| Abdomen 2 views (74019) |
$226.20 |
$290 |
2.1× |
| Ankle 2 views (73600) |
$291.33 |
$373.50 |
3.2× |
| Bone &/joint imaging whole body (78306) |
$1,077.96 |
$1,382 |
2.6× |
| Bone age studies (77072) |
$166.92 |
$214 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$222.30 |
$285 |
2.5× |
| Chest 1 view (71045) |
$446.16 |
$572 |
5.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$445.38 |
$571 |
2.5× |
| Clavicle complete (73000) |
$194.22 |
$249 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$722.28 |
$926 |
6.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,371.98 |
$3,041 |
6.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,734.72 |
$2,224 |
7.0× |
| CT abdomen w contrast (74160) |
$1,166.88 |
$1,496 |
6.4× |
| CT abdomen w wo contrast (74170) |
$1,372.80 |
$1,760 |
7.6× |
| CT abdomen w/o contrast (74150) |
$960.96 |
$1,232 |
8.9× |
| CT c-spine w/contrast (72126) |
$1,465.62 |
$1,879 |
4.1× |
| CT c-spine w/o contrast (72125) |
$1,331.46 |
$1,707 |
12.3× |
| CT chest w contrast (71260) |
$1,372.80 |
$1,760 |
7.6× |
| CT chest w/wo contrast (71270) |
$1,578.72 |
$2,024 |
8.7× |
| CT colonography w/o cntrst (74261) |
$769.08 |
$986 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,353.69 |
$1,735.50 |
7.5× |
| CT lower ext w/o (73700) |
$999.96 |
$1,282 |
9.3× |
| CT lower extremity w/contrast material (73701) |
$1,150.11 |
$1,474.50 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$1,233.96 |
$1,582 |
11.4× |
| CT maxillofacial w contrast (70487) |
$1,203.77 |
$1,543.30 |
6.6× |
| CT maxillofacial wo contrast (70486) |
$1,046.76 |
$1,342 |
9.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,292.85 |
$1,657.50 |
7.1× |
| CT orbits w/o contrast (70480) |
$994.50 |
$1,275 |
9.2× |
| CT pelvis w/o contrast (72192) |
$984.36 |
$1,262 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,070.94 |
$1,373 |
5.9× |
| CT soft tissue neck w/o contrast (70490) |
$910.26 |
$1,167 |
8.4× |
| CT thoracic spine w/contrast (72129) |
$1,293.24 |
$1,658 |
7.1× |
| CT thoracic spine w/o contrast (72128) |
$1,233.96 |
$1,582 |
11.4× |
| CT thorax w/o contrast (71250) |
$1,166.88 |
$1,496 |
10.8× |
| CT upper ext wo (73200) |
$1,020.24 |
$1,308 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,173.12 |
$1,504 |
3.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,638 |
$2,100 |
9.0× |
| Cta Abdomen (74175) |
$1,354.08 |
$1,736 |
7.5× |
| CTA abdomen pelvis (74174) |
$2,044.38 |
$2,621 |
5.7× |
| CTA chest (71275) |
$1,299.48 |
$1,666 |
7.2× |
| Cta Head (70496) |
$1,510.86 |
$1,937 |
8.3× |
| Cta Neck (70498) |
$1,510.86 |
$1,937 |
8.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$300.30 |
$385 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$296.40 |
$380 |
3.3× |
| Facial bones min 3 views (70150) |
$258.96 |
$332 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$482.04 |
$618 |
4.5× |
| Fluoroscopy up to 1 hr (76000) |
$521.04 |
$668 |
2.1× |
| Foot 2 views (73620) |
$187.59 |
$240.50 |
2.1× |
| Forearm 2 views (73090) |
$410.28 |
$526 |
4.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$191.10 |
$245 |
1.8× |
| Knee 3 views (73562) |
$403.65 |
$517.50 |
4.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,364.96 |
$3,032 |
6.6× |
| MRA head w & w/o contrast (70546) |
$2,243.28 |
$2,876 |
6.2× |
| MRA head w/o contrast (70544) |
$1,725.36 |
$2,212 |
7.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,083.38 |
$2,671 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,415.66 |
$3,097 |
6.7× |
| MRI abdomen w/o contrast (74181) |
$1,691.04 |
$2,168 |
6.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,332.20 |
$2,990 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$1,926.60 |
$2,470 |
7.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,035.80 |
$2,610 |
5.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,397.72 |
$3,074 |
6.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,517.84 |
$3,228 |
10.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,229.24 |
$2,858 |
6.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,382.90 |
$3,055 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$1,668.42 |
$2,139 |
6.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,382.12 |
$3,054 |
6.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,382.12 |
$3,054 |
6.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,382.12 |
$3,054 |
6.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,926.60 |
$2,470 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,741.31 |
$3,514.50 |
11.1× |
| MRI, joint upper extrem combo (73223) |
$2,375.88 |
$3,046 |
6.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,754.96 |
$3,532 |
2.1× |
| Neck soft tissue (70360) |
$173.94 |
$223 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$220.74 |
$283 |
2.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$341.64 |
$438 |
3.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$188.76 |
$242 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$336.57 |
$431.50 |
3.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$244.14 |
$313 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$287.04 |
$368 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$176.67 |
$226.50 |
2.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$326.43 |
$418.50 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$327.60 |
$420 |
3.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$200.85 |
$257.50 |
2.2× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$265.20 |
$340 |
2.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$265.98 |
$341 |
2.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$351.78 |
$451 |
3.3× |
| Radex Humerus Minimum 2 Views (73060) |
$230.88 |
$296 |
2.6× |
| Radex Kne 1/2 Views (73560) |
$340.08 |
$436 |
3.8× |
| Radex Kne Compl 4/More Views (73564) |
$456.30 |
$585 |
4.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$248.82 |
$319 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$216.84 |
$278 |
2.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$475.80 |
$610 |
5.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$148.20 |
$190 |
1.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$237.90 |
$305 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$179.40 |
$230 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$240.24 |
$308 |
2.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$461.76 |
$592 |
5.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$294.84 |
$378 |
3.3× |
| Radiologic exam chest 2 views (71046) |
$226.20 |
$290 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$349.83 |
$448.50 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$173.16 |
$222 |
1.6× |
| Scapula (73010) |
$209.04 |
$268 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$169.65 |
$217.50 |
7.3× |
| Shoulder 1 view (73020) |
$200.46 |
$257 |
2.2× |
| Spine thoracic 3 views (72072) |
$268.32 |
$344 |
2.5× |
| Ultrasound breast complete (76641) |
$571.74 |
$733 |
5.3× |
| Ultrasound Exam Aaa Screen (76706) |
$350.22 |
$449 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$654.03 |
$838.50 |
6.1× |
| Umbilical-artery Doppler (OB) (76820) |
$280.80 |
$360 |
2.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$118.56 |
$152 |
1.3× |
| Us breast unilateral limited (76642) |
$493.74 |
$633 |
5.5× |
| Us chest (76604) |
$356.46 |
$457 |
3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$532.35 |
$682.50 |
4.9× |
| Us ob limited (76815) |
$404.04 |
$518 |
3.7× |
| Us ob transvaginal (76817) |
$400.14 |
$513 |
3.7× |
| Us pelvic non ob complete (76856) |
$457.86 |
$587 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$327.60 |
$420 |
3.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$423.54 |
$543 |
3.9× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$438.36 |
$562 |
4.1× |
| Us retroperitoneal complete (76770) |
$432.90 |
$555 |
4.0× |
| Us retroperitoneal limited (76775) |
$358.02 |
$459 |
3.3× |
| Us scrotum and contents (76870) |
$428.22 |
$549 |
4.0× |
| Us soft tissue head/neck (76536) |
$389.22 |
$499 |
3.6× |
| Us, eye b-scan (76512) |
$289.38 |
$371 |
2.7× |
| Wrist 2 views (73100) |
$294.84 |
$378 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$212.94 |
$273 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$195.78 |
$251 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$290.16 |
$372 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$306.15 |
$392.50 |
2.8× |
| X-ray exam of femur 2/> (73552) |
$231.66 |
$297 |
2.6× |
| X-ray eye for foreign body (70030) |
$223.86 |
$287 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$245.70 |
$315 |
2.7× |
| X-ray leg, infant (73592) |
$233.22 |
$299 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$237.90 |
$305 |
2.2× |
| X-ray nose-rectum child f.b. (76010) |
$182.52 |
$234 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$256.62 |
$329 |
2.4× |
| X-ray retrograde pyelogram (74420) |
$614.64 |
$788 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$201.24 |
$258 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$283.92 |
$364 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$341.64 |
$438 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$203.58 |
$261 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$200.46 |
$257 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$197.34 |
$253 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$230.88 |
$296 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$193.44 |
$248 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$188.76 |
$242 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$228.15 |
$292.50 |
2.1× |
| Xr c-spine 4 or 5 views (72050) |
$291.72 |
$374 |
2.7× |
| Xr chest 4+ views (71048) |
$282.36 |
$362 |
2.6× |