 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$349.25 |
$635 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$664.12 |
$1,207.50 |
6.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$580.25 |
$1,055 |
5.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$496.10 |
$902 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$524.70 |
$954 |
4.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$524.70 |
$954 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$426.80 |
$776 |
4.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$490.05 |
$891 |
4.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$407 |
$740 |
3.9× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$226.60 |
$412 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$380.60 |
$692 |
3.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$509.30 |
$926 |
4.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$446.60 |
$812 |
4.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$455.40 |
$828 |
4.4× |
| Xr arthrogram ankle (73615) |
$959.20 |
$1,744 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$624.80 |
$1,136 |
5.0× |
| Xr chest 4+ views (71048) |
$360.25 |
$655 |
2.9× |
| Xr Cholecystography Oral Contrast (74290) |
$463.65 |
$843 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$348.15 |
$633 |
3.3× |
| Xr shoulder 1 view (73020) |
$451.82 |
$821.50 |
4.3× |
| Xr spine cervical 4 or 5 views (72050) |
$606.65 |
$1,103 |
4.8× |
| Xr tibia/fibula 2 views (73590) |
$660.28 |
$1,200.50 |
6.3× |
| Xr tmj bilateral (70330) |
$276.10 |
$502 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$334.95 |
$609 |
3.2× |