| Abdomen 1 View (74018) |
$115.25 |
$461 |
1.3× |
| Abdomen 2 views (74019) |
$116.25 |
$465 |
1.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$322.75 |
$1,291 |
0.8× |
| Angio pulmonary bilat (75743) |
$825.75 |
$3,303 |
0.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,831.50 |
$7,326 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$953.75 |
$3,815 |
0.3× |
| Ankle 2 views (73600) |
$100.50 |
$402 |
1.1× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$1,401.25 |
$5,605 |
0.2× |
| Arthrogram hip (73525) |
$239 |
$956 |
0.7× |
| Arthrogram Wrist (73115) |
$155.75 |
$623 |
0.4× |
| Bone age studies (77072) |
$93.25 |
$373 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$499.75 |
$1,999 |
1.2× |
| Bone Imaging Limited Area (78300) |
$295.75 |
$1,183 |
0.7× |
| Bone Imaging Whole Body (78306) |
$471 |
$1,884 |
1.1× |
| Bone survey infant (77076) |
$68.75 |
$275 |
0.6× |
| Brain Image W/Flow < 4 Views (78601) |
$176.75 |
$707 |
0.4× |
| Cat Scan Follow-Up Study (76380) |
$378.25 |
$1,513 |
4.2× |
| Cerebrospinal Fluid Scan (78630) |
$362.25 |
$1,449 |
0.6× |
| Chest 1 view (71045) |
$107.75 |
$431 |
1.2× |
| Chest 2 views (71046) |
$140.50 |
$562 |
1.5× |
| Chest 3 views (71047) |
$142.75 |
$571 |
1.6× |
| Chest 4 or more views (71048) |
$148 |
$592 |
1.4× |
| Clavicle complete (73000) |
$96.25 |
$385 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$204.75 |
$819 |
1.9× |
| Contrast Exam Abdominl Aorta (75625) |
$1,114.75 |
$4,459 |
0.3× |
| Contrast X-Ray Bladder (74430) |
$185 |
$740 |
0.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$144.25 |
$577 |
0.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,430 |
$5,720 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$997.75 |
$3,991 |
4.0× |
| CT abdomen w contrast (74160) |
$551.75 |
$2,207 |
3.0× |
| CT abdomen w wo contrast (74170) |
$649.50 |
$2,598 |
3.5× |
| CT abdomen w/o contrast (74150) |
$353.50 |
$1,414 |
3.2× |
| CT Angio Abdomen and Pelvis (74174) |
$1,128.50 |
$4,514 |
3.1× |
| CT Angio Chest (71275) |
$874 |
$3,496 |
4.8× |
| CT Angio Head (70496) |
$606.75 |
$2,427 |
3.3× |
| CT angio hrt w/3d image (75574) |
$863.25 |
$3,453 |
2.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$599 |
$2,396 |
3.3× |
| CT Angio Neck (70498) |
$735.75 |
$2,943 |
4.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$910 |
$3,640 |
5.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$112 |
$448 |
0.6× |
| CT cervical spine w/ contrast (72126) |
$412.50 |
$1,650 |
1.1× |
| CT cervical spine w/o contrast (72125) |
$563 |
$2,252 |
5.2× |
| CT cervical spine w/wo cont (72127) |
$646.50 |
$2,586 |
3.5× |
| CT chest w contrast (71260) |
$626 |
$2,504 |
3.4× |
| CT head/brain with contrast (70460) |
$602 |
$2,408 |
3.3× |
| CT head/brain without and with contrast (70470) |
$730.50 |
$2,922 |
4.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$353.25 |
$1,413 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$112 |
$448 |
1.2× |
| CT iac w contrast (70481) |
$598.50 |
$2,394 |
3.3× |
| CT lower ext w/o (73700) |
$423 |
$1,692 |
3.9× |
| CT lower extremity w/contrast material (73701) |
$524.25 |
$2,097 |
2.9× |
| CT lumbar spine w contrast (72132) |
$511.25 |
$2,045 |
1.4× |
| CT lumbar spine w/o contrast (72131) |
$510 |
$2,040 |
4.7× |
| CT maxillofacial w contrast (70487) |
$565.75 |
$2,263 |
3.1× |
| CT maxillofacial wo contrast (70486) |
$544 |
$2,176 |
5.0× |
| CT neck tissue combo (70492) |
$721.75 |
$2,887 |
3.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$605.50 |
$2,422 |
3.3× |
| CT orbits w/o contrast (70480) |
$421.50 |
$1,686 |
3.9× |
| CT pelvis w&w/o contrast (72194) |
$783.25 |
$3,133 |
4.3× |
| CT pelvis w/o contrast (72192) |
$529 |
$2,116 |
4.8× |
| CT scans face/jaw combo (70488) |
$583.75 |
$2,335 |
3.2× |
| CT soft tissue neck w contrast (70491) |
$571.25 |
$2,285 |
3.1× |
| CT soft tissue neck w/o contrast (70490) |
$401.25 |
$1,605 |
3.7× |
| CT thoracic spine w contrast (72129) |
$526.25 |
$2,105 |
2.9× |
| CT thoracic spine w/o contrast (72128) |
$514.25 |
$2,057 |
4.7× |
| CT thorax w/o contrast (71250) |
$418.25 |
$1,673 |
3.8× |
| CT upper ext wo (73200) |
$415.25 |
$1,661 |
3.8× |
| CT upper extremity with contrast (73201) |
$447.25 |
$1,789 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$956.75 |
$3,827 |
5.2× |
| Cta Abdomen (74175) |
$791 |
$3,164 |
4.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$222.77 |
$891.07 |
0.6× |
| Dxa Bone Density Axial (77080) |
$135.50 |
$542 |
1.2× |
| Dxa bone density study (77085) |
$159.50 |
$638 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$91.25 |
$365 |
1.0× |
| Esophagram (74220) |
$205 |
$820 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$120.75 |
$483 |
1.1× |
| Foot 2 views (73620) |
$96.25 |
$385 |
1.1× |
| Forearm 2 views (73090) |
$93 |
$372 |
1.0× |
| Gastric emptying imaging study (78264) |
$493.25 |
$1,973 |
1.2× |
| Gated Heart Planar Single (78472) |
$382 |
$1,528 |
0.9× |
| Hand 2 views (73120) |
$82.75 |
$331 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$398.50 |
$1,594 |
0.7× |
| Hepatobiliary System Imaging (78226) |
$283.50 |
$1,134 |
0.7× |
| Ht Muscle Image Spect Sing (78451) |
$934.25 |
$3,737 |
0.7× |
| Hysterosalpingogram (74740) |
$307 |
$1,228 |
1.2× |
| K Flow/Funct Image W/Drug (78708) |
$434.14 |
$1,736.55 |
0.8× |
| K Flow/Funct Image W/O Drug (78707) |
$338.25 |
$1,353 |
0.6× |
| Kidney Imaging Morphol (78700) |
$218.75 |
$875 |
0.5× |
| Knee 3 Views (73562) |
$114.75 |
$459 |
1.3× |
| Lung perfusion differential (78597) |
$257.50 |
$1,030 |
0.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$458.25 |
$1,833 |
0.8× |
| Lung Ventilation Imaging (78579) |
$104.25 |
$417 |
0.2× |
| Lymph System Imaging (78195) |
$378.91 |
$1,515.63 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$744.75 |
$2,979 |
3.0× |
| Meckels Divert Exam (78290) |
$204.75 |
$819 |
0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$15.25 |
$61 |
0.5× |
| MRA head w/o contrast (70544) |
$627.50 |
$2,510 |
2.5× |
| MRA head with contrast (70545) |
$646 |
$2,584 |
1.8× |
| MRA neck w contrast (70548) |
$886 |
$3,544 |
2.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,040 |
$4,160 |
2.9× |
| MRA neck w/o contrast (70547) |
$637.75 |
$2,551 |
2.6× |
| MRI abdomen w contrast (74182) |
$654.75 |
$2,619 |
1.8× |
| MRI abdomen w/o contrast (74181) |
$689.25 |
$2,757 |
2.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$881.25 |
$3,525 |
1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$951.75 |
$3,807 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$816.75 |
$3,267 |
1.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,037.50 |
$4,150 |
4.2× |
| MRI cervical spine w/o cont (72141) |
$771.75 |
$3,087 |
3.1× |
| MRI chest w/o contrast (71550) |
$421.50 |
$1,686 |
1.7× |
| MRI chest wo w contrast (71552) |
$720.75 |
$2,883 |
2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,062.25 |
$4,249 |
2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$742 |
$2,968 |
3.0× |
| MRI lumbar spine w contrast (72149) |
$785.25 |
$3,141 |
2.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$992.50 |
$3,970 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$719 |
$2,876 |
2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,028 |
$4,112 |
2.8× |
| MRI pelvis w/o & w contrast (72197) |
$787.75 |
$3,151 |
2.2× |
| MRI pelvis w/o contrast (72195) |
$696 |
$2,784 |
2.8× |
| MRI thoracic spine w/o contrast (72146) |
$732.50 |
$2,930 |
2.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$566 |
$2,264 |
1.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$492.25 |
$1,969 |
2.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,046 |
$4,184 |
2.9× |
| MRI, abdomen, combo (74183) |
$733 |
$2,932 |
2.0× |
| MRI, dorsal spine combo (72157) |
$992 |
$3,968 |
2.7× |
| MRI, dorsal spine contrast (72147) |
$758.75 |
$3,035 |
2.1× |
| MRI, joint upper extrem (73221) |
$725.25 |
$2,901 |
2.9× |
| MRI, joint upper extrem combo (73223) |
$979.50 |
$3,918 |
2.7× |
| MRI, lumbar spine combo (72158) |
$984.75 |
$3,939 |
2.7× |
| Myelogram cervical (72240) |
$1,891 |
$7,564 |
2.3× |
| Myelogram Lumbar (72265) |
$1,995.75 |
$7,983 |
2.4× |
| Myelography thoracic (72255) |
$1,662 |
$6,648 |
2.0× |
| Myelograpy 2/more regions rs&i (72270) |
$512 |
$2,048 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$938.66 |
$3,754.65 |
0.7× |
| Neck soft tissue (70360) |
$114.50 |
$458 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$104.25 |
$417 |
0.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$365.50 |
$1,462 |
0.6× |
| Parathyroid Planar Imaging (78070) |
$231 |
$924 |
0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$234.50 |
$938 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$112.50 |
$450 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$279.75 |
$1,119 |
0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$226.75 |
$907 |
2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$126.75 |
$507 |
1.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$96.25 |
$385 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$109 |
$436 |
1.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$121.25 |
$485 |
1.1× |
| Radex fingr minimum 2 views (73140) |
$81.50 |
$326 |
0.9× |
| Radex foot complete minimum 3 views (73630) |
$100.25 |
$401 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$99.75 |
$399 |
1.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$43.25 |
$173 |
0.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$100.25 |
$401 |
1.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$127.75 |
$511 |
1.4× |
| Radex shoulder complete minimum 2 views (73030) |
$104.50 |
$418 |
1.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$302.50 |
$1,210 |
1.7× |
| Radex Spine 1 View Specify Level (72020) |
$72.50 |
$290 |
0.8× |
| Radex Sternum Minimum 2 Views (71120) |
$103.75 |
$415 |
1.1× |
| Radex Toe Minimum 2 Views (73660) |
$64.50 |
$258 |
0.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$54.75 |
$219 |
0.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$97.50 |
$390 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$121.25 |
$485 |
1.1× |
| Radiologic exam colon double contrast study (74280) |
$370.50 |
$1,482 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$298.25 |
$1,193 |
1.6× |
| Radiologic exam knee complete 4/more views (73564) |
$118.75 |
$475 |
1.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$115.50 |
$462 |
1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$209.25 |
$837 |
1.1× |
| Radiologic exam swallow function contrast study (74230) |
$238 |
$952 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$339.50 |
$1,358 |
1.9× |
| Radiologic examination femur 1 view (73551) |
$83.75 |
$335 |
0.9× |
| Radiologic examination femur minimum 2 views (73552) |
$89.50 |
$358 |
1.0× |
| Radiologic examination knee 1/2 views (73560) |
$109.50 |
$438 |
1.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$97.50 |
$390 |
1.1× |
| Ribs bilateral 3 views (71110) |
$132.25 |
$529 |
1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$589.25 |
$2,357 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$567 |
$2,268 |
1.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$626.50 |
$2,506 |
1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$951 |
$3,804 |
0.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$626.50 |
$2,506 |
0.5× |
| Scapula (73010) |
$94.75 |
$379 |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$56.50 |
$226 |
2.4× |
| Shoulder 1 view (73020) |
$72.75 |
$291 |
0.8× |
| Shoulder Arthrography (73040) |
$192.75 |
$771 |
0.5× |
| Skull less than 4 views (70250) |
$140.25 |
$561 |
1.3× |
| Thoracic spine 2 views (72070) |
$111.25 |
$445 |
1.0× |
| Thoracic spine 3 views (72072) |
$111.25 |
$445 |
1.0× |
| Thoracolumbar 2 views (72080) |
$61.25 |
$245 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$186.25 |
$745 |
0.4× |
| Ultrasound Breast Limited (76642) |
$134.75 |
$539 |
1.5× |
| Ultrasound Exam Aaa Screen (76706) |
$246.25 |
$985 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$208.25 |
$833 |
1.9× |
| Upper gi w/o kub (74240) |
$352.50 |
$1,410 |
1.9× |
| Urethrocystogram voiding (74455) |
$350.75 |
$1,403 |
1.4× |
| Urethrocystography retrograde (74450) |
$232.75 |
$931 |
0.9× |
| Us breast unilateral complete (76641) |
$187.75 |
$751 |
1.7× |
| Us chest (76604) |
$90.50 |
$362 |
0.8× |
| Us exam, pelvic, limited (76857) |
$133.75 |
$535 |
1.2× |
| Us head (76506) |
$227.25 |
$909 |
2.1× |
| Us kidney transplant (76776) |
$243.25 |
$973 |
2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$172 |
$688 |
1.6× |
| Us ob detailed single fetus (76811) |
$105 |
$420 |
0.4× |
| Us ob limited 1 or more fetuses (76815) |
$88.75 |
$355 |
0.8× |
| Us ob transvaginal (76817) |
$186.75 |
$747 |
1.7× |
| Us pelvic non ob complete (76856) |
$265 |
$1,060 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$261 |
$1,044 |
2.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$132.25 |
$529 |
1.2× |
| Us retroperitoneal complete (76770) |
$218.50 |
$874 |
2.0× |
| Us retroperitoneal limited (76775) |
$202.25 |
$809 |
1.9× |
| Us scrotum and contents (76870) |
$213 |
$852 |
2.0× |
| Us thyroid (76536) |
$206.75 |
$827 |
1.9× |
| Venography extremity unilateral rs&i (75820) |
$484 |
$1,936 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$61.75 |
$247 |
0.7× |
| Wrist 2 views (73100) |
$94 |
$376 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$94 |
$376 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$129.25 |
$517 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$91.75 |
$367 |
1.0× |
| X-Ray Exam Breast Specimen (76098) |
$198 |
$792 |
0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$89 |
$356 |
1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$117.50 |
$470 |
1.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$88.50 |
$354 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$121.50 |
$486 |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$150.25 |
$601 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$165.75 |
$663 |
1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$193.50 |
$774 |
1.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$179 |
$716 |
1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$122.25 |
$489 |
1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$236.75 |
$947 |
2.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$128.50 |
$514 |
1.2× |
| X-ray humerus (73060) |
$106.75 |
$427 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98.50 |
$394 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$112 |
$448 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$118.25 |
$473 |
1.1× |
| X-ray nose-rectum child f.b. (76010) |
$125 |
$500 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$199.75 |
$799 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$98.25 |
$393 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$107.50 |
$430 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$128.25 |
$513 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$149 |
$596 |
1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$297 |
$1,188 |
0.8× |
| X-Rays Bone Length Studies (77073) |
$95.25 |
$381 |
0.9× |
| X-Rays Bone Survey Complete (77075) |
$301.50 |
$1,206 |
2.8× |
| Xr c-spine 4 or 5 views (72050) |
$177.50 |
$710 |
1.6× |
| Xr facial bones less than 3 views (70140) |
$92 |
$368 |
1.0× |
| Xr orbits complete 4 views (70200) |
$121.25 |
$485 |
1.1× |