| Abdomen 2 views (74019) |
$249.74 |
$624.34 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,596.04 |
$3,990.10 |
4.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,726.71 |
$4,316.78 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$5,208.03 |
$13,020.08 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$13,143.80 |
$32,859.51 |
4.3× |
| Angiography internal mammary rs&i (75756) |
$13,735.28 |
$34,338.19 |
4.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,174.65 |
$7,936.62 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,288.05 |
$23,220.13 |
3.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$9,288.05 |
$23,220.13 |
3.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,208.03 |
$13,020.08 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,343.41 |
$13,358.54 |
1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,948.58 |
$12,371.47 |
1.6× |
| Ankle 2 views (73600) |
$312.80 |
$782 |
3.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$815.59 |
$2,038.98 |
2.4× |
| Aortogram thoracic (75605) |
$13,680.29 |
$34,200.72 |
2.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,208.03 |
$13,020.08 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$5,208.03 |
$13,020.08 |
1.7× |
| Artery X-Rays Adrenal Gland (75731) |
$1,726.71 |
$4,316.78 |
0.6× |
| Arthrogram elbow (73085) |
$663.68 |
$1,659.20 |
1.9× |
| Arthrogram hip (73525) |
$658.27 |
$1,645.67 |
1.9× |
| Arthrogram shoulder (73040) |
$658.27 |
$1,645.67 |
1.9× |
| Arthrogram wrist (73115) |
$663.68 |
$1,659.20 |
1.9× |
| Arthrography knee lt (73580) |
$658.27 |
$1,645.67 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$909.24 |
$2,273.10 |
2.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,087.16 |
$2,717.90 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,473.26 |
$3,683.16 |
3.8× |
| Bone age studies (77072) |
$206.40 |
$516.01 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,491.94 |
$3,729.84 |
3.8× |
| Bone survey complete (77075) |
$692.14 |
$1,730.36 |
6.8× |
| Brain image w/flow 4 + views (78606) |
$839.01 |
$2,097.54 |
1.6× |
| Brain imaging < 4 static views (78600) |
$233.84 |
$584.60 |
0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,517.36 |
$6,293.42 |
1.8× |
| Brain Imaging Vascular Flow Only (78610) |
$210.23 |
$525.57 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$334.52 |
$836.28 |
3.9× |
| Chest 1 view (71045) |
$320.27 |
$800.67 |
3.8× |
| Chest 3 views (71047) |
$397.68 |
$994.19 |
4.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$503.54 |
$1,258.84 |
2.9× |
| Clavicle complete (73000) |
$340.74 |
$851.84 |
4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$133.54 |
$333.84 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,996.29 |
$12,490.72 |
14.7× |
| CT abdomen and pelvis without contrast (74176) |
$3,860.20 |
$9,650.51 |
16.6× |
| CT abdomen w contrast (74160) |
$2,498.14 |
$6,245.36 |
14.6× |
| CT abdomen w wo contrast (74170) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT abdomen w/o contrast (74150) |
$1,725.04 |
$4,312.59 |
16.9× |
| CT angio hrt w/3d image (75574) |
$624.54 |
$1,561.34 |
1.8× |
| CT angiography upper extremity lt (73206) |
$2,918.96 |
$7,297.39 |
17.0× |
| CT c-spine w/o contrast (72125) |
$1,650.75 |
$4,126.88 |
16.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT cervical spine with contrast (72126) |
$2,054.20 |
$5,135.50 |
6.0× |
| CT chest w/wo contrast (71270) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT chest with contrast (71260) |
$2,054.20 |
$5,135.50 |
12.0× |
| CT head/brain with contrast (70460) |
$2,054.20 |
$5,135.50 |
12.0× |
| CT head/brain without and with contrast (70470) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$624.54 |
$1,561.34 |
1.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$69.80 |
$174.52 |
0.8× |
| CT hrt w/3d image congen (75573) |
$624.54 |
$1,561.34 |
1.8× |
| CT iac w contrast (70481) |
$2,142.66 |
$5,356.64 |
12.5× |
| CT limited/localized follow up study (76380) |
$292.88 |
$732.21 |
3.4× |
| CT lower ext w/o (73700) |
$1,725.04 |
$4,312.59 |
16.9× |
| CT lower extremity w wo contrast (73702) |
$2,346.30 |
$5,865.74 |
13.7× |
| CT lower extremity with contrast (73701) |
$1,965.74 |
$4,914.35 |
11.5× |
| CT lumbar spine w & w/o contrast (72133) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT lumbar spine w/o contrast (72131) |
$2,173.48 |
$5,433.69 |
21.3× |
| CT lumbar spine with contrast (72132) |
$1,725.04 |
$4,312.59 |
5.1× |
| CT maxillofacial w contrast (70487) |
$2,054.20 |
$5,135.50 |
12.0× |
| CT maxillofacial w/o contrast (70486) |
$1,725.04 |
$4,312.59 |
16.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,107.05 |
$2,767.63 |
6.5× |
| CT neck soft tissue w contrast (70491) |
$2,384.26 |
$5,960.66 |
13.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT orbits w/o contrast (70480) |
$1,513.51 |
$3,783.77 |
14.8× |
| CT pelvis w & w/o contrast (72194) |
$2,740.14 |
$6,850.34 |
16.0× |
| CT pelvis w/o contrast (72192) |
$1,986.60 |
$4,966.50 |
19.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,725.04 |
$4,312.59 |
16.9× |
| CT thoracic spine w/contrast (72129) |
$2,054.20 |
$5,135.50 |
12.0× |
| CT thoracic spine w/o contrast (72128) |
$1,901.05 |
$4,752.63 |
18.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT thorax w/o contrast (71250) |
$1,901.05 |
$4,752.63 |
18.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,451.88 |
$6,129.70 |
14.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,725.04 |
$4,312.59 |
16.9× |
| CT upper extremity with contrast (73201) |
$2,054.20 |
$5,135.50 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,918.96 |
$7,297.39 |
17.0× |
| Cta Abdomen (74175) |
$2,918.96 |
$7,297.39 |
17.0× |
| CTA abdomen pelvis (74174) |
$2,780.15 |
$6,950.38 |
8.2× |
| CTA chest (71275) |
$2,918.96 |
$7,297.39 |
17.0× |
| Cta Head (70496) |
$2,103.14 |
$5,257.84 |
12.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,918.96 |
$7,297.39 |
17.0× |
| Cta Neck (70498) |
$1,393.20 |
$3,482.98 |
8.1× |
| Cta Pelvis (72191) |
$2,329.12 |
$5,822.78 |
13.6× |
| Cystography minimum 3 views rs&i (74430) |
$693.94 |
$1,734.84 |
2.0× |
| Diskogram cervical (72285) |
$1,243.29 |
$3,108.22 |
0.7× |
| Diskography lumbar (72295) |
$1,243.29 |
$3,108.22 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$462.28 |
$1,155.69 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$229.67 |
$574.18 |
2.7× |
| Echoencephalography real time imaging (76506) |
$317.60 |
$793.99 |
3.1× |
| Esophagus (74220) |
$428.72 |
$1,071.80 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$531.58 |
$1,328.95 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$946.60 |
$2,366.48 |
9.3× |
| Fluoroscopy up to 1 hr (76000) |
$455.63 |
$1,139.07 |
2.0× |
| Foot 2 views (73620) |
$230.78 |
$576.96 |
2.7× |
| Forearm 2 views (73090) |
$337.13 |
$842.83 |
4.0× |
| Gastric mucosa imaging (78261) |
$738.56 |
$1,846.41 |
1.9× |
| Gated Heart Planar Single (78472) |
$326.45 |
$816.12 |
0.8× |
| Hand 2 views (73120) |
$285.21 |
$659.27 |
2.8× |
| Hand 3 views (73130) |
$352.30 |
$880.76 |
4.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,249.08 |
$3,122.70 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,092.50 |
$2,731.24 |
2.8× |
| Ht muscle image spect sing (78451) |
$2,041.76 |
$5,104.38 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$308.19 |
$770.48 |
3.6× |
| Hysterosalpingogram (74740) |
$1,086.31 |
$2,715.77 |
4.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$994.64 |
$2,486.59 |
1.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,517.76 |
$3,794.40 |
2.9× |
| Knee 3 views (73562) |
$369.21 |
$923.03 |
4.3× |
| Liver & spleen imaging static only (78215) |
$596.96 |
$1,492.42 |
1.5× |
| Lung Ventilation Imaging (78579) |
$686.80 |
$1,717.01 |
1.8× |
| Lymphoscintigraphy (78195) |
$813.14 |
$2,032.85 |
1.5× |
| Mammary ductogram or galactogram multiple (77054) |
$852.30 |
$2,130.74 |
3.7× |
| Mammary ductogram or galactogram single (77053) |
$623.64 |
$1,559.10 |
2.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$89.83 |
$224.58 |
1.1× |
| Meckels Diverticulum (78290) |
$1,596.04 |
$3,990.10 |
4.1× |
| MRA head w & w/o contrast (70546) |
$1,450.27 |
$3,625.68 |
4.3× |
| MRA head w/o contrast (70544) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRA head with contrast (70545) |
$1,305.34 |
$3,263.35 |
3.8× |
| MRA neck w contrast (70548) |
$2,507.94 |
$6,269.84 |
7.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRA neck w/o contrast (70547) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRI abdomen w contrast (74182) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$1,593.31 |
$3,983.27 |
6.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,445.76 |
$6,114.38 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,507.94 |
$6,269.84 |
3.3× |
| MRI breast w/o contrast bilateral (77047) |
$384.85 |
$962.13 |
1.7× |
| MRI breast w/o contrast unilat (77046) |
$384.85 |
$962.13 |
1.7× |
| MRI c-spine with contrast (72142) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI cervical spine w/o contrast (72141) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,666.40 |
$6,666 |
7.8× |
| MRI chest w/o contrast (71550) |
$1,999.80 |
$4,999.49 |
8.6× |
| MRI chest with contrast (71551) |
$2,399.94 |
$5,999.85 |
3.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,999.80 |
$4,999.49 |
8.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,058.34 |
$5,145.84 |
6.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,285.66 |
$5,714.14 |
6.7× |
| MRI pelvis w contrast (72196) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,666.40 |
$6,666 |
7.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,507.94 |
$6,269.84 |
7.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRI tmj (70336) |
$1,755.28 |
$4,388.22 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,089.79 |
$5,224.46 |
9.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,786.39 |
$6,965.97 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,089.79 |
$5,224.46 |
9.0× |
| Myelogram Cervical (72240) |
$795.46 |
$1,988.66 |
1.0× |
| Myelogram Lumbar (72265) |
$1,460.06 |
$3,650.14 |
1.9× |
| Myelogram thoracic (72255) |
$795.46 |
$1,988.66 |
1.0× |
| Myelography 2 or more regions (72270) |
$813.98 |
$2,034.96 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$4,751.62 |
$11,879.06 |
3.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,553.92 |
$8,884.79 |
4.2× |
| Neck soft tissue (70360) |
$210.85 |
$527.13 |
2.5× |
| Nm adrenal scan (78075) |
$1,026.12 |
$2,565.30 |
0.8× |
| Nm cisternogram (78630) |
$1,052.45 |
$2,631.12 |
2.0× |
| Nm gastric emptying study (78264) |
$1,596.04 |
$3,990.10 |
4.1× |
| Nm gastroesophageal reflux study (78262) |
$746.90 |
$1,867.25 |
1.9× |
| Nm red cell sequestration (78140) |
$828.86 |
$2,072.15 |
2.1× |
| Nuclear medicine of heart pumping function (78473) |
$627.20 |
$1,568 |
1.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$962.62 |
$2,406.54 |
2.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$387.50 |
$968.75 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$326.24 |
$815.61 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$507.36 |
$1,268.38 |
2.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$336.29 |
$840.72 |
3.3× |
| Osseous survey infant (77076) |
$514.22 |
$1,285.53 |
5.0× |
| Osseous survey limited (77074) |
$397.68 |
$994.19 |
3.9× |
| Parathyroid imaging (78070) |
$963.50 |
$2,408.76 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$374.55 |
$936.37 |
3.7× |
| PET image w/CT, skull-thigh (78815) |
$2,564.91 |
$6,412.26 |
1.8× |
| PET imaging CT for attenuation limited area (78814) |
$2,564.91 |
$6,412.26 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,564.91 |
$6,412.26 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,786.39 |
$6,965.97 |
8.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$670.80 |
$1,676.98 |
1.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,326.46 |
$3,316.16 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$571.26 |
$1,428.15 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$198.51 |
$496.28 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$352.30 |
$880.76 |
3.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$245.54 |
$613.86 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$270.46 |
$676.14 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$312.26 |
$780.66 |
3.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$398.58 |
$996.43 |
4.7× |
| Radiologic exam colon single contrast study (74270) |
$726.85 |
$1,817.12 |
4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$289.64 |
$724.11 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$881.57 |
$2,203.93 |
5.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$682.78 |
$1,706.95 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$374.82 |
$937.06 |
4.4× |
| Radiological examination surgical specimen (76098) |
$657.23 |
$1,643.07 |
1.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,417.12 |
$6,042.80 |
0.8× |
| Ribs bilateral 3 views (71110) |
$306.92 |
$767.31 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$932.58 |
$2,331.46 |
2.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$690.87 |
$1,727.18 |
1.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,714.60 |
$4,286.51 |
3.2× |
| Rp Therapy Intravenous Administration (79101) |
$536.68 |
$1,341.69 |
2.4× |
| Salivary gland imaging serial images (78231) |
$241.72 |
$604.29 |
0.6× |
| Scanogram (77073) |
$342.51 |
$856.28 |
3.4× |
| Scapula complete (73010) |
$388.78 |
$971.94 |
3.8× |
| Screening digital breast tomosynthesis (77063) |
$42.02 |
$105.06 |
1.8× |
| Sella turcica (70240) |
$127.80 |
$319.50 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$376.24 |
$940.62 |
3.7× |
| Sialogram (70390) |
$326.45 |
$816.12 |
1.4× |
| Small bowel series (74250) |
$626.32 |
$1,565.80 |
3.7× |
| Spine thoracic 3 views (72072) |
$510.65 |
$1,276.64 |
5.0× |
| Spleen imaging only (78185) |
$310.71 |
$776.77 |
0.8× |
| Testicular Imaging With Vascular Flow (78761) |
$460.27 |
$1,150.68 |
1.2× |
| Therapeutic Enema (74283) |
$726.85 |
$1,817.12 |
4.2× |
| Thoracolumbar 2 views (72080) |
$454.60 |
$1,136.52 |
5.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,327.36 |
$3,318.41 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$274.92 |
$687.28 |
0.7× |
| Thyroid uptake measurement (78012) |
$209.08 |
$522.68 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$426.15 |
$1,065.36 |
1.1× |
| Tmj unilateral (70328) |
$219.75 |
$549.38 |
2.6× |
| Tomogram (76100) |
$192.63 |
$481.57 |
1.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,791.76 |
$4,479.40 |
3.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,327.36 |
$3,318.41 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$894.58 |
$2,215.59 |
8.8× |
| Unlisted Ultrasound Procedure (76999) |
$91.22 |
$228.05 |
1.1× |
| Upper Extremity Infant (73092) |
$212.62 |
$531.56 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$402.12 |
$1,005.30 |
1.7× |
| Urethrocystography voiding (74455) |
$578.27 |
$1,445.68 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$727.05 |
$1,817.63 |
4.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$449.16 |
$1,122.90 |
2.6× |
| Us abdl aorta screen aaa (76706) |
$311.06 |
$777.66 |
3.0× |
| Us breast unilateral complete (76641) |
$704.91 |
$1,762.28 |
6.9× |
| Us breast unilateral limited (76642) |
$487.19 |
$1,217.97 |
5.7× |
| Us chest (76604) |
$243.77 |
$609.42 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$305.15 |
$762.88 |
3.0× |
| Us elastography parenchyma (76981) |
$181.54 |
$453.86 |
1.8× |
| Us guided compression repair (76936) |
$1,176.66 |
$2,941.65 |
5.6× |
| Us infant hips dynamic (76885) |
$400.98 |
$1,002.45 |
4.7× |
| Us kidney transplant (76776) |
$588.06 |
$1,470.16 |
5.8× |
| Us ob detailed single fetus (76811) |
$1,084.49 |
$2,711.23 |
4.7× |
| Us ob transvaginal (76817) |
$868.29 |
$2,170.74 |
8.5× |
| Us pelvic non ob complete (76856) |
$811.37 |
$2,028.43 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$309.01 |
$772.53 |
3.0× |
| Us pregnancy ltd (76815) |
$612.96 |
$1,532.42 |
6.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$543.59 |
$1,358.97 |
5.3× |
| Us retroperitoneal complete (76770) |
$450.55 |
$1,126.37 |
4.4× |
| Us retroperitoneal limited (76775) |
$388.82 |
$972.06 |
3.8× |
| Us scrotum and contents (76870) |
$810.47 |
$2,026.18 |
7.9× |
| Us soft tissue head/neck (76536) |
$785.06 |
$1,962.65 |
7.7× |
| Us spinal canal and contents (76800) |
$735.74 |
$1,839.34 |
7.2× |
| Us xtr non-vasc lmtd (76882) |
$586.28 |
$1,465.68 |
5.7× |
| Venogram extremity bilateral (75822) |
$2,189.43 |
$5,473.58 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$8,993.88 |
$22,484.71 |
2.9× |
| Venography caval superior serialography rs&i (75827) |
$4,684.68 |
$11,711.72 |
3.0× |
| Venography extremity unilateral rs&i (75820) |
$995.53 |
$2,488.82 |
0.6× |
| Venography Renal Bilateral (75833) |
$13,143.80 |
$32,859.51 |
4.3× |
| Venography renal unilateral selective rs&i (75831) |
$13,143.80 |
$32,859.51 |
4.3× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,159.52 |
$7,898.81 |
0.6× |
| Wrist 2 views (73100) |
$248.54 |
$621.36 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$539.14 |
$1,347.83 |
5.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$276.68 |
$691.68 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$380.55 |
$951.38 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$806.92 |
$2,017.30 |
4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$315.01 |
$787.52 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$408.34 |
$1,020.87 |
4.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$774.88 |
$1,937.21 |
7.6× |
| X-ray exam hip uni 1 view (73501) |
$147.18 |
$367.96 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$352.30 |
$880.76 |
4.1× |
| X-ray exam hip uni 4/> views (73503) |
$183.37 |
$458.42 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$352.30 |
$880.76 |
3.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$352.30 |
$880.76 |
3.5× |
| X-ray exam of femur 1 (73551) |
$248.21 |
$620.53 |
2.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$626.32 |
$1,565.80 |
3.7× |
| X-ray eye for foreign body (70030) |
$203.73 |
$509.32 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$439.48 |
$1,098.72 |
4.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$380.55 |
$951.38 |
4.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,915.84 |
$7,289.60 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$269.02 |
$672.56 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$96.32 |
$240.79 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$515.11 |
$1,287.78 |
5.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$169.04 |
$422.60 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$212.62 |
$531.56 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$290.04 |
$725.10 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$822.93 |
$2,057.32 |
8.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$696.60 |
$1,741.50 |
6.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$423.12 |
$1,057.79 |
5.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$174.37 |
$435.92 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$220.63 |
$551.57 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$497.32 |
$1,243.31 |
4.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$418.14 |
$1,045.36 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$331.84 |
$829.60 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$397.68 |
$994.19 |
3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$431.48 |
$1,078.69 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$332.74 |
$831.84 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$335.39 |
$838.48 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$414.80 |
$1,037 |
4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$567.60 |
$1,419 |
6.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$317.55 |
$793.88 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$613.86 |
$1,534.66 |
6.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$282.10 |
$705.26 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$248.88 |
$622.21 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$195.73 |
$489.32 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$298.04 |
$745.12 |
3.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$397.68 |
$994.19 |
3.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$374.55 |
$936.37 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$141.46 |
$353.66 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$380.55 |
$951.38 |
4.5× |
| Xr arthrogram ankle (73615) |
$345.44 |
$863.59 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$515.11 |
$1,287.78 |
5.0× |
| Xr chest 4+ views (71048) |
$580.05 |
$1,450.12 |
5.7× |
| Xr finger(s) 2+ views (73140) |
$112.98 |
$282.46 |
1.3× |
| Xr shoulder 1 view (73020) |
$347.85 |
$869.63 |
4.1× |
| Xr spine cervical 4 or 5 views (72050) |
$684.14 |
$1,710.34 |
6.7× |
| Xr tibia/fibula 2 views (73590) |
$380.55 |
$951.38 |
4.5× |
| Xr tmj bilateral (70330) |
$331.84 |
$829.60 |
3.9× |
| Xray knee 1 or 2 views rt (73560) |
$221.78 |
$554.45 |
2.6× |