| Abdomen 2 views (74019) |
$165.38 |
$330.75 |
1.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$472.50 |
$945 |
1.3× |
| Ankle 2 views (73600) |
$110.25 |
$220.50 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$315 |
$630 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$604 |
$1,208 |
1.7× |
| Bone age studies (77072) |
$82.95 |
$165.90 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$656 |
$1,312 |
1.9× |
| Bone survey complete (77075) |
$275.63 |
$551.25 |
3.0× |
| Cervical spine 2 or 3 views (72040) |
$234.15 |
$468.30 |
3.1× |
| Chest 1 view (71045) |
$59 |
$118 |
0.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$151.73 |
$303.45 |
1.0× |
| Clavicle complete (73000) |
$112.88 |
$225.75 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$186.38 |
$372.75 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,157.63 |
$2,315.25 |
3.8× |
| CT abdomen and pelvis without contrast (74176) |
$826.88 |
$1,653.75 |
4.0× |
| CT abdomen w contrast (74160) |
$1,088.85 |
$2,177.70 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,157.63 |
$2,315.25 |
7.5× |
| CT abdomen w/o contrast (74150) |
$758.10 |
$1,516.20 |
8.3× |
| CT c-spine w/o contrast (72125) |
$771.75 |
$1,543.50 |
8.4× |
| CT chest w/wo contrast (71270) |
$945 |
$1,890 |
6.1× |
| CT chest with contrast (71260) |
$879.50 |
$1,759 |
5.7× |
| CT head/brain with contrast (70460) |
$744.45 |
$1,488.90 |
4.8× |
| CT head/brain without and with contrast (70470) |
$1,047.38 |
$2,094.75 |
6.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$882 |
$1,764 |
11.6× |
| CT iac w contrast (70481) |
$937.13 |
$1,874.25 |
6.1× |
| CT limited/localized follow up study (76380) |
$303.45 |
$606.90 |
4.0× |
| CT lower ext w/o (73700) |
$1,033.60 |
$2,067.19 |
11.3× |
| CT lower extremity w wo contrast (73702) |
$992.25 |
$1,984.50 |
6.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,157.63 |
$2,315.25 |
7.5× |
| CT lumbar spine w/o contrast (72131) |
$826.88 |
$1,653.75 |
9.0× |
| CT maxillofacial w contrast (70487) |
$882 |
$1,764 |
5.7× |
| CT maxillofacial w/o contrast (70486) |
$744.45 |
$1,488.90 |
8.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,124.55 |
$2,249.10 |
7.3× |
| CT neck soft tissue w contrast (70491) |
$882 |
$1,764 |
5.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,019.55 |
$2,039.10 |
6.6× |
| CT orbits w/o contrast (70480) |
$826.88 |
$1,653.75 |
9.0× |
| CT pelvis w & w/o contrast (72194) |
$1,157.63 |
$2,315.25 |
7.5× |
| CT pelvis w/o contrast (72192) |
$826.88 |
$1,653.75 |
9.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$992.25 |
$1,984.50 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$771.75 |
$1,543.50 |
8.4× |
| CT thoracic spine w/o contrast (72128) |
$771.75 |
$1,543.50 |
8.4× |
| CT thorax w/o contrast (71250) |
$740.05 |
$1,480.10 |
8.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,157.63 |
$2,315.25 |
7.5× |
| CT upper extremity w/o contrast rt (73200) |
$854.70 |
$1,709.40 |
9.3× |
| CT upper extremity with contrast (73201) |
$1,025.33 |
$2,050.65 |
3.4× |
| CTA abdomen pelvis (74174) |
$1,071 |
$2,142 |
3.5× |
| CTA chest (71275) |
$964.95 |
$1,929.90 |
6.3× |
| Cta Head (70496) |
$1,587.60 |
$3,175.20 |
10.3× |
| Cta Neck (70498) |
$926.10 |
$1,852.20 |
6.0× |
| Cystography minimum 3 views rs&i (74430) |
$193.20 |
$386.40 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$193.20 |
$386.40 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$112.88 |
$225.75 |
1.5× |
| Dxa bone density study axial skeleton (77085) |
$29.40 |
$58.80 |
0.3× |
| Echoencephalography real time imaging (76506) |
$220.50 |
$441 |
2.4× |
| Esophagus (74220) |
$234.15 |
$468.30 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$127.05 |
$254.10 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$191.10 |
$382.20 |
0.9× |
| Foot 2 views (73620) |
$123.90 |
$247.80 |
1.6× |
| Forearm 2 views (73090) |
$115.50 |
$231 |
1.5× |
| Gated Heart Planar Single (78472) |
$499 |
$998 |
1.4× |
| Hand 2 views (73120) |
$123.90 |
$247.80 |
1.4× |
| Hand 3 views (73130) |
$137.55 |
$275.10 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$682.50 |
$1,365 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$394 |
$788 |
1.1× |
| Ht muscle image spect sing (78451) |
$1,050 |
$2,100 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$123.90 |
$247.80 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$472.50 |
$945 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$472.50 |
$945 |
1.0× |
| Knee 3 views (73562) |
$110.25 |
$220.50 |
1.4× |
| Liver imaging static only (78201) |
$367.50 |
$735 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$604 |
$1,208 |
1.3× |
| Lymphoscintigraphy (78195) |
$577.50 |
$1,155 |
1.2× |
| Meckels Diverticulum (78290) |
$341 |
$682 |
1.0× |
| MRA head w & w/o contrast (70546) |
$826.88 |
$1,653.75 |
2.7× |
| MRA head w/o contrast (70544) |
$647.85 |
$1,295.70 |
3.1× |
| MRA neck w contrast (70548) |
$647.85 |
$1,295.70 |
2.1× |
| MRA neck w/o contrast (70547) |
$771.75 |
$1,543.50 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$937.13 |
$1,874.25 |
3.1× |
| MRI abdomen w/o contrast (74181) |
$826.88 |
$1,653.75 |
4.0× |
| MRI c-spine with contrast (72142) |
$868.35 |
$1,736.70 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$716.63 |
$1,433.25 |
3.4× |
| MRI chest w/o contrast (71550) |
$716.63 |
$1,433.25 |
3.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$882 |
$1,764 |
4.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$826.88 |
$1,653.75 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,157.63 |
$2,315.25 |
3.8× |
| MRI orbit/face/neck w/contrast (70542) |
$992.25 |
$1,984.50 |
3.2× |
| MRI pelvis w contrast (72196) |
$909.30 |
$1,818.60 |
3.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,047.38 |
$2,094.75 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$826.88 |
$1,653.75 |
4.0× |
| MRI scan of arm joint before and after contrast (73223) |
$992.25 |
$1,984.50 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,047.38 |
$2,094.75 |
3.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$937.13 |
$1,874.25 |
3.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$992.25 |
$1,984.50 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,157.63 |
$2,315.25 |
3.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$992.25 |
$1,984.50 |
3.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,047.38 |
$2,094.75 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$826.88 |
$1,653.75 |
4.0× |
| MRI tmj (70336) |
$992.25 |
$1,984.50 |
4.7× |
| MRI upper ext joint w/o contrast (73221) |
$826.88 |
$1,653.75 |
4.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,190.70 |
$2,381.40 |
3.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$882 |
$1,764 |
4.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,155 |
$2,310 |
1.0× |
| Neck soft tissue (70360) |
$107.63 |
$215.25 |
1.4× |
| Nm gastric emptying study (78264) |
$499 |
$998 |
1.4× |
| Nm red cell sequestration (78140) |
$682.50 |
$1,365 |
1.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$165.38 |
$330.75 |
1.8× |
| Parathyroid imaging (78070) |
$472.50 |
$945 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$115.50 |
$231 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,157.63 |
$2,315.25 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$407 |
$814 |
1.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$165.38 |
$330.75 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$165.38 |
$330.75 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$67.14 |
$134.28 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$123.90 |
$247.80 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$303.45 |
$606.90 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$234.15 |
$468.30 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$165.38 |
$330.75 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$137.55 |
$275.10 |
1.8× |
| Ribs bilateral 3 views (71110) |
$247.80 |
$495.60 |
2.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,111.50 |
$2,223 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$66.15 |
$132.30 |
0.7× |
| Scanogram (77073) |
$157.50 |
$315 |
1.7× |
| Scapula complete (73010) |
$151.73 |
$303.45 |
1.7× |
| Small bowel series (74250) |
$247.80 |
$495.60 |
1.6× |
| Spine thoracic 3 views (72072) |
$179.03 |
$358.05 |
2.0× |
| Thoracolumbar 2 views (72080) |
$49.35 |
$98.70 |
0.6× |
| Thyroid uptake measurement (78012) |
$735 |
$1,470 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$399.53 |
$799.05 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$117.60 |
$235.20 |
1.3× |
| Unlisted Ultrasound Procedure (76999) |
$142.28 |
$284.55 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$264.60 |
$529.20 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$220.50 |
$441 |
2.4× |
| Us breast unilateral limited (76642) |
$264.60 |
$529.20 |
3.5× |
| Us chest (76604) |
$220.50 |
$441 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$220.50 |
$441 |
2.4× |
| Us kidney transplant (76776) |
$330.75 |
$661.50 |
3.6× |
| Us ob transvaginal (76817) |
$137.03 |
$274.05 |
1.5× |
| Us pelvic non ob complete (76856) |
$385.88 |
$771.75 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$179.03 |
$358.05 |
2.0× |
| Us pregnancy ltd (76815) |
$144.50 |
$289 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$265.65 |
$531.30 |
2.9× |
| Us retroperitoneal complete (76770) |
$330.75 |
$661.50 |
3.6× |
| Us scrotum and contents (76870) |
$289.28 |
$578.55 |
3.2× |
| Us soft tissue head/neck (76536) |
$220.50 |
$441 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$220.50 |
$441 |
2.4× |
| Wrist 2 views (73100) |
$123.90 |
$247.80 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$193.20 |
$386.40 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$193.20 |
$386.40 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$137.55 |
$275.10 |
1.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$427.35 |
$854.70 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$110.25 |
$220.50 |
1.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$123.90 |
$247.80 |
1.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$206.85 |
$413.70 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$66.15 |
$132.30 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$137.55 |
$275.10 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$165.38 |
$330.75 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$137.55 |
$275.10 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$107.63 |
$215.25 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$179.03 |
$358.05 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$110.25 |
$220.50 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$111.30 |
$222.60 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$193.20 |
$386.40 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$303.45 |
$606.90 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$151.73 |
$303.45 |
2.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$57.75 |
$115.50 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$193.20 |
$386.40 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$165.38 |
$330.75 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$179.03 |
$358.05 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$179.03 |
$358.05 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$247.80 |
$495.60 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$206.85 |
$413.70 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$123.90 |
$247.80 |
1.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$151.73 |
$303.45 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$206.85 |
$413.70 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$151.73 |
$303.45 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$217.88 |
$435.75 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$151.73 |
$303.45 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$112.88 |
$225.75 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$110.25 |
$220.50 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$137.55 |
$275.10 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$99.23 |
$198.45 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$151.73 |
$303.45 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$289.28 |
$578.55 |
3.2× |
| Xr chest 4+ views (71048) |
$78.50 |
$157 |
0.9× |
| Xr finger(s) 2+ views (73140) |
$112.88 |
$225.75 |
1.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$110.25 |
$220.50 |
1.2× |
| Xr shoulder 1 view (73020) |
$110.25 |
$220.50 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$171.15 |
$342.30 |
2.2× |
| Xr tmj bilateral (70330) |
$165.38 |
$330.75 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$77.18 |
$154.35 |
1.0× |