| Abdomen 2 views (74019) |
$630 |
$700 |
6.0× |
| Ankle 2 views (73600) |
$1,044.81 |
$1,160.90 |
12.0× |
| Bone &/joint imaging whole body (78306) |
$4,915.89 |
$5,462.10 |
12.2× |
| Bone Imaging 3 Phase (78315) |
$10,551.38 |
$11,723.76 |
26.3× |
| Cervical spine 2 or 3 views (72040) |
$360 |
$400 |
4.1× |
| Chest 1 view (71045) |
$360 |
$400 |
4.1× |
| Chest 3 views (71047) |
$853.02 |
$947.80 |
9.8× |
| Clavicle complete (73000) |
$360 |
$400 |
4.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$16,516.77 |
$18,351.97 |
47.1× |
| CT abdomen and pelvis without contrast (74176) |
$14,299.02 |
$15,887.80 |
59.7× |
| CT abdomen w contrast (74160) |
$10,688.43 |
$11,876.03 |
60.7× |
| CT abdomen w wo contrast (74170) |
$10,523.34 |
$11,692.60 |
59.7× |
| CT abdomen w/o contrast (74150) |
$11,645.10 |
$12,939 |
110.9× |
| CT angio hrt w/3d image (75574) |
$8,589.33 |
$9,543.70 |
24.5× |
| CT c-spine w/o contrast (72125) |
$7,633.36 |
$8,481.51 |
72.7× |
| CT cervical spine w&w/o contrast (72127) |
$9,578.85 |
$10,643.17 |
54.4× |
| CT cervical spine with contrast (72126) |
$9,610.20 |
$10,678 |
27.4× |
| CT chest w/wo contrast (71270) |
$10,341.07 |
$11,490.08 |
58.7× |
| CT chest with contrast (71260) |
$10,687.50 |
$11,875 |
60.7× |
| CT head/brain with contrast (70460) |
$6,868.23 |
$7,631.37 |
39.0× |
| CT head/brain without and with contrast (70470) |
$9,411.84 |
$10,457.60 |
53.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$384.75 |
$427.50 |
4.4× |
| CT iac w contrast (70481) |
$9,297.27 |
$10,330.30 |
52.8× |
| CT lower ext w/o (73700) |
$3,968.49 |
$4,409.43 |
37.8× |
| CT lower extremity with contrast (73701) |
$2,736 |
$3,040 |
15.5× |
| CT lumbar spine w/o contrast (72131) |
$6,749.37 |
$7,499.30 |
64.3× |
| CT lumbar spine with contrast (72132) |
$2,565 |
$2,850 |
7.3× |
| CT maxillofacial w contrast (70487) |
$10,687.50 |
$11,875 |
60.7× |
| CT maxillofacial w/o contrast (70486) |
$6,022.20 |
$6,691.33 |
57.3× |
| CT maxillofacial w/wo contrast (70488) |
$7,116.30 |
$7,907 |
40.4× |
| CT neck soft tissue w contrast (70491) |
$6,030.94 |
$6,701.05 |
34.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$10,218.26 |
$11,353.62 |
58.0× |
| CT orbits w/o contrast (70480) |
$6,749.37 |
$7,499.30 |
64.3× |
| CT pelvis w/o contrast (72192) |
$6,749.37 |
$7,499.30 |
64.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$6,474.92 |
$7,194.35 |
36.7× |
| CT soft tissue neck w/o contrast (70490) |
$6,798.96 |
$7,554.40 |
64.7× |
| CT thoracic spine w/contrast (72129) |
$2,419.99 |
$2,688.88 |
13.7× |
| CT thoracic spine w/o contrast (72128) |
$3,288.33 |
$3,653.70 |
31.3× |
| CT thorax w/o contrast (71250) |
$5,266.80 |
$5,852 |
50.2× |
| CT upper extremity w/o contrast rt (73200) |
$16,746.03 |
$18,606.70 |
159.5× |
| CT upper extremity with contrast (73201) |
$6,783.42 |
$7,537.13 |
19.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$10,102.68 |
$11,225.20 |
57.3× |
| Cta Abdomen (74175) |
$6,908.40 |
$7,676 |
39.2× |
| CTA abdomen pelvis (74174) |
$15,238.46 |
$16,931.62 |
43.5× |
| CTA chest (71275) |
$10,820.88 |
$12,023.20 |
61.4× |
| Cta Head (70496) |
$11,833.20 |
$13,148 |
67.2× |
| CTA lwr ext w&w/o contrast (73706) |
$13,366.08 |
$14,851.20 |
75.9× |
| Cta Neck (70498) |
$10,248.03 |
$11,386.70 |
58.2× |
| Cta Pelvis (72191) |
$7,233.30 |
$8,037 |
41.1× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$812.25 |
$902.50 |
7.7× |
| Fluoroscopy up to 1 hr (76000) |
$2,457.23 |
$2,730.26 |
10.3× |
| Foot 2 views (73620) |
$450 |
$500 |
5.1× |
| Forearm 2 views (73090) |
$360 |
$400 |
4.1× |
| Functional MRI brain by tech (70554) |
$2,610 |
$2,900 |
10.9× |
| Hand 2 views (73120) |
$360 |
$400 |
3.4× |
| Hand 3 views (73130) |
$360 |
$400 |
4.1× |
| Humerus Min 2 Views Left (73060) |
$360 |
$400 |
4.1× |
| Knee 3 views (73562) |
$450 |
$500 |
5.1× |
| MRA head w & w/o contrast (70546) |
$19,853.10 |
$22,059 |
56.6× |
| MRA head w/o contrast (70544) |
$6,405.66 |
$7,117.40 |
26.7× |
| MRA neck w/o contrast (70547) |
$8,886.87 |
$9,874.30 |
37.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,610 |
$2,900 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$2,610 |
$2,900 |
10.9× |
| MRI chest w/o contrast (71550) |
$7,175.70 |
$7,973 |
29.9× |
| MRI chest with contrast (71551) |
$2,880 |
$3,200 |
3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,610 |
$2,900 |
10.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$7,020 |
$7,800 |
20.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,610 |
$2,900 |
7.4× |
| MRI pelvis w/o contrast (72195) |
$2,610 |
$2,900 |
10.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,610 |
$2,900 |
7.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,610 |
$2,900 |
7.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,610 |
$2,900 |
7.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,610 |
$2,900 |
7.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,610 |
$2,900 |
7.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,610 |
$2,900 |
10.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,610 |
$2,900 |
10.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,610 |
$2,900 |
7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,610 |
$2,900 |
10.9× |
| Neck soft tissue (70360) |
$1,335.34 |
$1,483.71 |
15.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$3,182.65 |
$3,536.28 |
30.3× |
| Pelvis 1 or 2 views (72170) |
$360 |
$400 |
3.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$634.16 |
$704.62 |
6.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,804.05 |
$2,004.50 |
17.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$634.50 |
$705 |
6.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,105.31 |
$1,228.12 |
10.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$540 |
$600 |
6.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,026 |
$1,140 |
9.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$720.27 |
$800.30 |
8.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,704.87 |
$1,894.30 |
9.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$450 |
$500 |
5.1× |
| Ribs bilateral 3 views (71110) |
$1,311.95 |
$1,457.72 |
12.5× |
| Sacroiliac Joints < 3 Views (72200) |
$769.50 |
$855 |
7.3× |
| Scapula complete (73010) |
$360 |
$400 |
3.4× |
| Spine thoracic 3 views (72072) |
$405 |
$450 |
3.9× |
| Thoracolumbar 2 views (72080) |
$410.40 |
$456 |
4.7× |
| Tmj unilateral (70328) |
$1,733.94 |
$1,926.60 |
19.8× |
| Ultrasound, abdomen limited (76705) |
$2,147.76 |
$2,386.40 |
20.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,350 |
$1,500 |
15.4× |
| Us breast unilateral complete (76641) |
$742.72 |
$825.25 |
7.1× |
| Us breast unilateral limited (76642) |
$427.50 |
$475 |
4.9× |
| Us chest (76604) |
$1,248.30 |
$1,387 |
11.9× |
| Us compl joint r-t w/image documentation (76881) |
$2,465.82 |
$2,739.80 |
23.5× |
| Us ob detailed single fetus (76811) |
$3,059.19 |
$3,399.10 |
12.8× |
| Us ob transvaginal (76817) |
$902.88 |
$1,003.20 |
8.6× |
| Us pelvic non ob complete (76856) |
$2,147.76 |
$2,386.40 |
20.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$684 |
$760 |
6.5× |
| Us pregnancy ltd (76815) |
$1,040.48 |
$1,156.09 |
9.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$2,007.54 |
$2,230.60 |
19.1× |
| Us retroperitoneal complete (76770) |
$2,147.76 |
$2,386.40 |
20.5× |
| Us retroperitoneal limited (76775) |
$903 |
$1,003.33 |
8.6× |
| Us scrotum and contents (76870) |
$2,343.18 |
$2,603.53 |
22.3× |
| Us soft tissue head/neck (76536) |
$983.25 |
$1,092.50 |
9.4× |
| Us transrectal (76872) |
$726.75 |
$807.50 |
6.9× |
| Us xtr non-vasc lmtd (76882) |
$1,391.37 |
$1,545.97 |
13.2× |
| Us, eye b-scan (76512) |
$769.50 |
$855 |
7.3× |
| Wrist 2 views (73100) |
$360 |
$400 |
4.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$675 |
$750 |
6.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,082.70 |
$1,203 |
12.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$450 |
$500 |
5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$360 |
$400 |
4.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$360 |
$400 |
4.1× |
| X-ray exam hip uni 1 view (73501) |
$1,027.71 |
$1,141.90 |
11.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$450 |
$500 |
5.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$513 |
$570 |
4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$3,609.81 |
$4,010.90 |
34.4× |
| X-ray exam of femur 1 (73551) |
$726.75 |
$807.50 |
8.3× |
| X-ray eye for foreign body (70030) |
$1,653.57 |
$1,837.30 |
18.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$1,269.56 |
$1,410.62 |
12.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$299.25 |
$332.50 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$450 |
$500 |
5.1× |
| X-ray head for orthodontia (70350) |
$1,024.29 |
$1,138.10 |
11.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$540 |
$600 |
6.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$555.75 |
$617.50 |
6.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,149.86 |
$1,277.62 |
10.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$564.30 |
$627 |
6.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$721.80 |
$802 |
8.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$405 |
$450 |
3.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$360 |
$400 |
3.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$585 |
$650 |
5.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$1,045.32 |
$1,161.47 |
12.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$831.44 |
$923.82 |
9.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,084.77 |
$1,205.30 |
10.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,350 |
$1,500 |
3.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,538.07 |
$1,708.97 |
17.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,044.81 |
$1,160.90 |
9.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$769.50 |
$855 |
7.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$427.50 |
$475 |
4.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$360 |
$400 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,044.81 |
$1,160.90 |
12.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$1,044.81 |
$1,160.90 |
12.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$812.25 |
$902.50 |
7.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$636.50 |
$707.22 |
6.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$360 |
$400 |
4.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$720 |
$800 |
8.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$1,359.22 |
$1,510.25 |
15.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$360 |
$400 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$360 |
$400 |
4.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$360 |
$400 |
4.1× |
| Xr c-spine 6 or more views (72052) |
$450 |
$500 |
4.3× |
| Xr finger(s) 2+ views (73140) |
$450 |
$500 |
5.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$1,094.40 |
$1,216 |
10.4× |
| Xr shoulder 1 view (73020) |
$360 |
$400 |
4.1× |
| Xr spine cervical 4 or 5 views (72050) |
$360 |
$400 |
3.4× |
| Xr tibia/fibula 2 views (73590) |
$982 |
$1,091.11 |
11.2× |
| Xray knee 1 or 2 views rt (73560) |
$450 |
$500 |
5.1× |