| Abdomen 2 views (74019) |
$387 |
$430 |
3.6× |
| Ankle 2 views (73600) |
$258 |
$287 |
2.9× |
| Bone age studies (77072) |
$91 |
$101 |
0.8× |
| Bone survey complete (77075) |
$838 |
$931 |
7.7× |
| Cervical spine 2 or 3 views (72040) |
$355 |
$394 |
3.9× |
| Chest 1 view (71045) |
$274 |
$304 |
3.0× |
| Chest 3 views (71047) |
$321 |
$357 |
3.6× |
| Clavicle complete (73000) |
$284 |
$315 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,707 |
$1,897 |
15.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,091 |
$5,657 |
14.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,794 |
$4,215 |
15.3× |
| CT abdomen w contrast (74160) |
$2,463 |
$2,737 |
13.5× |
| CT abdomen w wo contrast (74170) |
$2,902 |
$3,224 |
15.9× |
| CT abdomen w/o contrast (74150) |
$2,234 |
$2,482 |
20.6× |
| CT angiography upper extremity lt (73206) |
$1,949 |
$2,166 |
10.7× |
| CT c-spine w/o contrast (72125) |
$2,320 |
$2,578 |
21.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,480 |
$2,756 |
13.6× |
| CT cervical spine with contrast (72126) |
$2,986 |
$3,318 |
8.2× |
| CT chest w/wo contrast (71270) |
$2,866 |
$3,184 |
15.7× |
| CT chest with contrast (71260) |
$2,568 |
$2,853 |
14.1× |
| CT head/brain with contrast (70460) |
$2,281 |
$2,534 |
12.5× |
| CT head/brain without and with contrast (70470) |
$2,676 |
$2,973 |
14.7× |
| CT iac w contrast (70481) |
$2,525 |
$2,805 |
13.9× |
| CT lower ext w/o (73700) |
$2,156 |
$2,395 |
19.9× |
| CT lower extremity w wo contrast (73702) |
$2,633 |
$2,925 |
14.5× |
| CT lower extremity with contrast (73701) |
$2,166 |
$2,407 |
11.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,589 |
$2,877 |
14.2× |
| CT lumbar spine w/o contrast (72131) |
$2,311 |
$2,568 |
21.3× |
| CT lumbar spine with contrast (72132) |
$2,822 |
$3,135 |
7.8× |
| CT maxillofacial w contrast (70487) |
$2,256 |
$2,507 |
12.4× |
| CT maxillofacial w/o contrast (70486) |
$1,830 |
$2,033 |
16.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,075 |
$2,306 |
11.4× |
| CT neck soft tissue w contrast (70491) |
$2,388 |
$2,653 |
13.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,202 |
$2,447 |
12.1× |
| CT orbits w/o contrast (70480) |
$1,874 |
$2,082 |
17.3× |
| CT pelvis w & w/o contrast (72194) |
$2,629 |
$2,921 |
14.4× |
| CT pelvis w/o contrast (72192) |
$2,255 |
$2,505 |
20.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,218 |
$3,576 |
17.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,013 |
$2,237 |
18.5× |
| CT thoracic spine w/contrast (72129) |
$2,092 |
$2,324 |
11.5× |
| CT thoracic spine w/o contrast (72128) |
$2,313 |
$2,570 |
21.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,678 |
$2,975 |
14.7× |
| CT thorax w/o contrast (71250) |
$2,309 |
$2,566 |
21.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,385 |
$2,650 |
13.1× |
| CT upper extremity w/o contrast rt (73200) |
$2,084 |
$2,316 |
19.2× |
| CT upper extremity with contrast (73201) |
$2,166 |
$2,407 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,392 |
$3,769 |
18.6× |
| Cta Abdomen (74175) |
$4,136 |
$4,595 |
22.7× |
| CTA abdomen pelvis (74174) |
$5,365 |
$5,961 |
14.8× |
| CTA chest (71275) |
$3,281 |
$3,645 |
18.0× |
| Cta Head (70496) |
$3,010 |
$3,344 |
16.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,150 |
$3,500 |
8.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,949 |
$2,166 |
10.7× |
| Cta Neck (70498) |
$3,000 |
$3,333 |
16.5× |
| Cta Pelvis (72191) |
$2,532 |
$2,813 |
13.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$464 |
$516 |
4.3× |
| Esophagus (74220) |
$635 |
$706 |
3.5× |
| Foot 2 views (73620) |
$266 |
$295 |
2.9× |
| Forearm 2 views (73090) |
$290 |
$322 |
3.2× |
| Hand 2 views (73120) |
$280 |
$311 |
2.6× |
| Hand 3 views (73130) |
$328 |
$364 |
3.6× |
| Humerus Min 2 Views Left (73060) |
$316 |
$351 |
3.5× |
| Knee 3 views (73562) |
$374 |
$415 |
4.1× |
| MRA head w/o contrast (70544) |
$3,217 |
$3,574 |
13.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,038 |
$3,375 |
8.4× |
| MRA neck w/o contrast (70547) |
$2,434 |
$2,704 |
9.8× |
| MRI abdomen w contrast (74182) |
$3,344 |
$3,716 |
9.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,368 |
$4,853 |
12.1× |
| MRI abdomen w/o contrast (74181) |
$3,115 |
$3,461 |
12.6× |
| MRI cervical spine w/o contrast (72141) |
$3,355 |
$3,728 |
13.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,407 |
$3,786 |
9.4× |
| MRI chest w/o contrast (71550) |
$3,457 |
$3,841 |
14.0× |
| MRI chest with contrast (71551) |
$3,793 |
$4,214 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,863 |
$3,181 |
11.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,215 |
$3,572 |
13.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,139 |
$3,488 |
8.7× |
| MRI pelvis w contrast (72196) |
$3,038 |
$3,375 |
8.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,191 |
$3,546 |
8.8× |
| MRI pelvis w/o contrast (72195) |
$3,069 |
$3,410 |
12.4× |
| MRI scan of arm joint before and after contrast (73223) |
$3,881 |
$4,312 |
10.7× |
| MRI scan of leg joint before and after contrast (73723) |
$3,203 |
$3,559 |
8.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,016 |
$4,462 |
11.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,089 |
$4,543 |
11.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,181 |
$4,646 |
11.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,416 |
$6,018 |
15.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,557 |
$3,952 |
14.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,540 |
$2,822 |
10.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,921 |
$3,245 |
8.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,726 |
$3,029 |
11.0× |
| Neck soft tissue (70360) |
$296 |
$329 |
3.3× |
| Osseous survey infant (77076) |
$838 |
$931 |
7.7× |
| Osseous survey limited (77074) |
$674 |
$749 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$319 |
$354 |
2.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,214 |
$3,571 |
8.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$225 |
$250 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$330 |
$367 |
3.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$477 |
$530 |
4.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$198 |
$220 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$255 |
$283 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$303 |
$337 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$344 |
$382 |
3.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$349 |
$388 |
3.9× |
| Ribs bilateral 3 views (71110) |
$563 |
$625 |
5.2× |
| Sacroiliac Joints < 3 Views (72200) |
$376 |
$418 |
3.5× |
| Scanogram (77073) |
$243 |
$270 |
2.2× |
| Scapula complete (73010) |
$301 |
$334 |
2.8× |
| Screening digital breast tomosynthesis (77063) |
$103.50 |
$115 |
4.4× |
| Sella turcica (70240) |
$162 |
$180 |
1.8× |
| Spine thoracic 3 views (72072) |
$491 |
$545 |
4.5× |
| Thoracolumbar 2 views (72080) |
$238 |
$264 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$678 |
$753 |
6.2× |
| Upper Extremity Infant (73092) |
$122 |
$135 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$761 |
$845 |
4.2× |
| Us abdl aorta screen aaa (76706) |
$599 |
$665 |
5.5× |
| Us breast unilateral complete (76641) |
$528 |
$587 |
4.9× |
| Us breast unilateral limited (76642) |
$403 |
$448 |
4.5× |
| Us pelvic non ob complete (76856) |
$792 |
$880 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$428 |
$476 |
3.9× |
| Us pregnancy ltd (76815) |
$300 |
$333 |
2.8× |
| Us retroperitoneal complete (76770) |
$782 |
$869 |
7.2× |
| Us retroperitoneal limited (76775) |
$590 |
$656 |
5.4× |
| Us scrotum and contents (76870) |
$658 |
$731 |
6.1× |
| Us soft tissue head/neck (76536) |
$617 |
$685 |
5.7× |
| Us xtr non-vasc lmtd (76882) |
$540 |
$600 |
5.0× |
| Wrist 2 views (73100) |
$256 |
$284 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$536 |
$595 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$170 |
$189 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$327 |
$363 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$278 |
$309 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$338 |
$375 |
3.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$625 |
$694 |
5.8× |
| X-ray exam hip uni 1 view (73501) |
$243 |
$270 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$338 |
$375 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$559 |
$621 |
5.1× |
| X-ray exam of femur 1 (73551) |
$337 |
$374 |
3.7× |
| X-ray eye for foreign body (70030) |
$185 |
$206 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$201 |
$223 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$153 |
$170 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$340 |
$378 |
3.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$194 |
$216 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$198 |
$220 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$399 |
$443 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$234 |
$260 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$127 |
$141 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$450 |
$500 |
4.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$590 |
$656 |
5.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$434 |
$482 |
4.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$248 |
$276 |
2.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$155 |
$172 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$242 |
$269 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$370 |
$411 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$321 |
$357 |
3.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$432 |
$480 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$541 |
$601 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$426 |
$473 |
3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$328 |
$364 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$350 |
$389 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$255 |
$283 |
2.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$286 |
$318 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$430 |
$478 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$203 |
$226 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$138 |
$153 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$157 |
$174 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$286 |
$318 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$366 |
$407 |
3.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$211 |
$234 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$239 |
$265 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$323 |
$359 |
3.6× |
| Xr c-spine 6 or more views (72052) |
$597 |
$663 |
5.5× |
| Xr chest 4+ views (71048) |
$390 |
$433 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$237 |
$263 |
2.6× |
| Xr shoulder 1 view (73020) |
$247 |
$274 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$517 |
$574 |
4.8× |
| Xr tibia/fibula 2 views (73590) |
$300 |
$333 |
3.3× |
| Xr tmj bilateral (70330) |
$219 |
$243 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$329 |
$365 |
3.6× |