| Abdomen 2 views (74019) |
$135.25 |
$270.49 |
1.4× |
| Ankle 2 views (73600) |
$90.17 |
$180.33 |
1.1× |
| Bone age studies (77072) |
$63.12 |
$126.23 |
0.7× |
| Bone survey complete (77075) |
$77.58 |
$155.15 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$135.25 |
$270.49 |
1.7× |
| Chest 1 view (71045) |
$99.18 |
$198.36 |
1.3× |
| Chest 3 views (71047) |
$210.38 |
$420.76 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$198.36 |
$396.71 |
1.2× |
| Clavicle complete (73000) |
$102.19 |
$204.37 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$112.50 |
$225 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,097.75 |
$4,195.49 |
6.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,274.28 |
$2,548.55 |
5.9× |
| CT abdomen w contrast (74160) |
$1,006.80 |
$2,013.59 |
6.3× |
| CT abdomen w wo contrast (74170) |
$1,133.02 |
$2,266.04 |
7.1× |
| CT abdomen w/o contrast (74150) |
$736.32 |
$1,472.63 |
7.7× |
| CT angiography upper extremity lt (73206) |
$901.61 |
$1,803.22 |
5.6× |
| CT c-spine w/o contrast (72125) |
$931.67 |
$1,863.33 |
9.8× |
| CT chest w/wo contrast (71270) |
$961.72 |
$1,923.43 |
6.0× |
| CT chest with contrast (71260) |
$901.61 |
$1,803.22 |
5.6× |
| CT head/brain with contrast (70460) |
$901.61 |
$1,803.22 |
5.6× |
| CT head/brain without and with contrast (70470) |
$961.72 |
$1,923.43 |
6.0× |
| CT iac w contrast (70481) |
$769.98 |
$1,539.94 |
4.8× |
| CT limited/localized follow up study (76380) |
$399.72 |
$799.43 |
5.0× |
| CT lower ext w/o (73700) |
$646.15 |
$1,292.30 |
6.8× |
| CT lower extremity with contrast (73701) |
$766.37 |
$1,532.73 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$931.67 |
$1,863.33 |
9.8× |
| CT lumbar spine with contrast (72132) |
$1,051.88 |
$2,103.76 |
3.3× |
| CT maxillofacial w contrast (70487) |
$631.13 |
$1,262.26 |
4.0× |
| CT maxillofacial w/o contrast (70486) |
$742.33 |
$1,484.65 |
7.8× |
| CT maxillofacial w/wo contrast (70488) |
$887.30 |
$1,774.60 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$811.45 |
$1,622.90 |
5.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$809.42 |
$1,618.84 |
5.1× |
| CT orbits w/o contrast (70480) |
$761.86 |
$1,523.72 |
8.0× |
| CT pelvis w & w/o contrast (72194) |
$920.19 |
$1,840.37 |
5.8× |
| CT pelvis w/o contrast (72192) |
$841.50 |
$1,683 |
8.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$147.27 |
$294.53 |
1.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$991.77 |
$1,983.54 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$691.24 |
$1,382.47 |
7.3× |
| CT thoracic spine w/o contrast (72128) |
$931.67 |
$1,863.33 |
9.8× |
| CT thorax w/o contrast (71250) |
$742.33 |
$1,484.65 |
7.8× |
| CT upper extremity w/o contrast rt (73200) |
$646.15 |
$1,292.30 |
6.8× |
| CT upper extremity with contrast (73201) |
$766.37 |
$1,532.73 |
2.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$991.77 |
$1,983.54 |
6.2× |
| Cta Abdomen (74175) |
$991.77 |
$1,983.54 |
6.2× |
| CTA abdomen pelvis (74174) |
$1,316.35 |
$2,632.70 |
4.1× |
| CTA chest (71275) |
$1,202.15 |
$2,404.29 |
7.5× |
| Cta Head (70496) |
$991.77 |
$1,983.54 |
6.2× |
| Cta Neck (70498) |
$1,051.88 |
$2,103.76 |
6.6× |
| Cta Pelvis (72191) |
$961.72 |
$1,923.43 |
6.0× |
| Cystography minimum 3 views rs&i (74430) |
$204.37 |
$408.73 |
0.6× |
| Esophagus (74220) |
$192.35 |
$384.69 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$198.36 |
$396.71 |
0.9× |
| Foot 2 views (73620) |
$90.17 |
$180.33 |
1.1× |
| Forearm 2 views (73090) |
$105.19 |
$210.37 |
1.3× |
| Hand 2 views (73120) |
$93.17 |
$186.33 |
1.0× |
| Hand 3 views (73130) |
$123.22 |
$246.44 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$106.70 |
$213.38 |
1.3× |
| Knee 3 views (73562) |
$123.22 |
$246.44 |
1.6× |
| MRA head w & w/o contrast (70546) |
$1,348.72 |
$2,697.43 |
4.2× |
| MRA head w/o contrast (70544) |
$1,312.74 |
$2,625.48 |
6.0× |
| MRA head with contrast (70545) |
$1,251.53 |
$2,503.05 |
3.9× |
| MRA neck w contrast (70548) |
$1,218.71 |
$2,437.42 |
3.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,332.94 |
$2,665.87 |
4.2× |
| MRA neck w/o contrast (70547) |
$1,246.48 |
$2,492.95 |
5.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,577.82 |
$3,155.63 |
5.0× |
| MRI abdomen w/o contrast (74181) |
$1,238.21 |
$2,476.42 |
5.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,146.76 |
$2,293.51 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,209.87 |
$2,419.73 |
1.7× |
| MRI c-spine with contrast (72142) |
$1,218.08 |
$2,436.15 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$1,250.23 |
$2,500.46 |
5.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,146.76 |
$2,293.51 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,146.76 |
$2,293.51 |
3.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,021.83 |
$2,043.65 |
4.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,003.50 |
$2,006.99 |
4.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,325.99 |
$2,651.98 |
4.2× |
| MRI pelvis w contrast (72196) |
$1,003.50 |
$2,006.99 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,322.36 |
$2,644.72 |
4.2× |
| MRI pelvis w/o contrast (72195) |
$871.56 |
$1,743.12 |
4.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,325.99 |
$2,651.98 |
4.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,325.99 |
$2,651.98 |
4.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,562.79 |
$3,125.58 |
4.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,250.23 |
$2,500.46 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,683.01 |
$3,366.01 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,218.08 |
$2,436.15 |
3.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,562.79 |
$3,125.58 |
4.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,142.04 |
$2,284.08 |
5.3× |
| MRI tmj (70336) |
$1,003.50 |
$2,006.99 |
4.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,262.25 |
$2,524.50 |
5.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,081.93 |
$2,163.86 |
3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$860.23 |
$1,720.45 |
4.0× |
| Neck soft tissue (70360) |
$96.17 |
$192.34 |
1.2× |
| Osseous survey infant (77076) |
$86.46 |
$172.92 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$114.21 |
$228.41 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,202.15 |
$2,404.29 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$562.34 |
$1,124.67 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$142 |
$284 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$107.30 |
$214.59 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$96.17 |
$192.34 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$153.27 |
$306.54 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$294.53 |
$589.06 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$270.49 |
$540.97 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$246.44 |
$492.88 |
1.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$126.23 |
$252.46 |
1.6× |
| Radiological examination surgical specimen (76098) |
$249.30 |
$498.59 |
0.5× |
| Ribs bilateral 3 views (71110) |
$129.38 |
$258.76 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$108.20 |
$216.39 |
1.1× |
| Scapula complete (73010) |
$105.19 |
$210.37 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$25.50 |
$51 |
1.1× |
| Sella turcica (70240) |
$60.59 |
$121.18 |
0.8× |
| Small bowel series (74250) |
$240.43 |
$480.86 |
1.5× |
| Spine thoracic 3 views (72072) |
$135.25 |
$270.49 |
1.4× |
| Thoracolumbar 2 views (72080) |
$123.22 |
$246.44 |
1.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$823.47 |
$1,646.94 |
1.7× |
| Tmj unilateral (70328) |
$58.07 |
$116.13 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$252.45 |
$504.90 |
2.7× |
| Unlisted Ultrasound Procedure (76999) |
$138.25 |
$276.50 |
1.7× |
| Upper Extremity Infant (73092) |
$64.38 |
$128.75 |
0.7× |
| Urethrocystography voiding (74455) |
$156.28 |
$312.56 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$381.68 |
$763.36 |
2.4× |
| Us breast unilateral complete (76641) |
$178.62 |
$357.22 |
1.9× |
| Us breast unilateral limited (76642) |
$148.95 |
$297.89 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$234.42 |
$468.84 |
2.5× |
| Us ob transvaginal (76817) |
$198.81 |
$397.61 |
2.1× |
| Us pelvic non ob complete (76856) |
$321.57 |
$643.14 |
3.4× |
| Us pregnancy ltd (76815) |
$129.38 |
$258.76 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$258.47 |
$516.93 |
2.7× |
| Us retroperitoneal complete (76770) |
$273.49 |
$546.97 |
2.9× |
| Us scrotum and contents (76870) |
$240.43 |
$480.86 |
2.5× |
| Us soft tissue head/neck (76536) |
$234.42 |
$468.84 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$123.22 |
$246.44 |
1.3× |
| Wrist 2 views (73100) |
$90.17 |
$180.33 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$219.40 |
$438.79 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$94.68 |
$189.35 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$126.23 |
$252.46 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$339.61 |
$679.21 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$96.17 |
$192.34 |
1.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$119.92 |
$239.83 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$65.64 |
$131.28 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$94.68 |
$189.35 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$116.76 |
$233.52 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$99.18 |
$198.36 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$126.23 |
$252.46 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$96.17 |
$192.34 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$72.13 |
$144.26 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$78.89 |
$157.78 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$59.33 |
$118.65 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$150.27 |
$300.54 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$85.21 |
$170.41 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$108.20 |
$216.39 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$110.45 |
$220.90 |
1.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$264.47 |
$528.94 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$126.23 |
$252.46 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$150.27 |
$300.54 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$165.30 |
$330.59 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$114.21 |
$228.41 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$138.25 |
$276.50 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$132.24 |
$264.47 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$81.15 |
$162.29 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$135.69 |
$271.38 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$102.19 |
$204.37 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$108.20 |
$216.39 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$59.96 |
$119.91 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$60.59 |
$121.18 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$150.27 |
$300.54 |
1.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$90.17 |
$180.33 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$97.83 |
$195.65 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$186.19 |
$372.37 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$84.15 |
$168.30 |
1.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$66.90 |
$133.80 |
0.7× |
| Xr shoulder 1 view (73020) |
$102.19 |
$204.37 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$195.35 |
$390.70 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$111.20 |
$222.40 |
1.4× |
| Xr tmj bilateral (70330) |
$119.92 |
$239.83 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$114.21 |
$228.41 |
1.4× |