| Abdomen 2 views (74019) |
$255.30 |
$555 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$291.18 |
$633 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,532.76 |
$5,506 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,335.88 |
$5,078 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$2,235.14 |
$4,859 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,080.20 |
$8,870 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,223.64 |
$4,834 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,881.40 |
$4,090 |
0.6× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,338.18 |
$5,083 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,834.48 |
$3,988 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,038.68 |
$2,258 |
0.3× |
| Ankle 2 views (73600) |
$89.24 |
$194 |
1.0× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,259.02 |
$2,737 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,930.16 |
$4,196 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$2,271.02 |
$4,937 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$291.18 |
$633 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$291.18 |
$633 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$291.18 |
$633 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$306.36 |
$666 |
0.7× |
| Bone survey complete (77075) |
$599.84 |
$1,304 |
5.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$630.20 |
$1,370 |
1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,287.54 |
$2,799 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$207.92 |
$452 |
2.3× |
| Chest 1 view (71045) |
$148.12 |
$322 |
1.6× |
| Chest 3 views (71047) |
$241.96 |
$526 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$372.14 |
$809 |
2.0× |
| Cineradiography/videoradiography (76120) |
$218.50 |
$475 |
2.0× |
| Clavicle complete (73000) |
$102.58 |
$223 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$677.81 |
$1,473.50 |
6.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,832.68 |
$6,158 |
7.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,646.80 |
$3,580 |
6.6× |
| CT abdomen w contrast (74160) |
$1,344.12 |
$2,922 |
7.4× |
| CT abdomen w wo contrast (74170) |
$1,476.60 |
$3,210 |
8.1× |
| CT abdomen w/o contrast (74150) |
$1,123.32 |
$2,442 |
10.3× |
| CT angio hrt w/3d image (75574) |
$197.80 |
$430 |
0.5× |
| CT angiography upper extremity lt (73206) |
$1,485.80 |
$3,230 |
8.2× |
| CT c-spine w/o contrast (72125) |
$1,013.84 |
$2,204 |
9.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,143.56 |
$2,486 |
6.3× |
| CT cervical spine with contrast (72126) |
$1,263.16 |
$2,746 |
3.5× |
| CT chest w/wo contrast (71270) |
$1,728.22 |
$3,757 |
9.5× |
| CT chest with contrast (71260) |
$1,303.64 |
$2,834 |
7.2× |
| CT head/brain with contrast (70460) |
$1,208.42 |
$2,627 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,541.92 |
$3,352 |
8.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$186.76 |
$406 |
0.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$52.44 |
$114 |
0.6× |
| CT hrt w/3d image congen (75573) |
$186.76 |
$406 |
0.5× |
| CT lower ext w/o (73700) |
$881.36 |
$1,916 |
8.1× |
| CT lower extremity w wo contrast (73702) |
$1,555.26 |
$3,381 |
8.5× |
| CT lower extremity with contrast (73701) |
$1,015.68 |
$2,208 |
5.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,332.62 |
$2,897 |
7.3× |
| CT lumbar spine w/o contrast (72131) |
$714.84 |
$1,554 |
6.6× |
| CT lumbar spine with contrast (72132) |
$1,198.30 |
$2,605 |
3.3× |
| CT maxillofacial w contrast (70487) |
$1,132.52 |
$2,462 |
6.2× |
| CT maxillofacial w/o contrast (70486) |
$928.28 |
$2,018 |
8.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,800.90 |
$3,915 |
9.9× |
| CT neck soft tissue w contrast (70491) |
$1,236.94 |
$2,689 |
6.8× |
| CT pelvis w & w/o contrast (72194) |
$1,128.84 |
$2,454 |
6.2× |
| CT pelvis w/o contrast (72192) |
$927.36 |
$2,016 |
8.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,303.64 |
$2,834 |
7.2× |
| CT soft tissue neck w/o contrast (70490) |
$947.60 |
$2,060 |
8.7× |
| CT thoracic spine w/contrast (72129) |
$1,207.50 |
$2,625 |
6.6× |
| CT thoracic spine w/o contrast (72128) |
$912.18 |
$1,983 |
8.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,478.90 |
$3,215 |
8.1× |
| CT thorax w/o contrast (71250) |
$1,034.54 |
$2,249 |
9.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,082.38 |
$2,353 |
10.0× |
| CT upper extremity with contrast (73201) |
$1,325.26 |
$2,881 |
3.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,672.56 |
$3,636 |
9.2× |
| Cta Abdomen (74175) |
$1,943.04 |
$4,224 |
10.7× |
| CTA abdomen pelvis (74174) |
$1,646.80 |
$3,580 |
4.5× |
| CTA chest (71275) |
$1,791.70 |
$3,895 |
9.8× |
| Cta Head (70496) |
$1,365.28 |
$2,968 |
7.5× |
| CTA lwr ext w&w/o contrast (73706) |
$1,288 |
$2,800 |
7.1× |
| Cta Neck (70498) |
$1,497.30 |
$3,255 |
8.2× |
| Cta Pelvis (72191) |
$722.66 |
$1,571 |
4.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$88.78 |
$193 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$121.90 |
$265 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$149.50 |
$325 |
1.4× |
| Echo exam of fetal heart (76825) |
$437.46 |
$951 |
0.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$628.82 |
$1,367 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$194.12 |
$422 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$143.52 |
$312 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$411.47 |
$894.50 |
1.7× |
| Foot 2 views (73620) |
$126.50 |
$275 |
1.4× |
| Forearm 2 views (73090) |
$120.98 |
$263 |
1.3× |
| Gated Heart Planar Single (78472) |
$1,163.34 |
$2,529 |
2.8× |
| Hand 2 views (73120) |
$184.92 |
$402 |
1.7× |
| Hand 3 views (73130) |
$146.28 |
$318 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$899.30 |
$1,955 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$343.16 |
$746 |
0.8× |
| Ht muscle image spect sing (78451) |
$316.94 |
$689 |
0.2× |
| Humerus Min 2 Views Left (73060) |
$191.36 |
$416 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$383.64 |
$834 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$383.64 |
$834 |
0.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$383.64 |
$834 |
0.7× |
| Knee 3 views (73562) |
$138.92 |
$302 |
1.5× |
| Liver & spleen imaging static only (78215) |
$343.16 |
$746 |
0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$343.16 |
$746 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$343.16 |
$746 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$846.40 |
$1,840 |
1.5× |
| Lung perfusion differential (78597) |
$313.26 |
$681 |
0.8× |
| Lung Ventilation Imaging (78579) |
$627.44 |
$1,364 |
1.5× |
| Meckels Diverticulum (78290) |
$290.72 |
$632 |
0.7× |
| Mr safety determination physician/other qhp (76016) |
$56.58 |
$123 |
0.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$38.18 |
$83 |
0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$15.64 |
$34 |
0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$59.34 |
$129 |
0.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$155.48 |
$338 |
0.6× |
| MRA head w/o contrast (70544) |
$607.20 |
$1,320 |
2.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,312.38 |
$2,853 |
3.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,111.86 |
$4,591 |
1.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,229.12 |
$2,672 |
0.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$924.14 |
$2,009 |
1.0× |
| Neck soft tissue (70360) |
$107.18 |
$233 |
1.2× |
| Nm gastric emptying study (78264) |
$291.18 |
$633 |
0.7× |
| Nuclear medicine of heart pumping function (78473) |
$1,309.62 |
$2,847 |
3.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$288.42 |
$627 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$182.62 |
$397 |
1.7× |
| Parathyroid imaging (78070) |
$260.82 |
$567 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$199.64 |
$434 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$3,927.94 |
$8,539 |
2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$256.22 |
$557 |
0.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$883.66 |
$1,921 |
1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$557.06 |
$1,211 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$151.80 |
$330 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$205.62 |
$447 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$281.98 |
$613 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$226.78 |
$493 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$155.02 |
$337 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$125.12 |
$272 |
1.4× |
| Ribs bilateral 3 views (71110) |
$177.10 |
$385 |
1.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$317.17 |
$689.50 |
0.6× |
| Thyroid uptake measurement (78012) |
$148.12 |
$322 |
0.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$757.16 |
$1,646 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$196.42 |
$427 |
1.8× |
| Umbilical-artery Doppler (OB) (76820) |
$82.80 |
$180 |
0.8× |
| Us abdl aorta screen aaa (76706) |
$250.70 |
$545 |
2.3× |
| Us chest (76604) |
$213.44 |
$464 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$451.26 |
$981 |
4.2× |
| Us ob detailed single fetus (76811) |
$288.42 |
$627 |
1.2× |
| Us ob transvaginal (76817) |
$155.02 |
$337 |
1.4× |
| Us pelvic non ob complete (76856) |
$177.10 |
$385 |
1.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$82.80 |
$180 |
0.8× |
| Us pregnancy ltd (76815) |
$132.94 |
$289 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$199.18 |
$433 |
1.8× |
| Us retroperitoneal complete (76770) |
$197.34 |
$429 |
1.8× |
| Us retroperitoneal limited (76775) |
$302.22 |
$657 |
2.8× |
| Us scrotum and contents (76870) |
$439.76 |
$956 |
4.1× |
| Us soft tissue head/neck (76536) |
$408.94 |
$889 |
3.8× |
| Us xtr non-vasc lmtd (76882) |
$330.28 |
$718 |
3.0× |
| Vascular flow imaging (78445) |
$220.80 |
$480 |
0.5× |
| Venogram extremity bilateral (75822) |
$977.96 |
$2,126 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$836.74 |
$1,819 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$877.68 |
$1,908 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$441.83 |
$960.50 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$694.60 |
$1,510 |
0.2× |
| Wrist 2 views (73100) |
$144.44 |
$314 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$401.12 |
$872 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$110.40 |
$240 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$188.14 |
$409 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$205.62 |
$447 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$43.70 |
$95 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$62.33 |
$135.50 |
0.7× |
| X-ray exam hip uni 4/> views (73503) |
$82.34 |
$179 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$170.20 |
$370 |
1.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$189.52 |
$412 |
1.7× |
| X-ray exam of femur 1 (73551) |
$105.80 |
$230 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$237.36 |
$516 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$162.84 |
$354 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$127.42 |
$277 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$149.50 |
$325 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$201.48 |
$438 |
1.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$152.72 |
$332 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$115 |
$250 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$359.72 |
$782 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$182.16 |
$396 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$236.44 |
$514 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$322.46 |
$701 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$146.28 |
$318 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$276.92 |
$602 |
3.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$175.72 |
$382 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$193.66 |
$421 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$132.94 |
$289 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$251.16 |
$546 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$529.46 |
$1,151 |
4.9× |
| Xr chest 4+ views (71048) |
$255.30 |
$555 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$84.18 |
$183 |
0.9× |
| Xr shoulder 1 view (73020) |
$147.66 |
$321 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$328.90 |
$715 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$126.50 |
$275 |
1.4× |