| Abdomen 2 views (74019) |
$478.50 |
$478.50 |
4.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$970.20 |
$970.20 |
2.3× |
| Ankle 2 views (73600) |
$443.22 |
$443.22 |
4.9× |
| Arthrogram hip (73525) |
$931.70 |
$931.70 |
2.6× |
| Arthrogram shoulder (73040) |
$941.55 |
$941.55 |
2.6× |
| Arthrography knee lt (73580) |
$873.20 |
$873.20 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$816.95 |
$816.95 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$2,157.60 |
$2,157.60 |
5.2× |
| Bone age studies (77072) |
$281.15 |
$281.15 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$2,595.30 |
$2,595.30 |
6.3× |
| Bone survey complete (77075) |
$977.95 |
$977.95 |
9.0× |
| Cervical spine 2 or 3 views (72040) |
$422.30 |
$422.30 |
4.7× |
| Chest 1 view (71045) |
$314.85 |
$314.85 |
3.5× |
| Chest 3 views (71047) |
$432.20 |
$432.20 |
4.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$430.12 |
$430.12 |
2.4× |
| Clavicle complete (73000) |
$484.02 |
$484.02 |
5.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,526.95 |
$2,526.95 |
23.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,733 |
$5,733 |
15.8× |
| CT abdomen and pelvis without contrast (74176) |
$4,630.50 |
$4,630.50 |
18.7× |
| CT abdomen w contrast (74160) |
$3,115.70 |
$3,115.70 |
17.1× |
| CT abdomen w wo contrast (74170) |
$3,601.90 |
$3,601.90 |
19.8× |
| CT abdomen w/o contrast (74150) |
$2,881.95 |
$2,881.95 |
26.5× |
| CT angiography upper extremity lt (73206) |
$3,910.60 |
$3,910.60 |
21.5× |
| CT c-spine w/o contrast (72125) |
$2,866.50 |
$2,866.50 |
26.4× |
| CT cervical spine with contrast (72126) |
$3,381.40 |
$3,381.40 |
9.3× |
| CT chest w/wo contrast (71270) |
$3,528 |
$3,528 |
19.4× |
| CT chest with contrast (71260) |
$2,976.75 |
$2,976.75 |
16.3× |
| CT head/brain with contrast (70460) |
$2,630.60 |
$2,630.60 |
14.4× |
| CT head/brain without and with contrast (70470) |
$3,233.65 |
$3,233.65 |
17.8× |
| CT iac w contrast (70481) |
$2,786.05 |
$2,786.05 |
15.3× |
| CT lower ext w/o (73700) |
$2,480.65 |
$2,480.65 |
22.9× |
| CT lower extremity w wo contrast (73702) |
$4,228.10 |
$4,228.10 |
23.2× |
| CT lower extremity with contrast (73701) |
$2,786.05 |
$2,786.05 |
15.3× |
| CT lumbar spine w & w/o contrast (72133) |
$3,182.95 |
$3,182.95 |
17.5× |
| CT lumbar spine w/o contrast (72131) |
$2,794.85 |
$2,794.85 |
25.7× |
| CT lumbar spine with contrast (72132) |
$3,486.15 |
$3,486.15 |
9.6× |
| CT maxillofacial w contrast (70487) |
$2,743.05 |
$2,743.05 |
15.1× |
| CT maxillofacial w/o contrast (70486) |
$2,195.10 |
$2,195.10 |
20.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,952.50 |
$2,952.50 |
16.2× |
| CT neck soft tissue w contrast (70491) |
$2,836.75 |
$2,836.75 |
15.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,298.70 |
$3,298.70 |
18.1× |
| CT orbits w/o contrast (70480) |
$2,615.15 |
$2,615.15 |
24.1× |
| CT pelvis w & w/o contrast (72194) |
$2,679.10 |
$2,679.10 |
14.7× |
| CT pelvis w/o contrast (72192) |
$2,679.10 |
$2,679.10 |
24.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,200.60 |
$3,200.60 |
17.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,629.50 |
$2,629.50 |
24.2× |
| CT thoracic spine w/contrast (72129) |
$3,084.80 |
$3,084.80 |
16.9× |
| CT thoracic spine w/o contrast (72128) |
$2,842.25 |
$2,842.25 |
26.2× |
| CT thorax w/o contrast (71250) |
$2,646 |
$2,646 |
24.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,758.85 |
$2,758.85 |
15.1× |
| CT upper extremity w/o contrast rt (73200) |
$2,517.05 |
$2,517.05 |
23.2× |
| CT upper extremity with contrast (73201) |
$2,771.70 |
$2,771.70 |
7.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,074.85 |
$4,074.85 |
22.4× |
| Cta Abdomen (74175) |
$3,748.50 |
$3,748.50 |
20.6× |
| CTA abdomen pelvis (74174) |
$4,851 |
$4,851 |
13.4× |
| CTA chest (71275) |
$3,638.25 |
$3,638.25 |
20.0× |
| Cta Head (70496) |
$3,654.80 |
$3,654.80 |
20.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$7,288.65 |
$7,288.65 |
20.1× |
| CTA lwr ext w&w/o contrast (73706) |
$4,130 |
$4,130 |
22.7× |
| Cta Neck (70498) |
$3,633.85 |
$3,633.85 |
20.0× |
| Cta Pelvis (72191) |
$3,158.70 |
$3,158.70 |
17.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$565.60 |
$565.60 |
5.2× |
| Esophagus (74220) |
$783.90 |
$783.90 |
4.3× |
| Fetal biophysical profile non-stress testing (76818) |
$706.65 |
$706.65 |
6.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$594.25 |
$594.25 |
5.5× |
| Fluoroscopy up to 1 hr (76000) |
$781.70 |
$781.70 |
3.2× |
| Foot 2 views (73620) |
$428.90 |
$428.90 |
4.7× |
| Forearm 2 views (73090) |
$478.50 |
$478.50 |
5.3× |
| Gated Heart Planar Single (78472) |
$1,054 |
$1,054 |
2.5× |
| Hand 2 views (73120) |
$421.18 |
$421.18 |
3.9× |
| Hand 3 views (73130) |
$536.95 |
$536.95 |
5.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,976.15 |
$1,976.15 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,283.30 |
$2,283.30 |
5.5× |
| Ht muscle image spect sing (78451) |
$805.95 |
$805.95 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$529.78 |
$529.78 |
5.9× |
| Hysterosalpingogram (74740) |
$804.85 |
$804.85 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,218.30 |
$1,218.30 |
2.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,889.70 |
$1,889.70 |
3.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,826.85 |
$1,826.85 |
3.2× |
| Knee 3 views (73562) |
$612.48 |
$612.48 |
6.8× |
| Liver & spleen imaging static only (78215) |
$801.55 |
$801.55 |
1.9× |
| Meckels Diverticulum (78290) |
$805.95 |
$805.95 |
1.9× |
| MRA head w & w/o contrast (70546) |
$4,417.75 |
$4,417.75 |
12.2× |
| MRA head w/o contrast (70544) |
$4,051.70 |
$4,051.70 |
16.4× |
| MRA head with contrast (70545) |
$4,238.05 |
$4,238.05 |
11.7× |
| MRA neck w contrast (70548) |
$4,238.05 |
$4,238.05 |
11.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,754 |
$4,754 |
13.1× |
| MRA neck w/o contrast (70547) |
$4,051.70 |
$4,051.70 |
16.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,028.50 |
$5,028.50 |
13.9× |
| MRI abdomen w/o contrast (74181) |
$3,737.50 |
$3,737.50 |
15.1× |
| MRI any jnt lwr ext with con lt (73722) |
$4,003.20 |
$4,003.20 |
4.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,024.15 |
$4,024.15 |
4.9× |
| MRI c-spine with contrast (72142) |
$3,738.60 |
$3,738.60 |
10.3× |
| MRI cervical spine w/o contrast (72141) |
$4,074.85 |
$4,074.85 |
16.4× |
| MRI chest w/o contrast (71550) |
$4,235.85 |
$4,235.85 |
17.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,433.15 |
$4,433.15 |
12.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,303.65 |
$3,303.65 |
9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,236.95 |
$3,236.95 |
13.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,736.40 |
$3,736.40 |
15.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,438.70 |
$4,438.70 |
12.3× |
| MRI orbit/face/neck w/contrast (70542) |
$3,566.60 |
$3,566.60 |
9.8× |
| MRI pelvis w contrast (72196) |
$3,985.55 |
$3,985.55 |
11.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,759.50 |
$4,759.50 |
13.1× |
| MRI pelvis w/o contrast (72195) |
$3,577.65 |
$3,577.65 |
14.4× |
| MRI scan of arm joint before and after contrast (73223) |
$4,571 |
$4,571 |
12.6× |
| MRI scan of leg joint before and after contrast (73723) |
$4,264.50 |
$4,264.50 |
11.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,175.15 |
$5,175.15 |
14.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,802.55 |
$3,802.55 |
10.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,873.05 |
$4,873.05 |
13.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,738.60 |
$3,738.60 |
10.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,138.75 |
$5,138.75 |
14.2× |
| MRI thoracic spine w/o contrast (72146) |
$4,164.15 |
$4,164.15 |
16.8× |
| MRI upper ext joint w/o contrast (73221) |
$3,006.55 |
$3,006.55 |
12.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,300.90 |
$3,300.90 |
9.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,300.90 |
$3,300.90 |
13.3× |
| Myocardial Spect Multiple Studies (78452) |
$4,740.75 |
$4,740.75 |
3.5× |
| Neck soft tissue (70360) |
$367.15 |
$367.15 |
4.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$403.62 |
$403.62 |
3.7× |
| Osseous survey infant (77076) |
$665.95 |
$665.95 |
6.1× |
| Parathyroid imaging (78070) |
$1,544.60 |
$1,544.60 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$407.95 |
$407.95 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,125.60 |
$4,125.60 |
11.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,071.65 |
$1,071.65 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$755.25 |
$755.25 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$361.65 |
$361.65 |
4.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$592.05 |
$592.05 |
5.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$568.90 |
$568.90 |
5.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$363.85 |
$363.85 |
4.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$418.95 |
$418.95 |
4.6× |
| Radiologic exam colon single contrast study (74270) |
$1,644.95 |
$1,644.95 |
9.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$883.58 |
$883.58 |
4.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$588.75 |
$588.75 |
6.5× |
| Radiological examination surgical specimen (76098) |
$325.25 |
$325.25 |
0.6× |
| Ribs bilateral 3 views (71110) |
$513.80 |
$513.80 |
4.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,063.95 |
$1,063.95 |
1.9× |
| Scapula complete (73010) |
$552.92 |
$552.92 |
5.1× |
| Screening digital breast tomosynthesis (77063) |
$111.35 |
$111.35 |
4.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$840.15 |
$840.15 |
7.7× |
| Small bowel series (74250) |
$844.55 |
$844.55 |
4.6× |
| Ultrasound scan to determine eye length and lens power (76519) |
$348.40 |
$348.40 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$816.95 |
$816.95 |
7.5× |
| Umbilical-artery Doppler (OB) (76820) |
$368.25 |
$368.25 |
3.4× |
| Urethrocystography voiding (74455) |
$755.25 |
$755.25 |
3.0× |
| Us breast unilateral complete (76641) |
$606.52 |
$606.52 |
5.6× |
| Us breast unilateral limited (76642) |
$488.72 |
$488.72 |
5.4× |
| Us chest (76604) |
$657.10 |
$657.10 |
6.1× |
| Us compl joint r-t w/image documentation (76881) |
$760.75 |
$760.75 |
7.0× |
| Us ob transvaginal (76817) |
$682.45 |
$682.45 |
6.3× |
| Us pelvic non ob complete (76856) |
$927.20 |
$927.20 |
8.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$379.08 |
$379.08 |
3.5× |
| Us pregnancy ltd (76815) |
$538.05 |
$538.05 |
5.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$818.10 |
$818.10 |
7.5× |
| Us retroperitoneal complete (76770) |
$957 |
$957 |
8.8× |
| Us retroperitoneal limited (76775) |
$703.40 |
$703.40 |
6.5× |
| Us scrotum and contents (76870) |
$811.45 |
$811.45 |
7.5× |
| Us soft tissue head/neck (76536) |
$749.70 |
$749.70 |
6.9× |
| Us spinal canal and contents (76800) |
$753.05 |
$753.05 |
6.9× |
| Us transrectal (76872) |
$397.20 |
$397.20 |
3.7× |
| Us xtr non-vasc lmtd (76882) |
$552.15 |
$552.15 |
5.1× |
| Wrist 2 views (73100) |
$408.50 |
$408.50 |
4.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$643.90 |
$643.90 |
5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$435.50 |
$435.50 |
4.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$535.30 |
$535.30 |
5.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$857.75 |
$857.75 |
4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$463.08 |
$463.08 |
5.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$554.58 |
$554.58 |
6.1× |
| X-ray exam hip uni 1 view (73501) |
$310.95 |
$310.95 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$405.75 |
$405.75 |
4.5× |
| X-ray eye for foreign body (70030) |
$304.30 |
$304.30 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$523.70 |
$523.70 |
4.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$361.65 |
$361.65 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$554.58 |
$554.58 |
6.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,117.28 |
$1,117.28 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$447.08 |
$447.08 |
4.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$362.75 |
$362.75 |
4.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$456.45 |
$456.45 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$281.15 |
$281.15 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$388.10 |
$388.10 |
4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$529.20 |
$529.20 |
4.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$389.20 |
$389.20 |
4.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$534.75 |
$534.75 |
4.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$705.60 |
$705.60 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$414.55 |
$414.55 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$506.10 |
$506.10 |
4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,012.20 |
$1,012.20 |
9.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$442.10 |
$442.10 |
4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$392.50 |
$392.50 |
4.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$562.30 |
$562.30 |
6.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$514.90 |
$514.90 |
5.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$320.85 |
$320.85 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$557.90 |
$557.90 |
5.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$367.15 |
$367.15 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$405.75 |
$405.75 |
4.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$391.40 |
$391.40 |
4.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$428.90 |
$428.90 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$388.10 |
$388.10 |
4.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$528.12 |
$528.12 |
5.8× |
| Xr c-spine 6 or more views (72052) |
$726.55 |
$726.55 |
6.7× |
| Xr finger(s) 2+ views (73140) |
$411.80 |
$411.80 |
4.6× |
| Xr shoulder 1 view (73020) |
$408.50 |
$408.50 |
4.5× |
| Xr spine cervical 4 or 5 views (72050) |
$600.90 |
$600.90 |
5.5× |
| Xr tibia/fibula 2 views (73590) |
$507.72 |
$507.72 |
5.6× |
| Xray knee 1 or 2 views rt (73560) |
$537.50 |
$537.50 |
5.9× |