| Abdomen 2 views (74019) |
$201.95 |
$577 |
2.0× |
| Acute gi blood loss imaging (78278) |
$757.40 |
$2,164 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$3,920.35 |
$11,201 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,903.90 |
$11,154 |
1.3× |
| Angiography internal mammary rs&i (75756) |
$4,007.50 |
$11,450 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,704.95 |
$19,157 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,183.20 |
$11,952 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,127.90 |
$11,794 |
1.3× |
| Angiography Spinal Selective Rs&I (75705) |
$6,704.95 |
$19,157 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,704.95 |
$19,157 |
1.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,903.90 |
$11,154 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,127.90 |
$11,794 |
1.3× |
| Ankle 2 views (73600) |
$164.50 |
$470 |
1.9× |
| Aortogram thoracic (75605) |
$6,704.95 |
$19,157 |
1.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,903.90 |
$11,154 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$3,903.90 |
$11,154 |
1.3× |
| Arthrogram elbow (73085) |
$534.45 |
$1,527 |
1.6× |
| Arthrogram hip (73525) |
$587.30 |
$1,678 |
1.7× |
| Arthrogram knee (73580) |
$534.45 |
$1,527 |
1.6× |
| Arthrogram shoulder (73040) |
$563.15 |
$1,609 |
1.7× |
| Arthrogram wrist (73115) |
$462 |
$1,320 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$859.25 |
$2,455 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$938.35 |
$2,681 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$974.75 |
$2,785 |
2.5× |
| Bone age studies (77072) |
$170.10 |
$486 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,237.95 |
$3,537 |
3.2× |
| Bone Marrow Imaging Limited Area (78102) |
$498.40 |
$1,424 |
1.3× |
| Bone survey complete (77075) |
$482.30 |
$1,378 |
4.7× |
| Bone survey infant (77076) |
$153.65 |
$439 |
1.5× |
| Bowel imaging (78290) |
$521.15 |
$1,489 |
1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,081.15 |
$3,089 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,903.60 |
$8,296 |
2.1× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$693.70 |
$1,982 |
1.8× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,242.80 |
$6,408 |
2.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,573.95 |
$4,497 |
4.6× |
| Cardiac shunt detection (78428) |
$726.25 |
$2,075 |
1.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$667.80 |
$1,908 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$198.80 |
$568 |
2.3× |
| Chest 1 view (71045) |
$127.40 |
$364 |
1.5× |
| Chest xray 3 views (71047) |
$145.25 |
$415 |
1.7× |
| Clavicle complete (73000) |
$193.90 |
$554 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$165.90 |
$474 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,153.90 |
$6,154 |
6.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,190.70 |
$3,402 |
5.1× |
| CT abdomen w contrast (74160) |
$1,149.75 |
$3,285 |
6.7× |
| CT abdomen w wo contrast (74170) |
$1,233.05 |
$3,523 |
7.2× |
| CT abdomen w/o contrast (74150) |
$660.80 |
$1,888 |
6.5× |
| CT angio hrt w/3d image (75574) |
$1,016.05 |
$2,903 |
3.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$859.95 |
$2,457 |
5.0× |
| CT angiography upper extremity lt (73206) |
$1,160.60 |
$3,316 |
6.8× |
| CT c-spine w/contrast (72126) |
$2,105.95 |
$6,017 |
6.2× |
| CT c-spine w/o contrast (72125) |
$1,004.15 |
$2,869 |
9.8× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$1,017.10 |
$2,906 |
5.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,023.75 |
$2,925 |
6.0× |
| CT chest w contrast (71260) |
$1,028.65 |
$2,939 |
6.0× |
| CT chest w/wo contrast (71270) |
$1,373.40 |
$3,924 |
8.0× |
| CT colonography screening (74263) |
$333.55 |
$953 |
1.4× |
| CT colonography w/dye (74262) |
$555.10 |
$1,586 |
3.2× |
| CT colonography w/o cntrst (74261) |
$481.60 |
$1,376 |
4.7× |
| CT head/brain with contrast (70460) |
$1,029 |
$2,940 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,261.40 |
$3,604 |
7.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$737.10 |
$2,106 |
2.2× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$224.70 |
$642 |
2.6× |
| CT hrt w/3d image congen (75573) |
$1,047.20 |
$2,992 |
3.1× |
| CT iac w contrast (70481) |
$654.85 |
$1,871 |
3.8× |
| CT limited/localized follow up study (76380) |
$513.10 |
$1,466 |
6.0× |
| CT lower ext w/o (73700) |
$760.55 |
$2,173 |
7.5× |
| CT lower extremity w wo contrast (73702) |
$900.38 |
$2,572.50 |
5.3× |
| CT lower extremity w/contrast material (73701) |
$1,010.45 |
$2,887 |
5.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,093.40 |
$3,124 |
6.4× |
| CT lumbar spine w/contrast (72132) |
$1,205.05 |
$3,443 |
3.5× |
| CT lumbar spine w/o contrast (72131) |
$1,026.55 |
$2,933 |
10.1× |
| CT maxillofacial w contrast (70487) |
$661.85 |
$1,891 |
3.9× |
| CT maxillofacial w/wo contrast (70488) |
$960.05 |
$2,743 |
5.6× |
| CT maxillofacial wo contrast (70486) |
$775.60 |
$2,216 |
7.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$831.60 |
$2,376 |
4.9× |
| CT orbits w/o contrast (70480) |
$952 |
$2,720 |
9.3× |
| CT pelvis w/o contrast (72192) |
$700.35 |
$2,001 |
6.9× |
| CT pelvis w/wo contrast (72194) |
$920.85 |
$2,631 |
5.4× |
| CT scan of arm combo (73202) |
$1,054.90 |
$3,014 |
6.2× |
| CT soft tissue neck w contrast (70491) |
$1,016.40 |
$2,904 |
5.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,405.95 |
$4,017 |
8.2× |
| CT soft tissue neck w/o contrast (70490) |
$468.65 |
$1,339 |
4.6× |
| CT thoracic spine w/contrast (72129) |
$1,291.15 |
$3,689 |
7.5× |
| CT thoracic spine w/o contrast (72128) |
$724.85 |
$2,071 |
7.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,090.95 |
$3,117 |
6.4× |
| CT thorax w/o contrast (71250) |
$868.70 |
$2,482 |
8.5× |
| CT upper ext wo (73200) |
$873.60 |
$2,496 |
8.6× |
| CT upper extremity with contrast (73201) |
$1,301.30 |
$3,718 |
3.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,125.25 |
$3,215 |
6.6× |
| Cta Abdomen (74175) |
$1,056.65 |
$3,019 |
6.2× |
| CTA abdomen pelvis (74174) |
$1,985.55 |
$5,673 |
5.8× |
| CTA chest (71275) |
$1,095.15 |
$3,129 |
6.4× |
| Cta Head (70496) |
$1,121.05 |
$3,203 |
6.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,543.10 |
$7,266 |
7.5× |
| Cta Neck (70498) |
$1,042.30 |
$2,978 |
6.1× |
| Cta Pelvis (72191) |
$990.50 |
$2,830 |
5.8× |
| Cystography minimum 3 views rs&i (74430) |
$443.10 |
$1,266 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$351.40 |
$1,004 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$166.25 |
$475 |
2.0× |
| Dxa bone density study axial skeleton (77085) |
$183.05 |
$523 |
1.8× |
| Esophagus (74220) |
$301.35 |
$861 |
1.8× |
| Facial bones min 3 views (70150) |
$155.40 |
$444 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$281.05 |
$803 |
2.8× |
| Fetal Echo (76825) |
$680.40 |
$1,944 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$421.75 |
$1,205 |
1.8× |
| Foot 2 views (73620) |
$176.05 |
$503 |
2.1× |
| Forearm 2 views (73090) |
$204.75 |
$585 |
2.4× |
| Hand 2 views (73120) |
$159.60 |
$456 |
1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,903.90 |
$11,154 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,127.90 |
$11,794 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,735.65 |
$4,959 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$748.65 |
$2,139 |
1.9× |
| Hysterosalpingogram (74740) |
$591.85 |
$1,691 |
2.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$187.25 |
$535 |
1.8× |
| Kidney imaging morphology (78700) |
$842.10 |
$2,406 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$992.95 |
$2,837 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$667.80 |
$1,908 |
1.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,353.10 |
$3,866 |
2.6× |
| Knee 3 views (73562) |
$216.30 |
$618 |
2.5× |
| Liver & spleen imaging static only (78215) |
$720.30 |
$2,058 |
1.8× |
| Liver imaging static only (78201) |
$911.75 |
$2,605 |
1.7× |
| Lung perfusion differential (78597) |
$498.40 |
$1,424 |
1.3× |
| Lung ventilation imaging (78579) |
$498.40 |
$1,424 |
1.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,903.90 |
$11,154 |
1.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,903.90 |
$11,154 |
1.3× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$766.85 |
$2,191 |
1.3× |
| Lymphoscintigraphy (78195) |
$987.70 |
$2,822 |
1.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,031.75 |
$5,805 |
2.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,885.10 |
$5,386 |
5.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,271.15 |
$6,489 |
6.7× |
| Mammary ductogram or galactogram multiple (77054) |
$299.95 |
$857 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$299.95 |
$857 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,369.55 |
$3,913 |
4.0× |
| MRA head w/o contrast (70544) |
$1,156.05 |
$3,303 |
5.0× |
| MRA head with contrast (70545) |
$1,015.70 |
$2,902 |
3.0× |
| MRA neck w contrast (70548) |
$983.15 |
$2,809 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,827.70 |
$5,222 |
5.4× |
| MRA neck w/o contrast (70547) |
$722.05 |
$2,063 |
3.1× |
| MRI abdomen w contrast (74182) |
$1,265.95 |
$3,617 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,989.40 |
$5,684 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$1,137.85 |
$3,251 |
4.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,647.10 |
$4,706 |
2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,424.10 |
$6,926 |
7.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,891.75 |
$5,405 |
8.1× |
| MRI breast wo contrast unilateral (77046) |
$1,261.05 |
$3,603 |
5.4× |
| MRI c-spine with contrast (72142) |
$1,981.70 |
$5,662 |
5.8× |
| MRI cardiac w/o contrast (75557) |
$1,390.55 |
$3,973 |
6.0× |
| MRI cervical spine w/o contrast (72141) |
$1,444.80 |
$4,128 |
6.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,987.65 |
$5,679 |
5.8× |
| MRI chest w/o contrast (71550) |
$1,455.65 |
$4,159 |
6.3× |
| MRI fetal sngl/1st gestation (74712) |
$644.70 |
$1,842 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,873.90 |
$5,354 |
5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,028.95 |
$5,797 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,611.05 |
$4,603 |
6.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,394.40 |
$3,984 |
6.0× |
| MRI orbit face neck w contrast (70542) |
$1,638.35 |
$4,681 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,073.75 |
$5,925 |
6.1× |
| MRI pelvis w/contrast (72196) |
$1,923.25 |
$5,495 |
5.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,877 |
$8,220 |
8.5× |
| MRI pelvis w/o contrast (72195) |
$1,744.40 |
$4,984 |
7.5× |
| MRI spectroscopy (76390) |
$1,224.30 |
$3,498 |
14.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,430.05 |
$6,943 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,162 |
$3,320 |
3.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,103.50 |
$6,010 |
6.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,004.10 |
$5,726 |
5.9× |
| MRI temporomandibular joint (70336) |
$1,004.15 |
$2,869 |
4.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,228.50 |
$3,510 |
5.3× |
| MRI up ext w/o contrast (73218) |
$1,744.05 |
$4,983 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,311.45 |
$3,747 |
5.6× |
| MRI, joint upper extrem combo (73223) |
$2,315.25 |
$6,615 |
6.8× |
| Myelogram Cervical (72240) |
$984.55 |
$2,813 |
1.3× |
| Myelogram Lumbar (72265) |
$984.55 |
$2,813 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,354.80 |
$6,728 |
1.9× |
| Myocardial spect single study at rest or stress (78451) |
$2,242.80 |
$6,408 |
1.8× |
| N-invas est c ffr sw aly CTA (75580) |
$1,068.20 |
$3,052 |
1.3× |
| Neck soft tissue (70360) |
$136.85 |
$391 |
1.6× |
| Nm adrenal scan (78075) |
$2,098.95 |
$5,997 |
1.7× |
| Nm bone marrow multi (78103) |
$609.35 |
$1,741 |
1.6× |
| Nm bone marrow wb (78104) |
$709.80 |
$2,028 |
1.8× |
| Nm cardiac blood pool multiple (78473) |
$1,231.65 |
$3,519 |
3.2× |
| Nm cisternogram (78630) |
$690.90 |
$1,974 |
1.3× |
| Nm gastric emptying study (78264) |
$964.60 |
$2,756 |
2.5× |
| Nm kidney scan w/flow (78701) |
$2,226.35 |
$6,361 |
5.7× |
| Nm peritoneal-venous shunt patency (78291) |
$749.35 |
$2,141 |
1.9× |
| Nonvascular shunt X-ray (75809) |
$377.30 |
$1,078 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$1,524.25 |
$4,355 |
6.7× |
| Osseous survey limited (77074) |
$153.65 |
$439 |
1.5× |
| Parathyrd planar w/spect&CT (78072) |
$856.10 |
$2,446 |
1.6× |
| Parathyroid Planar Imaging (78070) |
$498.40 |
$1,424 |
1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$498.40 |
$1,424 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$187.25 |
$535 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$3,282.30 |
$9,378 |
2.4× |
| PET imaging CT for attenuation limited area (78814) |
$3,086.30 |
$8,818 |
2.2× |
| PET imaging for CT attenuation whole body (78816) |
$3,467.80 |
$9,908 |
2.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,007.50 |
$11,450 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,903.90 |
$11,154 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$508.20 |
$1,452 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$990.50 |
$2,830 |
1.9× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$2,527.35 |
$7,221 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$680.40 |
$1,944 |
1.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$206.50 |
$590 |
2.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$109.55 |
$313 |
1.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$212.80 |
$608 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$109.55 |
$313 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$187.25 |
$535 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$511.35 |
$1,461 |
5.0× |
| Radex fingr minimum 2 views (73140) |
$132.30 |
$378 |
1.6× |
| Radex Foot Compl Minimum 3 Views (73630) |
$195.30 |
$558 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$184.10 |
$526 |
2.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$109.55 |
$313 |
1.3× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$299.25 |
$855 |
2.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$154 |
$440 |
1.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$236.95 |
$677 |
2.3× |
| Radex Humerus Minimum 2 Views (73060) |
$188.30 |
$538 |
2.2× |
| Radex Kne 1/2 Views (73560) |
$151.20 |
$432 |
1.8× |
| Radex Kne Compl 4/More Views (73564) |
$236.60 |
$676 |
2.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$207.20 |
$592 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$231.35 |
$661 |
2.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$230.65 |
$659 |
2.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$188.30 |
$538 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$109.55 |
$313 |
1.3× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$211.05 |
$603 |
2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$109.55 |
$313 |
1.3× |
| Radex Toe Minimum 2 Views (73660) |
$136.50 |
$390 |
1.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$158.55 |
$453 |
1.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$195.65 |
$559 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$536.90 |
$1,534 |
5.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$145.25 |
$415 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$361.55 |
$1,033 |
3.5× |
| Radiologic exam chest 2 views (71046) |
$145.25 |
$415 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$595.70 |
$1,702 |
3.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$273.70 |
$782 |
1.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$493.85 |
$1,411 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$486.85 |
$1,391 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$109.55 |
$313 |
1.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$185.85 |
$531 |
2.2× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$153.65 |
$439 |
1.5× |
| Radiological examination surgical specimen (76098) |
$680.40 |
$1,944 |
1.3× |
| Ribs bilateral 3 views (71110) |
$349.30 |
$998 |
3.4× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$603.75 |
$1,725 |
1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$855.05 |
$2,443 |
2.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,619.45 |
$4,627 |
3.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,654.45 |
$4,727 |
3.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,654.45 |
$4,727 |
1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,014.25 |
$5,755 |
1.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,654.45 |
$4,727 |
1.3× |
| Sacroiliac Joints < 3 Views (72200) |
$153.65 |
$439 |
1.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$299.95 |
$857 |
1.3× |
| Scapula (73010) |
$131.95 |
$377 |
1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$29.75 |
$85 |
1.3× |
| Shoulder 1 view (73020) |
$145.60 |
$416 |
1.7× |
| Small bowel series (74250) |
$305.55 |
$873 |
1.8× |
| Spine thoracic 3 views (72072) |
$280 |
$800 |
2.7× |
| Splenoportograpy rs&i (75810) |
$4,007.50 |
$11,450 |
1.3× |
| Thoracolumbar 2 views (72080) |
$313.95 |
$897 |
3.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,428.35 |
$4,081 |
2.7× |
| Thyroid imaging w/blood flow (78013) |
$498.40 |
$1,424 |
1.3× |
| Thyroid uptake measurement (78012) |
$498.40 |
$1,424 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$646.62 |
$1,847.50 |
1.7× |
| Tmj unilateral (70328) |
$109.55 |
$313 |
1.3× |
| Ultrasound breast complete (76641) |
$386.40 |
$1,104 |
3.8× |
| Ultrasound Exam Aaa Screen (76706) |
$180.95 |
$517 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$411.60 |
$1,176 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$330.75 |
$945 |
3.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$106.05 |
$303 |
1.2× |
| Unlisted fluoroscopic procedure (76496) |
$109.55 |
$313 |
1.3× |
| Unlisted gastrointestinal px dx nuclear medicine (78299) |
$647.15 |
$1,849 |
1.7× |
| Ureteral reflux study (78740) |
$1,559.25 |
$4,455 |
4.0× |
| Urethrocystogram voiding (74455) |
$653.80 |
$1,868 |
2.8× |
| Urethrocystography retrograde rs&i (74450) |
$357 |
$1,020 |
1.5× |
| Us breast unilateral limited (76642) |
$271.25 |
$775 |
3.2× |
| Us chest (76604) |
$406.35 |
$1,161 |
4.0× |
| Us compl joint r-t w/image documentation (76881) |
$602.35 |
$1,721 |
5.9× |
| Us elastography parenchyma (76981) |
$220.85 |
$631 |
2.2× |
| Us encephalogram (76506) |
$270.20 |
$772 |
2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$290.50 |
$830 |
2.8× |
| Us ob detailed single fetus (76811) |
$431.20 |
$1,232 |
1.9× |
| Us ob limited (76815) |
$283.15 |
$809 |
2.8× |
| Us ob transvaginal (76817) |
$355.95 |
$1,017 |
3.5× |
| Us pelvic non ob complete (76856) |
$427 |
$1,220 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$298.20 |
$852 |
2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$311.15 |
$889 |
3.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$249.20 |
$712 |
2.4× |
| Us retroperitoneal complete (76770) |
$394.80 |
$1,128 |
3.9× |
| Us retroperitoneal limited (76775) |
$227.85 |
$651 |
2.2× |
| Us scrotum and contents (76870) |
$537.25 |
$1,535 |
5.3× |
| Us soft tissue head/neck (76536) |
$516.95 |
$1,477 |
5.1× |
| Us spinal canal and contents (76800) |
$390.60 |
$1,116 |
3.8× |
| Us, eye b-scan (76512) |
$219.45 |
$627 |
2.2× |
| Venogram extremity bilateral (75822) |
$1,460.72 |
$4,173.50 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,926.75 |
$5,505 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$4,127.90 |
$11,794 |
1.3× |
| Venography caval superior serialography rs&i (75827) |
$1,926.75 |
$5,505 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$4,127.90 |
$11,794 |
1.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,127.90 |
$11,794 |
1.3× |
| Venous sampling by catheter (75893) |
$6,704.95 |
$19,157 |
1.2× |
| Vertebral fracture assessment via dxa (77086) |
$109.55 |
$313 |
1.3× |
| Wrist 2 views (73100) |
$156.10 |
$446 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$286.30 |
$818 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$128.10 |
$366 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$449.40 |
$1,284 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$164.85 |
$471 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$142.10 |
$406 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$217.70 |
$622 |
2.1× |
| X-ray exam of femur 2/> (73552) |
$170.45 |
$487 |
2.0× |
| X-ray eye for foreign body (70030) |
$141.05 |
$403 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$141.05 |
$403 |
1.7× |
| X-ray IV pyelogram (ivp) (74400) |
$429.10 |
$1,226 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$150.15 |
$429 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$156.10 |
$446 |
1.8× |
| X-ray leg, infant (73592) |
$109.55 |
$313 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$220.85 |
$631 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$331.45 |
$947 |
3.2× |
| X-ray nose-rectum child f.b. (76010) |
$292.25 |
$835 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$170.10 |
$486 |
1.7× |
| X-ray retrograde pyelogram (74420) |
$493.85 |
$1,411 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$161.35 |
$461 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$202.65 |
$579 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$442.75 |
$1,265 |
4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$220.85 |
$631 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$215.25 |
$615 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$263.90 |
$754 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$215.60 |
$616 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$223.30 |
$638 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$176.40 |
$504 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$275.45 |
$787 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$234.15 |
$669 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$196.35 |
$561 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$240.80 |
$688 |
2.4× |
| Xr bone length studies (77073) |
$150.85 |
$431 |
1.5× |
| Xr c-spine 4 or 5 views (72050) |
$290.50 |
$830 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$275.10 |
$786 |
2.7× |
| Xr chest 4+ views (71048) |
$161.35 |
$461 |
1.6× |
| Xr urogram antegrade (74425) |
$534.45 |
$1,527 |
1.6× |