| Abdomen 2 views (74019) |
$300 |
$428 |
2.8× |
| Ankle 2 views (73600) |
$200 |
$286 |
2.2× |
| Arthrogram hip (73525) |
$704 |
$1,006 |
1.9× |
| Arthrogram shoulder (73040) |
$704 |
$1,006 |
1.9× |
| Arthrogram wrist (73115) |
$704 |
$1,006 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$897 |
$1,282 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$1,378 |
$1,968 |
3.3× |
| Bone age studies (77072) |
$190 |
$271 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,672 |
$2,388 |
4.0× |
| Bone survey complete (77075) |
$670 |
$957 |
6.2× |
| Cervical spine 2 or 3 views (72040) |
$272 |
$388 |
3.0× |
| Chest 1 view (71045) |
$218 |
$312 |
2.4× |
| Clavicle complete (73000) |
$226 |
$323 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$811 |
$1,158 |
7.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,150 |
$5,928 |
11.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,021 |
$4,316 |
12.2× |
| CT abdomen w contrast (74160) |
$2,028 |
$2,897 |
11.1× |
| CT abdomen w wo contrast (74170) |
$2,405 |
$3,435 |
13.2× |
| CT abdomen w/o contrast (74150) |
$1,784 |
$2,549 |
16.4× |
| CT c-spine w/o contrast (72125) |
$1,891 |
$2,702 |
17.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,947 |
$2,782 |
10.7× |
| CT chest w/wo contrast (71270) |
$2,282 |
$3,260 |
12.5× |
| CT chest with contrast (71260) |
$2,019 |
$2,885 |
11.1× |
| CT head/brain with contrast (70460) |
$1,742 |
$2,489 |
9.6× |
| CT head/brain without and with contrast (70470) |
$1,981 |
$2,830 |
10.9× |
| CT iac w contrast (70481) |
$1,830 |
$2,615 |
10.0× |
| CT lower ext w/o (73700) |
$1,679 |
$2,398 |
15.5× |
| CT lower extremity w wo contrast (73702) |
$2,118 |
$3,025 |
11.6× |
| CT lower extremity with contrast (73701) |
$1,802 |
$2,575 |
9.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,024 |
$2,891 |
11.1× |
| CT lumbar spine w/o contrast (72131) |
$1,845 |
$2,636 |
17.0× |
| CT maxillofacial w contrast (70487) |
$1,733 |
$2,475 |
9.5× |
| CT maxillofacial w/o contrast (70486) |
$1,450 |
$2,071 |
13.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,938 |
$2,768 |
10.6× |
| CT neck soft tissue w contrast (70491) |
$1,874 |
$2,677 |
10.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,871 |
$2,673 |
10.3× |
| CT orbits w/o contrast (70480) |
$1,747 |
$2,496 |
16.1× |
| CT pelvis w & w/o contrast (72194) |
$2,172 |
$3,103 |
11.9× |
| CT pelvis w/o contrast (72192) |
$1,769 |
$2,527 |
16.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,100 |
$3,000 |
11.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,640 |
$2,343 |
15.1× |
| CT thoracic spine w/o contrast (72128) |
$1,836 |
$2,623 |
16.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,092 |
$2,988 |
11.5× |
| CT thorax w/o contrast (71250) |
$1,788 |
$2,554 |
16.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,998 |
$2,854 |
11.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,617 |
$2,310 |
14.9× |
| CT upper extremity with contrast (73201) |
$1,857 |
$2,653 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,694 |
$3,848 |
14.8× |
| Cta Abdomen (74175) |
$2,599 |
$3,713 |
14.3× |
| CTA abdomen pelvis (74174) |
$4,332 |
$6,188 |
12.0× |
| CTA chest (71275) |
$2,522 |
$3,603 |
13.8× |
| Cta Head (70496) |
$2,306 |
$3,294 |
12.7× |
| Cta Neck (70498) |
$2,304 |
$3,292 |
12.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$368 |
$525 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$467 |
$667 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$389 |
$555 |
3.6× |
| Foot 2 views (73620) |
$197 |
$282 |
2.2× |
| Forearm 2 views (73090) |
$222 |
$317 |
2.5× |
| Hand 2 views (73120) |
$194 |
$277 |
1.8× |
| Hand 3 views (73130) |
$255 |
$365 |
2.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,494 |
$2,134 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,333 |
$1,904 |
3.2× |
| Humerus Min 2 Views Left (73060) |
$234 |
$334.50 |
2.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,299 |
$1,856 |
2.3× |
| Knee 3 views (73562) |
$274 |
$392 |
3.0× |
| MRA head w & w/o contrast (70546) |
$2,845 |
$4,064 |
7.9× |
| MRA head w/o contrast (70544) |
$2,533 |
$3,618 |
10.2× |
| MRA head with contrast (70545) |
$1,852 |
$2,646 |
5.1× |
| MRA neck w contrast (70548) |
$2,411 |
$3,444 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,936 |
$4,194 |
8.1× |
| MRA neck w/o contrast (70547) |
$2,286 |
$3,266 |
9.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,275 |
$4,678 |
9.0× |
| MRI abdomen w/o contrast (74181) |
$2,549 |
$3,642 |
10.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,482 |
$3,545 |
3.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,449 |
$3,498 |
3.0× |
| MRI c-spine with contrast (72142) |
$2,594 |
$3,706 |
7.2× |
| MRI cervical spine w/o contrast (72141) |
$3,088 |
$4,412 |
12.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,104 |
$3,005 |
8.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,391 |
$3,415 |
9.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,866 |
$4,094 |
7.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,969 |
$4,241 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$2,383 |
$3,404 |
9.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,757 |
$3,938 |
7.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,716 |
$3,880 |
7.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,387 |
$4,839 |
9.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,759 |
$3,941 |
7.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,199 |
$4,570 |
8.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,162 |
$3,088 |
6.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,340 |
$4,772 |
9.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,750 |
$3,929 |
11.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,947 |
$2,782 |
7.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,561 |
$3,658 |
7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,047 |
$2,924 |
8.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,339 |
$4,770 |
2.5× |
| Neck soft tissue (70360) |
$242 |
$346 |
2.7× |
| Nm gastric emptying study (78264) |
$1,446 |
$2,065 |
3.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$284 |
$406 |
2.6× |
| Osseous survey infant (77076) |
$277 |
$395 |
2.6× |
| Parathyroid imaging (78070) |
$1,030 |
$1,472 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$247 |
$353 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,398 |
$3,425 |
6.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,343 |
$1,919 |
3.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,784 |
$2,548 |
3.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$240 |
$343 |
2.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$364 |
$520 |
3.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$239 |
$341 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$329 |
$470 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$239 |
$342 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$263 |
$376 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$489 |
$698 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$266 |
$380 |
2.9× |
| Ribs bilateral 3 views (71110) |
$320 |
$457 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,497 |
$2,139 |
2.7× |
| Scanogram (77073) |
$260 |
$371 |
2.4× |
| Scapula complete (73010) |
$242 |
$346 |
2.2× |
| Screening digital breast tomosynthesis (77063) |
$62 |
$88 |
2.7× |
| Spine thoracic 3 views (72072) |
$391 |
$558 |
3.6× |
| Thoracolumbar 2 views (72080) |
$244 |
$349 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$917 |
$1,310 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$533 |
$762 |
4.9× |
| Unlisted Ultrasound Procedure (76999) |
$475 |
$679 |
5.3× |
| Urethrocystography retrograde rs&i (74450) |
$470 |
$671 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$801 |
$1,144 |
7.4× |
| Us breast unilateral complete (76641) |
$393 |
$561 |
3.6× |
| Us breast unilateral limited (76642) |
$307 |
$438 |
3.4× |
| Us chest (76604) |
$432 |
$617 |
4.0× |
| Us compl joint r-t w/image documentation (76881) |
$526 |
$751 |
4.8× |
| Us pelvic non ob complete (76856) |
$616 |
$880 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$405 |
$579 |
3.7× |
| Us pregnancy ltd (76815) |
$341 |
$487 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$501 |
$716 |
4.6× |
| Us retroperitoneal limited (76775) |
$468 |
$669 |
4.3× |
| Us scrotum and contents (76870) |
$525 |
$750 |
4.8× |
| Us soft tissue head/neck (76536) |
$477 |
$681 |
4.4× |
| Us transrectal (76872) |
$553 |
$790 |
5.1× |
| Wrist 2 views (73100) |
$193 |
$276 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$403 |
$575 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$230 |
$329 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$259 |
$370 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$211 |
$301 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$252 |
$360 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$179 |
$256 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$248 |
$354 |
2.7× |
| X-ray eye for foreign body (70030) |
$207 |
$295 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$331 |
$473 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$226 |
$323 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$263 |
$376 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$183 |
$261 |
2.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$294 |
$420 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$181 |
$258 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$337 |
$481 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$496 |
$709 |
4.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$382 |
$546 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$255 |
$364 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$247 |
$353 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$344 |
$492 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$323 |
$462 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$320 |
$457 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$270 |
$385 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$247 |
$353 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$271 |
$387 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$316 |
$452 |
3.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$214 |
$305 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$352 |
$503 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$242 |
$346 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$234 |
$335 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$213 |
$304 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$249 |
$356 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$284 |
$405 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$183 |
$262 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$244 |
$348 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$479 |
$685 |
4.4× |
| Xr finger(s) 2+ views (73140) |
$181 |
$259 |
2.0× |
| Xr shoulder 1 view (73020) |
$183 |
$261 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$382 |
$546 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$243 |
$347 |
2.7× |
| Xr tmj bilateral (70330) |
$320 |
$457 |
3.5× |
| Xray knee 1 or 2 views rt (73560) |
$250 |
$357 |
2.8× |