| Abdomen 2 views (74019) |
$270 |
$450 |
2.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$930.60 |
$1,551 |
2.4× |
| Ankle 2 views (73600) |
$211.80 |
$353 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$693.60 |
$1,156 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$1,284 |
$2,140 |
3.4× |
| Bone age studies (77072) |
$225.60 |
$376 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$1,207.20 |
$2,012 |
3.2× |
| Bone survey complete (77075) |
$376.80 |
$628 |
3.8× |
| Cervical spine 2 or 3 views (72040) |
$309.60 |
$516 |
3.7× |
| Chest 1 view (71045) |
$150.60 |
$251 |
1.8× |
| Chest 3 views (71047) |
$233.40 |
$389 |
2.8× |
| Clavicle complete (73000) |
$221.40 |
$369 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$111.60 |
$186 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,995.40 |
$6,659 |
12.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,492.40 |
$4,154 |
10.9× |
| CT abdomen w contrast (74160) |
$2,304 |
$3,840 |
13.7× |
| CT abdomen w wo contrast (74170) |
$2,511.60 |
$4,186 |
15.0× |
| CT abdomen w/o contrast (74150) |
$1,636.20 |
$2,727 |
16.4× |
| CT angio hrt w/3d image (75574) |
$1,902 |
$3,170 |
5.7× |
| CT angiography upper extremity lt (73206) |
$1,416 |
$2,360 |
8.4× |
| CT c-spine w/o contrast (72125) |
$1,582.20 |
$2,637 |
15.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,977.60 |
$3,296 |
11.8× |
| CT cervical spine with contrast (72126) |
$1,803.60 |
$3,006 |
5.4× |
| CT chest w/wo contrast (71270) |
$2,145 |
$3,575 |
12.8× |
| CT chest with contrast (71260) |
$1,716 |
$2,860 |
10.2× |
| CT head/brain with contrast (70460) |
$1,755.60 |
$2,926 |
10.5× |
| CT head/brain without and with contrast (70470) |
$2,313 |
$3,855 |
13.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$522.60 |
$871 |
1.6× |
| CT hrt w/3d image congen (75573) |
$522.60 |
$871 |
1.6× |
| CT iac w contrast (70481) |
$1,397.40 |
$2,329 |
8.3× |
| CT limited/localized follow up study (76380) |
$208.80 |
$348 |
2.5× |
| CT lower ext w/o (73700) |
$1,843.80 |
$3,073 |
18.5× |
| CT lower extremity w wo contrast (73702) |
$1,954.80 |
$3,258 |
11.7× |
| CT lower extremity with contrast (73701) |
$1,530.60 |
$2,551 |
9.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,777.80 |
$2,963 |
10.6× |
| CT lumbar spine w/o contrast (72131) |
$1,422 |
$2,370 |
14.2× |
| CT lumbar spine with contrast (72132) |
$1,564.80 |
$2,608 |
4.7× |
| CT maxillofacial w contrast (70487) |
$1,876.20 |
$3,127 |
11.2× |
| CT maxillofacial w/o contrast (70486) |
$1,339.80 |
$2,233 |
13.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,983 |
$3,305 |
11.8× |
| CT neck soft tissue w contrast (70491) |
$2,038.20 |
$3,397 |
12.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,389.20 |
$3,982 |
14.3× |
| CT orbits w/o contrast (70480) |
$1,020 |
$1,700 |
10.2× |
| CT pelvis w/o contrast (72192) |
$1,155.60 |
$1,926 |
11.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,080 |
$1,800 |
10.8× |
| CT thoracic spine w/contrast (72129) |
$1,687.20 |
$2,812 |
10.1× |
| CT thoracic spine w/o contrast (72128) |
$1,739.40 |
$2,899 |
17.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,913.40 |
$3,189 |
11.4× |
| CT thorax w/o contrast (71250) |
$961.20 |
$1,602 |
9.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,168.40 |
$3,614 |
12.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,435.80 |
$2,393 |
14.4× |
| CT upper extremity with contrast (73201) |
$1,651.20 |
$2,752 |
5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,516.80 |
$2,528 |
9.0× |
| Cta Abdomen (74175) |
$2,068.20 |
$3,447 |
12.3× |
| CTA abdomen pelvis (74174) |
$2,872.20 |
$4,787 |
8.6× |
| CTA chest (71275) |
$2,569.80 |
$4,283 |
15.3× |
| Cta Head (70496) |
$2,329.20 |
$3,882 |
13.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,944.60 |
$3,241 |
11.6× |
| Cta Neck (70498) |
$2,367.60 |
$3,946 |
14.1× |
| Cta Pelvis (72191) |
$1,416 |
$2,360 |
8.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$359.40 |
$599 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$79.20 |
$132 |
1.0× |
| Echoencephalography real time imaging (76506) |
$155.40 |
$259 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$414 |
$690 |
1.8× |
| Foot 2 views (73620) |
$207 |
$345 |
2.5× |
| Forearm 2 views (73090) |
$237.60 |
$396 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,045.80 |
$1,743 |
2.7× |
| Hand 2 views (73120) |
$222.60 |
$371 |
2.2× |
| Hand 3 views (73130) |
$236.40 |
$394 |
2.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,323.60 |
$2,206 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,243.80 |
$2,073 |
3.3× |
| Ht muscle image spect sing (78451) |
$2,863.20 |
$4,772 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$298.20 |
$497 |
3.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$792 |
$1,320 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,089 |
$1,815 |
2.1× |
| Knee 3 views (73562) |
$259.20 |
$432 |
3.1× |
| Lymphoscintigraphy (78195) |
$1,364.40 |
$2,274 |
2.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$161.40 |
$269 |
1.9× |
| Meckels Diverticulum (78290) |
$562.80 |
$938 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,112.20 |
$5,187 |
2.5× |
| Neck soft tissue (70360) |
$258.60 |
$431 |
3.1× |
| Nm gastric emptying study (78264) |
$1,188 |
$1,980 |
3.1× |
| Nuclear medicine of heart pumping function (78473) |
$1,394.40 |
$2,324 |
3.6× |
| Nuclear Rx Oral Admin (79005) |
$652.80 |
$1,088 |
2.9× |
| Osseous survey infant (77076) |
$442.20 |
$737 |
4.4× |
| Osseous survey limited (77074) |
$202.20 |
$337 |
2.0× |
| Parathyroid imaging (78070) |
$588 |
$980 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$223.80 |
$373 |
2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$576 |
$960 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$800.40 |
$1,334 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$139.20 |
$232 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$229.80 |
$383 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$229.80 |
$383 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$277.20 |
$462 |
2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$232.80 |
$388 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$212.40 |
$354 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$227.40 |
$379 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$409.80 |
$683 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$207 |
$345 |
2.5× |
| Radiological examination surgical specimen (76098) |
$331.20 |
$552 |
0.6× |
| Ribs bilateral 3 views (71110) |
$232.20 |
$387 |
2.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,173.80 |
$3,623 |
4.2× |
| Sacroiliac Joints < 3 Views (72200) |
$230.40 |
$384 |
2.3× |
| Scapula complete (73010) |
$238.20 |
$397 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$45.60 |
$76 |
2.0× |
| Small bowel series (74250) |
$425.40 |
$709 |
2.5× |
| Spine thoracic 3 views (72072) |
$337.80 |
$563 |
3.4× |
| Thoracolumbar 2 views (72080) |
$145.80 |
$243 |
1.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,315.80 |
$2,193 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$520.20 |
$867 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,040.40 |
$1,734 |
2.7× |
| Tmj unilateral (70328) |
$161.40 |
$269 |
1.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$532.20 |
$887 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$279.60 |
$466 |
2.8× |
| Unlisted Ultrasound Procedure (76999) |
$353.40 |
$589 |
4.2× |
| Upper Extremity Infant (73092) |
$225.60 |
$376 |
2.3× |
| Urethrocystography retrograde rs&i (74450) |
$624.60 |
$1,041 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$215.40 |
$359 |
2.2× |
| Us breast unilateral complete (76641) |
$247.80 |
$413 |
2.5× |
| Us breast unilateral limited (76642) |
$247.80 |
$413 |
3.0× |
| Us chest (76604) |
$426 |
$710 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$367.20 |
$612 |
3.7× |
| Us ob transvaginal (76817) |
$366.60 |
$611 |
3.7× |
| Us pelvic non ob complete (76856) |
$506.40 |
$844 |
5.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$232.80 |
$388 |
2.3× |
| Us pregnancy ltd (76815) |
$366.60 |
$611 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$366.60 |
$611 |
3.7× |
| Us retroperitoneal complete (76770) |
$745.20 |
$1,242 |
7.5× |
| Us retroperitoneal limited (76775) |
$462 |
$770 |
4.6× |
| Us scrotum and contents (76870) |
$526.20 |
$877 |
5.3× |
| Us soft tissue head/neck (76536) |
$553.80 |
$923 |
5.5× |
| Us xtr non-vasc lmtd (76882) |
$277.80 |
$463 |
2.8× |
| Wrist 2 views (73100) |
$133.20 |
$222 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$348.60 |
$581 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$336.60 |
$561 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$271.80 |
$453 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$205.20 |
$342 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$238.80 |
$398 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$139.80 |
$233 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$139.80 |
$233 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$229.80 |
$383 |
2.3× |
| X-ray eye for foreign body (70030) |
$120.60 |
$201 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$225.60 |
$376 |
2.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$126.60 |
$211 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$238.20 |
$397 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$238.80 |
$398 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$138.60 |
$231 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$316.80 |
$528 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$138 |
$230 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$225.60 |
$376 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$391.80 |
$653 |
3.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$521.40 |
$869 |
5.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$172.20 |
$287 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$145.80 |
$243 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$120.60 |
$201 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$225.60 |
$376 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$259.20 |
$432 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$207.60 |
$346 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$305.40 |
$509 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$318 |
$530 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$346.80 |
$578 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$247.80 |
$413 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$279.60 |
$466 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$354.60 |
$591 |
4.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$138.60 |
$231 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$232.80 |
$388 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160.20 |
$267 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$228.60 |
$381 |
2.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$209.40 |
$349 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$145.80 |
$243 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$274.80 |
$458 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$258 |
$430 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$174 |
$290 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$246.60 |
$411 |
3.0× |
| Xr c-spine 6 or more views (72052) |
$408.60 |
$681 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$216.60 |
$361 |
2.6× |
| Xr shoulder 1 view (73020) |
$145.20 |
$242 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$429.60 |
$716 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$273 |
$455 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$205.80 |
$343 |
2.5× |