| Abdomen 2 views (74019) |
$318 |
$424 |
2.9× |
| Ankle 2 views (73600) |
$203 |
$270 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$915 |
$1,220 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$1,525 |
$2,033 |
3.7× |
| Bone age studies (77072) |
$195 |
$260 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,679 |
$2,238 |
4.0× |
| Bone survey complete (77075) |
$663 |
$884 |
6.1× |
| Cervical spine 2 or 3 views (72040) |
$287 |
$382 |
3.2× |
| Chest 1 view (71045) |
$215 |
$287 |
2.4× |
| Chest 3 views (71047) |
$224 |
$298 |
2.5× |
| Clavicle complete (73000) |
$230 |
$307 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,421 |
$1,894 |
13.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,103 |
$5,471 |
11.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,930 |
$3,907 |
11.8× |
| CT abdomen w contrast (74160) |
$2,036 |
$2,715 |
11.2× |
| CT abdomen w wo contrast (74170) |
$2,375 |
$3,167 |
13.0× |
| CT abdomen w/o contrast (74150) |
$1,856 |
$2,474 |
17.1× |
| CT c-spine w/o contrast (72125) |
$1,880 |
$2,507 |
17.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,126 |
$2,834 |
11.7× |
| CT cervical spine with contrast (72126) |
$2,004 |
$2,672 |
5.5× |
| CT chest w/wo contrast (71270) |
$2,280 |
$3,040 |
12.5× |
| CT chest with contrast (71260) |
$2,126 |
$2,834 |
11.7× |
| CT head/brain with contrast (70460) |
$1,880 |
$2,507 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,028 |
$2,704 |
11.1× |
| CT iac w contrast (70481) |
$1,957 |
$2,609 |
10.7× |
| CT limited/localized follow up study (76380) |
$977 |
$1,303 |
10.8× |
| CT lower ext w/o (73700) |
$1,628 |
$2,171 |
15.0× |
| CT lower extremity w wo contrast (73702) |
$2,048 |
$2,730 |
11.2× |
| CT lower extremity with contrast (73701) |
$1,851 |
$2,468 |
10.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,126 |
$2,834 |
11.7× |
| CT lumbar spine w/o contrast (72131) |
$1,880 |
$2,507 |
17.3× |
| CT lumbar spine with contrast (72132) |
$2,004 |
$2,672 |
5.5× |
| CT maxillofacial w contrast (70487) |
$1,711 |
$2,281 |
9.4× |
| CT maxillofacial w/o contrast (70486) |
$1,516 |
$2,021 |
14.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,759 |
$2,345 |
9.7× |
| CT neck soft tissue w contrast (70491) |
$1,880 |
$2,507 |
10.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,004 |
$2,672 |
11.0× |
| CT orbits w/o contrast (70480) |
$1,759 |
$2,345 |
16.2× |
| CT pelvis w & w/o contrast (72194) |
$2,126 |
$2,834 |
11.7× |
| CT pelvis w/o contrast (72192) |
$1,870 |
$2,493 |
17.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,004 |
$2,672 |
11.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,759 |
$2,345 |
16.2× |
| CT thoracic spine w/contrast (72129) |
$2,004 |
$2,672 |
11.0× |
| CT thoracic spine w/o contrast (72128) |
$1,880 |
$2,507 |
17.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,126 |
$2,834 |
11.7× |
| CT thorax w/o contrast (71250) |
$1,965 |
$2,620 |
18.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,637 |
$2,183 |
15.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,802 |
$3,736 |
15.4× |
| Cta Abdomen (74175) |
$2,639 |
$3,518 |
14.5× |
| CTA abdomen pelvis (74174) |
$3,941 |
$5,255 |
10.9× |
| CTA chest (71275) |
$2,604 |
$3,472 |
14.3× |
| Cta Head (70496) |
$2,497 |
$3,329 |
13.7× |
| Cta Neck (70498) |
$2,482 |
$3,309 |
13.6× |
| Cystography minimum 3 views rs&i (74430) |
$479 |
$639 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$365 |
$486 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$167 |
$222 |
1.8× |
| Esophagus (74220) |
$522 |
$696 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$472 |
$629 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$419 |
$559 |
3.9× |
| Foot 2 views (73620) |
$206 |
$274 |
2.3× |
| Forearm 2 views (73090) |
$236 |
$314 |
2.6× |
| Gated Heart Planar Single (78472) |
$1,626 |
$2,168 |
3.9× |
| Hand 2 views (73120) |
$209 |
$278 |
1.9× |
| Hand 3 views (73130) |
$269 |
$358 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,466 |
$1,954 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,466 |
$1,954 |
3.5× |
| Ht muscle image spect sing (78451) |
$3,236 |
$4,314 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$259 |
$345 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$221 |
$294 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,351 |
$1,801 |
2.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,423 |
$1,897 |
2.5× |
| Knee 3 views (73562) |
$301 |
$401 |
3.3× |
| Liver imaging w/vascular flow (78202) |
$1,118 |
$1,491 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$1,703 |
$2,270 |
3.0× |
| Lung Ventilation Imaging (78579) |
$1,017 |
$1,356 |
2.4× |
| Meckels Diverticulum (78290) |
$1,068 |
$1,424 |
2.6× |
| MRA head w/o contrast (70544) |
$2,832 |
$3,776 |
11.4× |
| MRA head with contrast (70545) |
$2,939 |
$3,918 |
8.1× |
| MRA neck w contrast (70548) |
$2,972 |
$3,962 |
8.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,111 |
$4,148 |
8.6× |
| MRA neck w/o contrast (70547) |
$2,787 |
$3,716 |
11.2× |
| MRI abdomen w contrast (74182) |
$3,086 |
$4,114 |
8.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,236 |
$4,314 |
8.9× |
| MRI abdomen w/o contrast (74181) |
$2,776 |
$3,701 |
11.2× |
| MRI any jnt lwr ext with con lt (73722) |
$2,787 |
$3,716 |
3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,312 |
$3,083 |
2.8× |
| MRI c-spine with contrast (72142) |
$2,938 |
$3,917 |
8.1× |
| MRI cervical spine w/o contrast (72141) |
$2,787 |
$3,716 |
11.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,787 |
$3,716 |
7.7× |
| MRI chest w/o contrast (71550) |
$2,489 |
$3,318 |
10.0× |
| MRI chest with contrast (71551) |
$2,639 |
$3,518 |
3.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,340 |
$3,120 |
6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,563.50 |
$3,418 |
7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,190 |
$2,920 |
8.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,630 |
$3,506 |
10.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,086 |
$4,114 |
8.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,938 |
$3,917 |
8.1× |
| MRI pelvis w contrast (72196) |
$2,787 |
$3,716 |
7.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,938 |
$3,917 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$2,588 |
$3,451 |
10.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,787 |
$3,716 |
7.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,489 |
$3,318 |
6.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,086 |
$4,114 |
8.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,644 |
$3,525 |
7.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,086 |
$4,114 |
8.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,938 |
$3,917 |
8.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,086 |
$4,114 |
8.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,787 |
$3,716 |
11.2× |
| MRI tmj (70336) |
$2,489 |
$3,318 |
10.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,123 |
$2,830 |
8.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,489 |
$3,318 |
6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,091 |
$2,788 |
8.4× |
| Myocardial Spect Multiple Studies (78452) |
$3,446 |
$4,595 |
2.6× |
| Neck soft tissue (70360) |
$246 |
$328 |
2.7× |
| Nm gastric emptying study (78264) |
$1,466 |
$1,954 |
3.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$311 |
$414 |
2.9× |
| Osseous survey infant (77076) |
$427 |
$569 |
3.9× |
| Osseous survey limited (77074) |
$696 |
$928 |
6.4× |
| Parathyroid imaging (78070) |
$1,061 |
$1,415 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$236 |
$314 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,546 |
$3,394 |
7.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,017 |
$1,356 |
2.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$255 |
$340 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$435 |
$580 |
4.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$386 |
$515 |
3.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$199 |
$265 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$330 |
$440 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$226 |
$301 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$373 |
$497 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$236 |
$314 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$273 |
$364 |
3.0× |
| Ribs bilateral 3 views (71110) |
$358 |
$477 |
3.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,484 |
$1,979 |
2.6× |
| Sacroiliac Joints < 3 Views (72200) |
$284 |
$379 |
2.6× |
| Scapula complete (73010) |
$265 |
$353 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$192 |
$256 |
8.2× |
| Spine thoracic 3 views (72072) |
$395 |
$527 |
3.6× |
| Tmj unilateral (70328) |
$219 |
$292 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$550 |
$733 |
5.1× |
| Upper Extremity Infant (73092) |
$189 |
$252 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$499 |
$665 |
4.6× |
| Us breast unilateral complete (76641) |
$419 |
$559 |
3.9× |
| Us breast unilateral limited (76642) |
$315 |
$420 |
3.5× |
| Us chest (76604) |
$462 |
$616 |
4.3× |
| Us ob transvaginal (76817) |
$472 |
$629 |
4.3× |
| Us pelvic non ob complete (76856) |
$647 |
$862 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$297 |
$396 |
2.7× |
| Us pregnancy ltd (76815) |
$383 |
$510 |
3.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$545 |
$727 |
5.0× |
| Us retroperitoneal complete (76770) |
$613 |
$817 |
5.6× |
| Us retroperitoneal limited (76775) |
$506 |
$675 |
4.7× |
| Us scrotum and contents (76870) |
$563 |
$750 |
5.2× |
| Us soft tissue head/neck (76536) |
$482 |
$642 |
4.4× |
| Us xtr non-vasc lmtd (76882) |
$435 |
$580 |
4.0× |
| Wrist 2 views (73100) |
$189 |
$252 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$422 |
$562 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$251 |
$335 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$261 |
$348 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$212 |
$282 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$270 |
$360 |
3.0× |
| X-ray exam hip uni 1 view (73501) |
$174 |
$232 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$274 |
$365 |
3.0× |
| X-ray exam hip uni 4/> views (73503) |
$304 |
$405 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$452 |
$603 |
4.2× |
| X-ray exam of femur 1 (73551) |
$266 |
$354 |
2.9× |
| X-ray eye for foreign body (70030) |
$199 |
$265 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$355 |
$473 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$246 |
$328 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$277 |
$369 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$189 |
$252 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$219 |
$292 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$314 |
$419 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$189 |
$252 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$169 |
$225 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$372 |
$496 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$413 |
$550 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$268 |
$357 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$254 |
$339 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$296 |
$395 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$247 |
$329 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$337 |
$449 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$428 |
$570 |
3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$248 |
$330 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$293 |
$390 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$313 |
$417 |
3.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$207 |
$276 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$375 |
$500 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$229 |
$305 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$215 |
$287 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$246 |
$328 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$266 |
$355 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$293 |
$391 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$407 |
$543 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$185 |
$247 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$266 |
$354 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$479 |
$639 |
4.4× |
| Xr chest 4+ views (71048) |
$238 |
$317 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$188 |
$251 |
2.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$199 |
$265 |
1.8× |
| Xr optic foramina (70190) |
$207 |
$276 |
2.3× |
| Xr shoulder 1 view (73020) |
$205 |
$273 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$408 |
$544 |
3.8× |
| Xr tibia/fibula 2 views (73590) |
$248 |
$330 |
2.7× |
| Xr tmj bilateral (70330) |
$322 |
$429 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$258 |
$344 |
2.9× |