| Abdomen 2 views (74019) |
$185.62 |
$247.50 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$804 |
$1,072 |
2.0× |
| Ankle 2 views (73600) |
$149.62 |
$199.50 |
1.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$514.50 |
$686 |
1.4× |
| Arthrogram elbow (73085) |
$337.50 |
$450 |
0.9× |
| Arthrogram hip (73525) |
$570 |
$760 |
1.6× |
| Arthrogram shoulder (73040) |
$413.62 |
$551.50 |
1.2× |
| Arthrogram wrist (73115) |
$696.75 |
$929 |
2.0× |
| Arthrography knee lt (73580) |
$637.50 |
$850 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$688.12 |
$917.50 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$942 |
$1,256 |
2.3× |
| Bone age studies (77072) |
$148.50 |
$198 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,054.50 |
$1,406 |
2.6× |
| Bone survey complete (77075) |
$372 |
$496 |
3.5× |
| Cervical spine 2 or 3 views (72040) |
$199.12 |
$265.50 |
2.2× |
| Chest 1 view (71045) |
$127.50 |
$170 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$312.38 |
$416.50 |
1.7× |
| Clavicle complete (73000) |
$195.75 |
$261 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$331.88 |
$442.50 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$733.50 |
$978 |
2.1× |
| CT abdomen and pelvis without contrast (74176) |
$419.25 |
$559 |
1.7× |
| CT abdomen w contrast (74160) |
$1,174.50 |
$1,566 |
6.6× |
| CT abdomen w wo contrast (74170) |
$1,347.38 |
$1,796.50 |
7.5× |
| CT abdomen w/o contrast (74150) |
$945 |
$1,260 |
8.8× |
| CT angiography upper extremity lt (73206) |
$1,333.50 |
$1,778 |
7.4× |
| CT c-spine w/o contrast (72125) |
$1,172.25 |
$1,563 |
11.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,723.12 |
$2,297.50 |
9.6× |
| CT cervical spine with contrast (72126) |
$1,534.12 |
$2,045.50 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,046.62 |
$1,395.50 |
5.8× |
| CT chest with contrast (71260) |
$913.88 |
$1,218.50 |
5.1× |
| CT head/brain with contrast (70460) |
$881.62 |
$1,175.50 |
4.9× |
| CT head/brain without and with contrast (70470) |
$1,139.62 |
$1,519.50 |
6.4× |
| CT iac w contrast (70481) |
$1,600.12 |
$2,133.50 |
8.9× |
| CT limited/localized follow up study (76380) |
$358.88 |
$478.50 |
4.0× |
| CT lower ext w/o (73700) |
$296.25 |
$395 |
2.8× |
| CT lower extremity w wo contrast (73702) |
$413.25 |
$551 |
2.3× |
| CT lower extremity with contrast (73701) |
$1,387.12 |
$1,849.50 |
7.7× |
| CT lumbar spine w & w/o contrast (72133) |
$419.25 |
$559 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$311.25 |
$415 |
2.9× |
| CT lumbar spine with contrast (72132) |
$357 |
$476 |
1.0× |
| CT maxillofacial w contrast (70487) |
$1,281.38 |
$1,708.50 |
7.2× |
| CT maxillofacial w/o contrast (70486) |
$1,006.50 |
$1,342 |
9.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,500.75 |
$2,001 |
8.4× |
| CT neck soft tissue w contrast (70491) |
$1,277.62 |
$1,703.50 |
7.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,271.38 |
$3,028.50 |
12.7× |
| CT orbits w/o contrast (70480) |
$1,540.12 |
$2,053.50 |
14.4× |
| CT pelvis w & w/o contrast (72194) |
$1,126.12 |
$1,501.50 |
6.3× |
| CT pelvis w/o contrast (72192) |
$924.38 |
$1,232.50 |
8.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$310.88 |
$414.50 |
3.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,531.50 |
$2,042 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,281.75 |
$1,709 |
12.0× |
| CT thoracic spine w/contrast (72129) |
$359.25 |
$479 |
2.0× |
| CT thoracic spine w/o contrast (72128) |
$1,137.75 |
$1,517 |
10.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,458.75 |
$1,945 |
8.1× |
| CT thorax w/o contrast (71250) |
$765.38 |
$1,020.50 |
7.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,056 |
$1,408 |
5.9× |
| CT upper extremity w/o contrast rt (73200) |
$868.88 |
$1,158.50 |
8.1× |
| CT upper extremity with contrast (73201) |
$1,002 |
$1,336 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,788.75 |
$2,385 |
10.0× |
| Cta Abdomen (74175) |
$1,233.75 |
$1,645 |
6.9× |
| CTA chest (71275) |
$1,380.38 |
$1,840.50 |
7.7× |
| Cta Head (70496) |
$881.25 |
$1,175 |
4.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,324.25 |
$3,099 |
13.0× |
| Cta Neck (70498) |
$1,288.88 |
$1,718.50 |
7.2× |
| Cystography minimum 3 views rs&i (74430) |
$246.38 |
$328.50 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$234.75 |
$313 |
2.2× |
| Echoencephalography real time imaging (76506) |
$214.12 |
$285.50 |
2.0× |
| Esophagus (74220) |
$333.38 |
$444.50 |
1.9× |
| Fetal biophysical profile non-stress testing (76818) |
$471 |
$628 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$347.25 |
$463 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$304.12 |
$405.50 |
1.2× |
| Foot 2 views (73620) |
$168.75 |
$225 |
1.9× |
| Forearm 2 views (73090) |
$152.25 |
$203 |
1.7× |
| Gated Heart Planar Single (78472) |
$1,000.12 |
$1,333.50 |
2.4× |
| Hand 2 views (73120) |
$149.62 |
$199.50 |
1.4× |
| Hand 3 views (73130) |
$168.38 |
$224.50 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,093.12 |
$1,457.50 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$856.12 |
$1,141.50 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$149.25 |
$199 |
1.7× |
| Hysterosalpingogram (74740) |
$471 |
$628 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$605.62 |
$807.50 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,060.88 |
$1,414.50 |
1.9× |
| Knee 3 views (73562) |
$174 |
$232 |
2.0× |
| Lung Ventilation Imaging (78579) |
$502.88 |
$670.50 |
1.2× |
| Meckels Diverticulum (78290) |
$819.38 |
$1,092.50 |
2.0× |
| MRA head w & w/o contrast (70546) |
$1,653.38 |
$2,204.50 |
4.6× |
| MRA head w/o contrast (70544) |
$1,554 |
$2,072 |
6.4× |
| MRA head with contrast (70545) |
$1,874.25 |
$2,499 |
5.3× |
| MRA neck w contrast (70548) |
$940.88 |
$1,254.50 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,715.62 |
$2,287.50 |
4.8× |
| MRA neck w/o contrast (70547) |
$1,518 |
$2,024 |
6.2× |
| MRI abdomen w contrast (74182) |
$1,173.38 |
$1,564.50 |
3.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,588.50 |
$2,118 |
4.5× |
| MRI abdomen w/o contrast (74181) |
$1,114.50 |
$1,486 |
4.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,379.62 |
$1,839.50 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,394.25 |
$1,859 |
1.7× |
| MRI c-spine with contrast (72142) |
$1,126.50 |
$1,502 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$1,341.75 |
$1,789 |
5.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,391.38 |
$3,188.50 |
6.7× |
| MRI chest w/o contrast (71550) |
$1,764 |
$2,352 |
7.2× |
| MRI chest with contrast (71551) |
$1,152 |
$1,536 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$985.50 |
$1,314 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,248 |
$1,664 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,028.62 |
$1,371.50 |
4.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,530.38 |
$2,040.50 |
6.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,801.12 |
$2,401.50 |
5.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,039.12 |
$1,385.50 |
2.9× |
| MRI pelvis w contrast (72196) |
$1,035.75 |
$1,381 |
2.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,103 |
$2,804 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,514.62 |
$2,019.50 |
6.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,734 |
$2,312 |
4.9× |
| MRI scan of leg joint before and after contrast (73723) |
$1,594.12 |
$2,125.50 |
4.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,629.38 |
$2,172.50 |
4.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,458 |
$1,944 |
4.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,616.62 |
$2,155.50 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,117.50 |
$1,490 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,599.38 |
$2,132.50 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,310.25 |
$1,747 |
5.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,128.38 |
$1,504.50 |
4.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,711.25 |
$3,615 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,296.75 |
$1,729 |
5.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,376.25 |
$1,835 |
1.0× |
| Neck soft tissue (70360) |
$143.62 |
$191.50 |
1.6× |
| Nm gastric emptying study (78264) |
$796.12 |
$1,061.50 |
1.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$323.25 |
$431 |
3.0× |
| Osseous survey infant (77076) |
$240.38 |
$320.50 |
2.3× |
| Osseous survey limited (77074) |
$212.62 |
$283.50 |
2.0× |
| Parathyroid imaging (78070) |
$696.38 |
$928.50 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$183.75 |
$245 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,476.38 |
$1,968.50 |
4.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$605.62 |
$807.50 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$874.12 |
$1,165.50 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$272.25 |
$363 |
2.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$216 |
$288 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$269.62 |
$359.50 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$150.38 |
$200.50 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$158.62 |
$211.50 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$441.75 |
$589 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$570 |
$760 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$536.25 |
$715 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$167.25 |
$223 |
1.9× |
| Radiological examination surgical specimen (76098) |
$250.12 |
$333.50 |
0.4× |
| Ribs bilateral 3 views (71110) |
$256.88 |
$342.50 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$169.12 |
$225.50 |
1.6× |
| Scanogram (77073) |
$189.38 |
$252.50 |
1.8× |
| Scapula complete (73010) |
$180.75 |
$241 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$20.25 |
$27 |
0.9× |
| Small bowel series (74250) |
$399.75 |
$533 |
2.2× |
| Spine thoracic 3 views (72072) |
$281.62 |
$375.50 |
2.6× |
| Thoracolumbar 2 views (72080) |
$246.38 |
$328.50 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$541.88 |
$722.50 |
1.3× |
| Thyroid uptake measurement (78012) |
$601.12 |
$801.50 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$654.38 |
$872.50 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$357.38 |
$476.50 |
3.3× |
| Upper Extremity Infant (73092) |
$144.75 |
$193 |
1.4× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$2,049 |
$2,732 |
21.7× |
| Urethrocystography retrograde rs&i (74450) |
$392.25 |
$523 |
1.6× |
| Urethrocystography voiding (74455) |
$437.62 |
$583.50 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$537.75 |
$717 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$424.12 |
$565.50 |
4.0× |
| Us breast unilateral complete (76641) |
$246 |
$328 |
2.3× |
| Us breast unilateral limited (76642) |
$262.50 |
$350 |
3.0× |
| Us chest (76604) |
$267.38 |
$356.50 |
2.5× |
| Us infant hips dynamic (76885) |
$407.25 |
$543 |
4.6× |
| Us ob detailed single fetus (76811) |
$451.50 |
$602 |
1.9× |
| Us ob transvaginal (76817) |
$398.25 |
$531 |
3.7× |
| Us pelvic non ob complete (76856) |
$466.88 |
$622.50 |
4.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$295.88 |
$394.50 |
2.8× |
| Us pregnancy ltd (76815) |
$288.38 |
$384.50 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$174.75 |
$233 |
1.6× |
| Us retroperitoneal complete (76770) |
$451.12 |
$601.50 |
4.2× |
| Us retroperitoneal limited (76775) |
$302.62 |
$403.50 |
2.8× |
| Us scrotum and contents (76870) |
$369.75 |
$493 |
3.5× |
| Us soft tissue head/neck (76536) |
$411 |
$548 |
3.8× |
| Us spinal canal and contents (76800) |
$407.25 |
$543 |
3.8× |
| Us xtr non-vasc lmtd (76882) |
$281.06 |
$374.75 |
2.6× |
| Wrist 2 views (73100) |
$136.12 |
$181.50 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$237.75 |
$317 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$183.75 |
$245 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$170.25 |
$227 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$603.38 |
$804.50 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$133.12 |
$177.50 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$178.50 |
$238 |
2.0× |
| X-ray exam hip uni 1 view (73501) |
$128.62 |
$171.50 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$151.50 |
$202 |
1.7× |
| X-ray eye for foreign body (70030) |
$156.75 |
$209 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$228.38 |
$304.50 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$229.50 |
$306 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$157.50 |
$210 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$144.38 |
$192.50 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$221.62 |
$295.50 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$189.75 |
$253 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$194.25 |
$259 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$154.88 |
$206.50 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$199.88 |
$266.50 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$301.12 |
$401.50 |
2.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$203.25 |
$271 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$192.38 |
$256.50 |
2.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$118.50 |
$158 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$208.50 |
$278 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$238.88 |
$318.50 |
2.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$441.38 |
$588.50 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$164.25 |
$219 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$201.75 |
$269 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$255 |
$340 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$193.50 |
$258 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$159.38 |
$212.50 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$162 |
$216 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$225 |
$300 |
2.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$203.62 |
$271.50 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$329.62 |
$439.50 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$205.50 |
$274 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$133.12 |
$177.50 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$264.75 |
$353 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$255.75 |
$341 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$211.50 |
$282 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$183 |
$244 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$159.75 |
$213 |
1.8× |
| Xr arthrogram ankle (73615) |
$503.25 |
$671 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$437.25 |
$583 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$184.50 |
$246 |
2.1× |
| Xr shoulder 1 view (73020) |
$135.75 |
$181 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$334.50 |
$446 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$154.12 |
$205.50 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$155.25 |
$207 |
1.7× |