| Abdomen 2 views (74019) |
$447 |
$470 |
4.1× |
| Ankle 2 views (73600) |
$323 |
$340 |
3.6× |
| Arthrogram hip (73525) |
$920 |
$968 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,283 |
$1,350 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$2,175 |
$2,289 |
5.2× |
| Bone age studies (77072) |
$278 |
$293 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$2,469 |
$2,599 |
5.9× |
| Bone survey complete (77075) |
$1,047 |
$1,102 |
9.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,149 |
$7,525 |
4.8× |
| Cervical spine 2 or 3 views (72040) |
$422 |
$444 |
4.7× |
| Chest 1 view (71045) |
$314 |
$331 |
3.5× |
| Chest 3 views (71047) |
$462 |
$486 |
5.1× |
| Clavicle complete (73000) |
$338 |
$356 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,204 |
$6,530 |
17.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,655 |
$4,900 |
18.8× |
| CT abdomen w contrast (74160) |
$2,972 |
$3,128 |
16.3× |
| CT abdomen w wo contrast (74170) |
$3,594 |
$3,783 |
19.7× |
| CT abdomen w/o contrast (74150) |
$2,598 |
$2,735 |
23.9× |
| CT angiography upper extremity lt (73206) |
$3,082 |
$3,244 |
16.9× |
| CT c-spine w/o contrast (72125) |
$2,798 |
$2,945 |
25.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,952 |
$3,107 |
16.2× |
| CT cervical spine with contrast (72126) |
$2,891 |
$3,043 |
8.0× |
| CT chest w/wo contrast (71270) |
$3,586 |
$3,775 |
19.7× |
| CT chest with contrast (71260) |
$2,960 |
$3,116 |
16.3× |
| CT head/brain with contrast (70460) |
$3,674 |
$3,867 |
20.2× |
| CT head/brain without and with contrast (70470) |
$2,837 |
$2,986 |
15.6× |
| CT iac w contrast (70481) |
$2,852 |
$3,002 |
15.7× |
| CT lower ext w/o (73700) |
$2,484 |
$2,615 |
22.9× |
| CT lower extremity w wo contrast (73702) |
$3,250 |
$3,421 |
17.8× |
| CT lower extremity with contrast (73701) |
$2,745 |
$2,889 |
15.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,374 |
$3,552 |
18.5× |
| CT lumbar spine w/o contrast (72131) |
$2,716 |
$2,859 |
25.0× |
| CT lumbar spine with contrast (72132) |
$3,068 |
$3,229 |
8.5× |
| CT maxillofacial w contrast (70487) |
$2,565 |
$2,700 |
14.1× |
| CT maxillofacial w/o contrast (70486) |
$2,191 |
$2,306 |
20.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,771 |
$2,917 |
15.2× |
| CT neck soft tissue w contrast (70491) |
$2,704 |
$2,846 |
14.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,750 |
$2,895 |
15.1× |
| CT orbits w/o contrast (70480) |
$2,518 |
$2,651 |
23.2× |
| CT pelvis w & w/o contrast (72194) |
$3,123 |
$3,287 |
17.1× |
| CT pelvis w/o contrast (72192) |
$2,575 |
$2,711 |
23.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,281 |
$3,454 |
18.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,623 |
$2,761 |
24.2× |
| CT thoracic spine w/contrast (72129) |
$2,930 |
$3,084 |
16.1× |
| CT thoracic spine w/o contrast (72128) |
$2,665 |
$2,805 |
24.5× |
| CT thoracic spine w/wo contrast (72130) |
$2,903 |
$3,056 |
15.9× |
| CT thorax w/o contrast (71250) |
$2,689 |
$2,831 |
24.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,082 |
$3,244 |
16.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,427 |
$2,555 |
22.4× |
| CT upper extremity with contrast (73201) |
$2,648 |
$2,787 |
7.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,297 |
$5,576 |
29.1× |
| Cta Abdomen (74175) |
$3,693 |
$3,887 |
20.3× |
| CTA abdomen pelvis (74174) |
$6,527 |
$6,871 |
18.0× |
| CTA chest (71275) |
$3,766 |
$3,964 |
20.7× |
| Cta Head (70496) |
$3,476 |
$3,659 |
19.1× |
| CTA lwr ext w&w/o contrast (73706) |
$3,080 |
$3,242 |
16.9× |
| Cta Neck (70498) |
$3,418 |
$3,598 |
18.8× |
| Cta Pelvis (72191) |
$3,210 |
$3,379 |
17.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$537 |
$565 |
4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$537 |
$565 |
5.9× |
| Esophagus (74220) |
$789 |
$831 |
4.3× |
| Fetal biophysical profile non-stress testing (76818) |
$710 |
$747 |
6.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$543 |
$572 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$760 |
$800 |
3.1× |
| Foot 2 views (73620) |
$305 |
$321 |
3.4× |
| Forearm 2 views (73090) |
$399 |
$420 |
4.4× |
| Hand 2 views (73120) |
$328 |
$345 |
3.0× |
| Hand 3 views (73130) |
$401 |
$422 |
4.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,165 |
$2,279 |
3.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,030 |
$2,137 |
4.9× |
| Ht muscle image spect sing (78451) |
$3,542 |
$3,728 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$385 |
$405 |
4.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,888 |
$1,987 |
3.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,766 |
$2,912 |
4.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,546 |
$2,680 |
4.5× |
| Knee 3 views (73562) |
$427 |
$449 |
4.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$34 |
$36 |
1.1× |
| MRA head w/o contrast (70544) |
$3,878 |
$4,082 |
15.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,385 |
$4,616 |
12.1× |
| MRA neck w/o contrast (70547) |
$3,547 |
$3,734 |
14.3× |
| MRI abdomen w contrast (74182) |
$3,658 |
$3,851 |
10.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,127 |
$5,397 |
14.2× |
| MRI abdomen w/o contrast (74181) |
$3,801 |
$4,001 |
15.3× |
| MRI any jnt lwr ext with con lt (73722) |
$3,995 |
$4,205 |
4.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,366 |
$3,543 |
4.1× |
| MRI c-spine with contrast (72142) |
$4,272 |
$4,497 |
11.8× |
| MRI cervical spine w/o contrast (72141) |
$3,928 |
$4,135 |
15.9× |
| MRI chest w/o & w/contrast material (71552) |
$3,658 |
$3,851 |
10.1× |
| MRI chest w/o contrast (71550) |
$3,220 |
$3,389 |
13.0× |
| MRI chest with contrast (71551) |
$3,439 |
$3,620 |
4.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,781 |
$2,927 |
7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,036 |
$3,196 |
8.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,234 |
$3,404 |
13.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,727 |
$3,923 |
15.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,442 |
$4,676 |
12.3× |
| MRI orbit/face/neck w/contrast (70542) |
$3,439 |
$3,620 |
9.5× |
| MRI pelvis w contrast (72196) |
$3,439 |
$3,620 |
9.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,782 |
$5,034 |
13.2× |
| MRI pelvis w/o contrast (72195) |
$3,514 |
$3,699 |
14.2× |
| MRI scan of arm joint before and after contrast (73223) |
$4,492 |
$4,728 |
12.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,853 |
$4,056 |
10.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,067 |
$5,334 |
14.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,634 |
$3,825 |
10.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,693 |
$4,940 |
13.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,439 |
$3,620 |
9.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,127 |
$5,397 |
14.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,995 |
$4,205 |
16.1× |
| MRI tmj (70336) |
$2,562 |
$2,697 |
10.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,936 |
$3,091 |
11.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,404 |
$4,636 |
12.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,189 |
$3,357 |
12.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,815 |
$5,068 |
3.6× |
| Neck soft tissue (70360) |
$357 |
$376 |
4.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$501 |
$527 |
4.6× |
| Osseous survey infant (77076) |
$936 |
$985 |
8.6× |
| Osseous survey limited (77074) |
$693 |
$729 |
6.4× |
| Parathyroid imaging (78070) |
$1,661 |
$1,748 |
4.0× |
| Pelvis 1 or 2 views (72170) |
$404 |
$425 |
3.7× |
| PET image w/CT, skull-thigh (78815) |
$8,254 |
$8,688 |
5.6× |
| PET imaging for CT attenuation whole body (78816) |
$9,721 |
$10,233 |
6.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,050 |
$4,263 |
11.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,857 |
$1,955 |
3.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$354 |
$373 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$622 |
$655 |
5.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$309 |
$325 |
2.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$335 |
$353 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$479 |
$504 |
4.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$349 |
$367 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$428 |
$451 |
3.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$395 |
$416 |
4.4× |
| Radiologic exam colon single contrast study (74270) |
$979 |
$1,031 |
5.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$751 |
$791 |
4.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,108.50 |
$1,166.50 |
6.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$393 |
$414 |
4.3× |
| Radiological examination surgical specimen (76098) |
$233 |
$245 |
0.4× |
| Ribs bilateral 3 views (71110) |
$467 |
$492 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,958 |
$2,061 |
3.5× |
| Sacroiliac Joints < 3 Views (72200) |
$414 |
$436 |
3.8× |
| Scapula complete (73010) |
$447 |
$471 |
4.1× |
| Screening digital breast tomosynthesis (77063) |
$103 |
$108 |
4.4× |
| Spine thoracic 3 views (72072) |
$623 |
$656 |
5.7× |
| Ultrasound, abdomen limited (76705) |
$777 |
$818 |
7.2× |
| Upper Extremity Infant (73092) |
$332 |
$349 |
3.1× |
| Urethrocystography retrograde rs&i (74450) |
$593 |
$624 |
2.4× |
| Urethrocystography voiding (74455) |
$916 |
$964 |
3.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,587 |
$1,671 |
8.7× |
| Us abdl aorta screen aaa (76706) |
$753 |
$793 |
6.9× |
| Us breast unilateral complete (76641) |
$808 |
$850 |
7.4× |
| Us breast unilateral limited (76642) |
$447 |
$470 |
4.9× |
| Us chest (76604) |
$637 |
$670 |
5.9× |
| Us infant hips limited static (76886) |
$855 |
$900 |
9.5× |
| Us kidney transplant (76776) |
$895 |
$942 |
8.2× |
| Us ob transvaginal (76817) |
$701 |
$738 |
6.5× |
| Us pelvic non ob complete (76856) |
$1,001 |
$1,054 |
9.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$612 |
$644 |
5.6× |
| Us pregnancy ltd (76815) |
$523 |
$551 |
4.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$862 |
$907 |
7.9× |
| Us retroperitoneal complete (76770) |
$955 |
$1,005 |
8.8× |
| Us retroperitoneal limited (76775) |
$763 |
$803 |
7.0× |
| Us scrotum and contents (76870) |
$907 |
$955 |
8.4× |
| Us soft tissue head/neck (76536) |
$751 |
$790 |
6.9× |
| Us spinal canal and contents (76800) |
$774 |
$815 |
7.1× |
| Us transrectal (76872) |
$834 |
$878 |
7.7× |
| Us xtr non-vasc lmtd (76882) |
$666 |
$701 |
6.1× |
| Wrist 2 views (73100) |
$315 |
$332 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$671 |
$706 |
6.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$315 |
$332 |
3.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$398 |
$419 |
4.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,170 |
$1,232 |
6.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$358 |
$377 |
4.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$427 |
$449 |
4.7× |
| X-ray exam hip uni 1 view (73501) |
$309 |
$325 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$394 |
$415 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$309 |
$325 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$754 |
$794 |
6.9× |
| X-ray eye for foreign body (70030) |
$290 |
$305 |
3.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$466 |
$490 |
4.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$333 |
$350 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$395 |
$416 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$287 |
$302 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$347 |
$365 |
3.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$453 |
$477 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$278 |
$293 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$271 |
$285 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$548 |
$577 |
5.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$865 |
$911 |
8.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$581 |
$612 |
5.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$390 |
$410 |
4.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$373 |
$393 |
4.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$518 |
$545 |
4.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$527 |
$555 |
4.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$419 |
$441.50 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$371 |
$391 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$399 |
$420 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$394 |
$415 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$391 |
$412 |
4.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$427 |
$449 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$533 |
$561 |
5.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$379 |
$399 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$372 |
$392 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$372 |
$392 |
3.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$366 |
$385 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$418 |
$440 |
3.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$648 |
$682 |
6.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$277 |
$292 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$398 |
$419 |
4.4× |
| Xr c-spine 6 or more views (72052) |
$740 |
$779 |
6.8× |
| Xr finger(s) 2+ views (73140) |
$279 |
$294 |
3.1× |
| Xr shoulder 1 view (73020) |
$279 |
$294 |
3.1× |
| Xr spine cervical 4 or 5 views (72050) |
$567 |
$597 |
5.2× |
| Xr tibia/fibula 2 views (73590) |
$426 |
$448 |
4.7× |
| Xr tmj bilateral (70330) |
$549 |
$578 |
6.1× |
| Xray knee 1 or 2 views rt (73560) |
$454 |
$478 |
5.0× |