| Abdomen 2 views (74019) |
$487 |
$487 |
4.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,619 |
$2,619 |
6.3× |
| Ankle 2 views (73600) |
$339 |
$339 |
3.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,401 |
$1,401 |
3.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,768 |
$2,768 |
6.7× |
| Bone &/joint imaging whole body (78306) |
$2,197 |
$2,197 |
5.3× |
| Bone age studies (77072) |
$310 |
$310 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$2,750 |
$2,750 |
6.6× |
| Bone survey complete (77075) |
$1,128 |
$1,128 |
10.4× |
| Cervical spine 2 or 3 views (72040) |
$448 |
$448 |
5.0× |
| Chest 1 view (71045) |
$350 |
$350 |
3.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$847 |
$847 |
4.7× |
| Clavicle complete (73000) |
$371 |
$371 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$787 |
$787 |
7.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,773 |
$6,773 |
18.7× |
| CT abdomen and pelvis without contrast (74176) |
$5,088 |
$5,088 |
20.5× |
| CT abdomen w contrast (74160) |
$3,279 |
$3,279 |
18.0× |
| CT abdomen w wo contrast (74170) |
$3,775 |
$3,775 |
20.7× |
| CT abdomen w/o contrast (74150) |
$2,990 |
$2,990 |
27.5× |
| CT c-spine w/o contrast (72125) |
$2,995 |
$2,995 |
27.6× |
| CT cervical spine with contrast (72126) |
$3,711 |
$3,711 |
10.2× |
| CT chest w/wo contrast (71270) |
$3,819 |
$3,819 |
21.0× |
| CT chest with contrast (71260) |
$3,152 |
$3,152 |
17.3× |
| CT head/brain with contrast (70460) |
$2,873 |
$2,873 |
15.8× |
| CT head/brain without and with contrast (70470) |
$3,275 |
$3,275 |
18.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$165 |
$165 |
1.8× |
| CT iac w contrast (70481) |
$3,355 |
$3,355 |
18.4× |
| CT lower ext w/o (73700) |
$2,806 |
$2,806 |
25.8× |
| CT lower extremity w wo contrast (73702) |
$3,826 |
$3,826 |
21.0× |
| CT lower extremity with contrast (73701) |
$3,154 |
$3,154 |
17.3× |
| CT lumbar spine w & w/o contrast (72133) |
$3,180 |
$3,180 |
17.5× |
| CT lumbar spine w/o contrast (72131) |
$2,908 |
$2,908 |
26.8× |
| CT lumbar spine with contrast (72132) |
$3,304 |
$3,304 |
9.1× |
| CT maxillofacial w contrast (70487) |
$2,814 |
$2,814 |
15.4× |
| CT maxillofacial w/o contrast (70486) |
$2,374 |
$2,374 |
21.9× |
| CT maxillofacial w/wo contrast (70488) |
$3,190 |
$3,190 |
17.5× |
| CT neck soft tissue w contrast (70491) |
$3,012 |
$3,012 |
16.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,051.50 |
$3,051.50 |
16.8× |
| CT orbits w/o contrast (70480) |
$2,839.50 |
$2,839.50 |
26.2× |
| CT pelvis w & w/o contrast (72194) |
$3,649 |
$3,649 |
20.0× |
| CT pelvis w/o contrast (72192) |
$2,940 |
$2,940 |
27.1× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$535 |
$535 |
5.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,445 |
$3,445 |
18.9× |
| CT soft tissue neck w/o contrast (70490) |
$2,625 |
$2,625 |
24.2× |
| CT thoracic spine w/contrast (72129) |
$2,960 |
$2,960 |
16.3× |
| CT thoracic spine w/o contrast (72128) |
$2,995 |
$2,995 |
27.6× |
| CT thoracic spine w/wo contrast (72130) |
$3,250 |
$3,250 |
17.8× |
| CT thorax w/o contrast (71250) |
$2,902 |
$2,902 |
26.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,386 |
$3,386 |
18.6× |
| CT upper extremity w/o contrast rt (73200) |
$2,625 |
$2,625 |
24.2× |
| CT upper extremity with contrast (73201) |
$2,883 |
$2,883 |
8.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,395 |
$4,395 |
24.1× |
| Cta Abdomen (74175) |
$4,098 |
$4,098 |
22.5× |
| CTA abdomen pelvis (74174) |
$6,270 |
$6,270 |
17.3× |
| CTA chest (71275) |
$4,180 |
$4,180 |
22.9× |
| Cta Head (70496) |
$3,814 |
$3,814 |
20.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$6,250 |
$6,250 |
17.3× |
| CTA lwr ext w&w/o contrast (73706) |
$4,121 |
$4,121 |
22.6× |
| Cta Neck (70498) |
$3,810 |
$3,810 |
20.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$605 |
$605 |
5.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$339 |
$339 |
3.8× |
| Esophagus (74220) |
$870 |
$870 |
4.8× |
| Fluoroscopy up to 1 hr (76000) |
$845 |
$845 |
3.4× |
| Foot 2 views (73620) |
$332 |
$332 |
3.7× |
| Forearm 2 views (73090) |
$366 |
$366 |
4.1× |
| Gated Heart Planar Single (78472) |
$2,452 |
$2,452 |
5.9× |
| Hand 2 views (73120) |
$336 |
$336 |
3.1× |
| Hand 3 views (73130) |
$413 |
$413 |
4.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,428 |
$2,428 |
5.8× |
| Ht muscle image spect sing (78451) |
$4,837 |
$4,837 |
3.6× |
| Humerus Min 2 Views Left (73060) |
$393 |
$393 |
4.3× |
| Hysterosalpingogram (74740) |
$803 |
$803 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,466 |
$2,466 |
4.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,027 |
$2,027 |
3.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,292 |
$2,292 |
4.1× |
| Knee 3 views (73562) |
$465 |
$465 |
5.1× |
| Liver & spleen imaging static only (78215) |
$2,274 |
$2,274 |
5.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,619 |
$2,619 |
6.3× |
| Lymphoscintigraphy (78195) |
$2,246 |
$2,246 |
4.0× |
| Meckels Diverticulum (78290) |
$2,835 |
$2,835 |
6.8× |
| MRA head w & w/o contrast (70546) |
$7,256 |
$7,256 |
20.0× |
| MRA head w/o contrast (70544) |
$4,129 |
$4,129 |
16.7× |
| MRA head with contrast (70545) |
$6,695 |
$6,695 |
18.5× |
| MRA neck w contrast (70548) |
$3,771 |
$3,771 |
10.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,941 |
$4,941 |
13.6× |
| MRA neck w/o contrast (70547) |
$3,720 |
$3,720 |
15.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,125 |
$5,125 |
14.1× |
| MRI abdomen w/o contrast (74181) |
$3,922 |
$3,922 |
15.8× |
| MRI c-spine with contrast (72142) |
$4,505 |
$4,505 |
12.4× |
| MRI cervical spine w/o contrast (72141) |
$4,277 |
$4,277 |
17.3× |
| MRI chest w/o & w/contrast material (71552) |
$4,557 |
$4,557 |
12.6× |
| MRI chest w/o contrast (71550) |
$4,398 |
$4,398 |
17.8× |
| MRI chest with contrast (71551) |
$5,579 |
$5,579 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,626 |
$3,626 |
14.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,922 |
$3,922 |
15.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,648 |
$4,648 |
12.8× |
| MRI orbit/face/neck w/contrast (70542) |
$5,487 |
$5,487 |
15.1× |
| MRI pelvis w contrast (72196) |
$4,468 |
$4,468 |
12.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,123 |
$5,123 |
14.1× |
| MRI pelvis w/o contrast (72195) |
$3,768 |
$3,768 |
15.2× |
| MRI scan of arm joint before and after contrast (73223) |
$4,570 |
$4,570 |
12.6× |
| MRI scan of leg joint before and after contrast (73723) |
$4,163 |
$4,163 |
11.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,201 |
$5,201 |
14.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,475 |
$5,475 |
15.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,057 |
$5,057 |
14.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,194 |
$5,194 |
14.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,186 |
$5,186 |
14.3× |
| MRI thoracic spine w/o contrast (72146) |
$4,304 |
$4,304 |
17.4× |
| MRI tmj (70336) |
$4,090 |
$4,090 |
16.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,078 |
$3,078 |
12.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,270 |
$4,270 |
11.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,488 |
$3,488 |
14.1× |
| Myocardial Spect Multiple Studies (78452) |
$5,118 |
$5,118 |
3.8× |
| Neck soft tissue (70360) |
$396 |
$396 |
4.4× |
| Nm gastric emptying study (78264) |
$2,376 |
$2,376 |
5.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$485 |
$485 |
4.5× |
| Parathyroid imaging (78070) |
$1,541 |
$1,541 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$425 |
$425 |
3.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,044 |
$4,044 |
11.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$393 |
$393 |
4.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$500 |
$500 |
4.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$570 |
$570 |
5.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$303 |
$303 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$396 |
$396 |
4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$716 |
$716 |
6.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$433 |
$433 |
4.8× |
| Radiologic exam colon single contrast study (74270) |
$1,208 |
$1,208 |
6.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,254 |
$1,254 |
6.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$428 |
$428 |
4.7× |
| Radiological examination surgical specimen (76098) |
$351 |
$351 |
0.6× |
| Ribs bilateral 3 views (71110) |
$576 |
$576 |
5.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,827 |
$2,827 |
5.0× |
| Sacroiliac Joints < 3 Views (72200) |
$476 |
$476 |
4.4× |
| Scapula complete (73010) |
$389 |
$389 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$116 |
$116 |
5.0× |
| Small bowel series (74250) |
$877 |
$877 |
4.8× |
| Spine thoracic 3 views (72072) |
$628 |
$628 |
5.8× |
| Thoracolumbar 2 views (72080) |
$438 |
$438 |
4.8× |
| Tmj unilateral (70328) |
$316 |
$316 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$851 |
$851 |
7.8× |
| Unlisted magnetic resonance procedure (76498) |
$5,206 |
$5,206 |
57.6× |
| Upper Extremity Infant (73092) |
$329 |
$329 |
3.0× |
| Urethrocystography voiding (74455) |
$1,318 |
$1,318 |
5.3× |
| Us abdl aorta screen aaa (76706) |
$736 |
$736 |
6.8× |
| Us breast unilateral complete (76641) |
$699 |
$699 |
6.4× |
| Us breast unilateral limited (76642) |
$527 |
$527 |
5.8× |
| Us chest (76604) |
$721 |
$721 |
6.6× |
| Us ob detailed single fetus (76811) |
$913 |
$913 |
3.7× |
| Us ob transvaginal (76817) |
$743 |
$743 |
6.8× |
| Us pelvic non ob complete (76856) |
$963 |
$963 |
8.9× |
| Us pregnancy ltd (76815) |
$563 |
$563 |
5.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$850 |
$850 |
7.8× |
| Us retroperitoneal complete (76770) |
$995 |
$995 |
9.2× |
| Us retroperitoneal limited (76775) |
$720 |
$720 |
6.6× |
| Us scrotum and contents (76870) |
$845 |
$845 |
7.8× |
| Us soft tissue head/neck (76536) |
$770 |
$770 |
7.1× |
| Us transrectal (76872) |
$1,080 |
$1,080 |
9.9× |
| Us xtr non-vasc lmtd (76882) |
$679 |
$679 |
6.3× |
| Wrist 2 views (73100) |
$331 |
$331 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$362 |
$362 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$418 |
$418 |
4.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,486 |
$1,486 |
8.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$356 |
$356 |
3.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$432 |
$432 |
4.8× |
| X-ray exam hip uni 1 view (73501) |
$340 |
$340 |
3.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$432 |
$432 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$620 |
$620 |
5.7× |
| X-ray exam of femur 1 (73551) |
$398 |
$398 |
4.4× |
| X-ray eye for foreign body (70030) |
$340 |
$340 |
3.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$534 |
$534 |
4.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$365 |
$365 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$436 |
$436 |
4.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$325 |
$325 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$475 |
$475 |
5.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$503 |
$503 |
4.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$435 |
$435 |
4.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$575 |
$575 |
5.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$413 |
$413 |
4.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$416 |
$416 |
4.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$496 |
$496 |
4.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$437 |
$437 |
4.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$530 |
$530 |
4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$644 |
$644 |
5.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$409 |
$409 |
4.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$436 |
$436 |
4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$514 |
$514 |
5.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$364 |
$364 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$572 |
$572 |
5.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$405 |
$405 |
3.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$413 |
$413 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$330 |
$330 |
3.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$409 |
$409 |
4.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$471 |
$471 |
4.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$304 |
$304 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$413 |
$413 |
4.6× |
| Xr finger(s) 2+ views (73140) |
$307 |
$307 |
3.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$475 |
$475 |
4.4× |
| Xr shoulder 1 view (73020) |
$318 |
$318 |
3.5× |
| Xr spine cervical 4 or 5 views (72050) |
$633 |
$633 |
5.8× |
| Xr tibia/fibula 2 views (73590) |
$380 |
$380 |
4.2× |
| Xr tmj bilateral (70330) |
$602 |
$602 |
6.7× |
| Xray knee 1 or 2 views rt (73560) |
$407 |
$407 |
4.5× |