| Abdomen 2 views (74019) |
$547 |
$547 |
5.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,275 |
$2,275 |
5.5× |
| Ankle 2 views (73600) |
$328 |
$328 |
3.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,777 |
$1,777 |
4.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,035 |
$2,035 |
4.9× |
| Bone &/joint imaging whole body (78306) |
$2,782 |
$2,782 |
6.7× |
| Bone Imaging 3 Phase (78315) |
$2,612 |
$2,612 |
6.3× |
| Bone survey complete (77075) |
$1,014 |
$1,014 |
9.3× |
| Cervical spine 2 or 3 views (72040) |
$474 |
$474 |
5.2× |
| Chest 1 view (71045) |
$376 |
$376 |
4.2× |
| Clavicle complete (73000) |
$410 |
$410 |
4.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,502 |
$7,502 |
20.7× |
| CT abdomen and pelvis without contrast (74176) |
$5,517 |
$5,517 |
22.3× |
| CT abdomen w contrast (74160) |
$4,614 |
$4,614 |
25.3× |
| CT abdomen w wo contrast (74170) |
$5,307 |
$5,307 |
29.1× |
| CT abdomen w/o contrast (74150) |
$4,194 |
$4,194 |
38.6× |
| CT c-spine w/o contrast (72125) |
$3,746 |
$3,746 |
34.5× |
| CT chest w/wo contrast (71270) |
$5,757 |
$5,757 |
31.6× |
| CT chest with contrast (71260) |
$4,112 |
$4,112 |
22.6× |
| CT head/brain with contrast (70460) |
$3,708 |
$3,708 |
20.4× |
| CT head/brain without and with contrast (70470) |
$4,262 |
$4,262 |
23.4× |
| CT iac w contrast (70481) |
$2,951 |
$2,951 |
16.2× |
| CT lower ext w/o (73700) |
$3,319 |
$3,319 |
30.6× |
| CT lower extremity with contrast (73701) |
$3,651 |
$3,651 |
20.0× |
| CT lumbar spine w & w/o contrast (72133) |
$3,296 |
$3,296 |
18.1× |
| CT lumbar spine w/o contrast (72131) |
$3,902 |
$3,902 |
35.9× |
| CT maxillofacial w contrast (70487) |
$3,745 |
$3,745 |
20.6× |
| CT maxillofacial w/o contrast (70486) |
$2,620 |
$2,620 |
24.1× |
| CT maxillofacial w/wo contrast (70488) |
$4,198 |
$4,198 |
23.0× |
| CT neck soft tissue w contrast (70491) |
$4,092 |
$4,092 |
22.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,396 |
$3,396 |
18.6× |
| CT orbits w/o contrast (70480) |
$2,685 |
$2,685 |
24.7× |
| CT pelvis w & w/o contrast (72194) |
$4,463 |
$4,463 |
24.5× |
| CT pelvis w/o contrast (72192) |
$4,706 |
$4,706 |
43.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,706 |
$4,706 |
25.8× |
| CT soft tissue neck w/o contrast (70490) |
$3,719 |
$3,719 |
34.3× |
| CT thoracic spine w/o contrast (72128) |
$3,464 |
$3,464 |
31.9× |
| CT thoracic spine w/wo contrast (72130) |
$4,198 |
$4,198 |
23.0× |
| CT thorax w/o contrast (71250) |
$3,886 |
$3,886 |
35.8× |
| CT upper extremity w/o contrast rt (73200) |
$3,183 |
$3,183 |
29.3× |
| CT upper extremity with contrast (73201) |
$3,500 |
$3,500 |
9.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,065 |
$5,065 |
27.8× |
| Cta Abdomen (74175) |
$6,287 |
$6,287 |
34.5× |
| CTA abdomen pelvis (74174) |
$7,313 |
$7,313 |
20.2× |
| CTA chest (71275) |
$5,126 |
$5,126 |
28.1× |
| Cta Head (70496) |
$3,692 |
$3,692 |
20.3× |
| CTA lwr ext w&w/o contrast (73706) |
$3,167 |
$3,167 |
17.4× |
| Cta Neck (70498) |
$3,550 |
$3,550 |
19.5× |
| Cta Pelvis (72191) |
$6,155 |
$6,155 |
33.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$582 |
$582 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$314 |
$314 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$607 |
$607 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$1,000 |
$1,000 |
4.0× |
| Foot 2 views (73620) |
$443 |
$443 |
4.9× |
| Forearm 2 views (73090) |
$406 |
$406 |
4.5× |
| Gated Heart Planar Single (78472) |
$2,543 |
$2,543 |
6.1× |
| Hand 2 views (73120) |
$492 |
$492 |
4.5× |
| Hand 3 views (73130) |
$456 |
$456 |
5.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,013 |
$3,013 |
5.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,740 |
$1,740 |
4.2× |
| Humerus Min 2 Views Left (73060) |
$443 |
$443 |
4.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$492 |
$492 |
4.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,009 |
$2,009 |
3.6× |
| Knee 3 views (73562) |
$468 |
$468 |
5.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$290 |
$290 |
3.2× |
| Meckels Diverticulum (78290) |
$2,511 |
$2,511 |
6.0× |
| MRA head w & w/o contrast (70546) |
$6,400 |
$6,400 |
17.7× |
| MRA head w/o contrast (70544) |
$5,060 |
$5,060 |
20.4× |
| MRA head with contrast (70545) |
$5,564 |
$5,564 |
15.4× |
| MRA neck w contrast (70548) |
$4,878 |
$4,878 |
13.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,609 |
$5,609 |
15.5× |
| MRA neck w/o contrast (70547) |
$4,435 |
$4,435 |
17.9× |
| MRI abdomen w contrast (74182) |
$4,393 |
$4,393 |
12.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,054 |
$5,054 |
14.0× |
| MRI abdomen w/o contrast (74181) |
$3,994 |
$3,994 |
16.1× |
| MRI any jnt lwr ext with con lt (73722) |
$4,256 |
$4,256 |
5.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,256 |
$4,256 |
5.2× |
| MRI bone marrow blood supply (77084) |
$4,176 |
$4,176 |
16.9× |
| MRI c-spine with contrast (72142) |
$5,961 |
$5,961 |
16.5× |
| MRI cervical spine w/o contrast (72141) |
$5,421 |
$5,421 |
21.9× |
| MRI chest w/o & w/contrast material (71552) |
$4,982 |
$4,982 |
13.8× |
| MRI chest w/o contrast (71550) |
$3,939 |
$3,939 |
15.9× |
| MRI chest with contrast (71551) |
$4,332 |
$4,332 |
5.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,136 |
$4,136 |
11.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,498 |
$3,498 |
14.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,703 |
$3,703 |
14.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,683 |
$4,683 |
12.9× |
| MRI orbit/face/neck w/contrast (70542) |
$4,072 |
$4,072 |
11.2× |
| MRI pelvis w contrast (72196) |
$5,049 |
$5,049 |
13.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,807 |
$5,807 |
16.0× |
| MRI pelvis w/o contrast (72195) |
$4,592 |
$4,592 |
18.5× |
| MRI scan of arm joint before and after contrast (73223) |
$4,895 |
$4,895 |
13.5× |
| MRI scan of leg joint before and after contrast (73723) |
$4,895 |
$4,895 |
13.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,855 |
$6,855 |
18.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,961 |
$5,961 |
16.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,855 |
$6,855 |
18.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,961 |
$5,961 |
16.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,855 |
$6,855 |
18.9× |
| MRI thoracic spine w/o contrast (72146) |
$5,421 |
$5,421 |
21.9× |
| MRI tmj (70336) |
$4,176 |
$4,176 |
16.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,869 |
$3,869 |
15.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,146 |
$4,146 |
11.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,761 |
$3,761 |
15.2× |
| Myocardial Spect Multiple Studies (78452) |
$6,252 |
$6,252 |
4.7× |
| Neck soft tissue (70360) |
$443 |
$443 |
4.9× |
| Nm gastric emptying study (78264) |
$2,218 |
$2,218 |
5.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$539 |
$539 |
5.0× |
| Osseous survey infant (77076) |
$492 |
$492 |
4.5× |
| Parathyroid imaging (78070) |
$1,614 |
$1,614 |
3.9× |
| Pelvis 1 or 2 views (72170) |
$517 |
$517 |
4.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,424 |
$4,424 |
12.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,974 |
$2,974 |
5.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$375 |
$375 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$574 |
$574 |
5.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$587 |
$587 |
5.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$762 |
$762 |
7.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$535 |
$535 |
4.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$426 |
$426 |
4.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$477 |
$477 |
5.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$415 |
$415 |
4.6× |
| Ribs bilateral 3 views (71110) |
$775 |
$775 |
7.1× |
| Scapula complete (73010) |
$492 |
$492 |
4.5× |
| Screening digital breast tomosynthesis (77063) |
$72 |
$72 |
3.1× |
| Small bowel series (74250) |
$819 |
$819 |
4.5× |
| Spine thoracic 3 views (72072) |
$664 |
$664 |
6.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,503 |
$1,503 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$582 |
$582 |
5.4× |
| Urethrocystography voiding (74455) |
$1,000 |
$1,000 |
4.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,214 |
$1,214 |
6.7× |
| Us abdl aorta screen aaa (76706) |
$912 |
$912 |
8.4× |
| Us breast unilateral limited (76642) |
$515 |
$515 |
5.7× |
| Us chest (76604) |
$882 |
$882 |
8.1× |
| Us ob transvaginal (76817) |
$727 |
$727 |
6.7× |
| Us pelvic non ob complete (76856) |
$1,036 |
$1,036 |
9.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$528 |
$528 |
4.9× |
| Us pregnancy ltd (76815) |
$562 |
$562 |
5.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$872 |
$872 |
8.0× |
| Us retroperitoneal complete (76770) |
$1,044 |
$1,044 |
9.6× |
| Us retroperitoneal limited (76775) |
$707 |
$707 |
6.5× |
| Us scrotum and contents (76870) |
$884 |
$884 |
8.1× |
| Us soft tissue head/neck (76536) |
$963 |
$963 |
8.9× |
| Us xtr non-vasc lmtd (76882) |
$1,019 |
$1,019 |
9.4× |
| Vertebral fracture assessment via dxa (77086) |
$136 |
$136 |
1.5× |
| Wrist 2 views (73100) |
$338 |
$338 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$762 |
$762 |
7.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$450 |
$450 |
5.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$452 |
$452 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$389 |
$389 |
4.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$435 |
$435 |
4.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$592 |
$592 |
5.5× |
| X-ray exam hip uni 1 view (73501) |
$381 |
$381 |
4.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$415 |
$415 |
4.6× |
| X-ray exam hip uni 4/> views (73503) |
$539 |
$539 |
5.0× |
| X-ray exam of femur 1 (73551) |
$501.50 |
$501.50 |
5.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$553 |
$553 |
5.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$452 |
$452 |
5.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$367 |
$367 |
4.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$492 |
$492 |
4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$583 |
$583 |
5.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$477 |
$477 |
5.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$513 |
$513 |
4.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$562 |
$562 |
6.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$553 |
$553 |
5.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$687 |
$687 |
6.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$492 |
$492 |
4.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$419 |
$419 |
4.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$489 |
$489 |
5.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$449 |
$449 |
5.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$324 |
$324 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$547 |
$547 |
5.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$492 |
$492 |
4.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$132 |
$132 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$376 |
$376 |
4.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$492 |
$492 |
4.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$348 |
$348 |
3.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$376 |
$376 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$795 |
$795 |
7.3× |
| Xr finger(s) 2+ views (73140) |
$330 |
$330 |
3.7× |
| Xr shoulder 1 view (73020) |
$268 |
$268 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$703 |
$703 |
6.5× |
| Xr tibia/fibula 2 views (73590) |
$437 |
$437 |
4.8× |
| Xray knee 1 or 2 views rt (73560) |
$442 |
$442 |
4.9× |