| Abdomen 2 views (74019) |
$360.36 |
$429 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,186.92 |
$1,413 |
2.9× |
| Angiography extremity bilateral rs&i (75716) |
$3,559.08 |
$4,237 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,246.16 |
$2,674 |
0.7× |
| Ankle 2 views (73600) |
$118.02 |
$140.50 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,148.28 |
$1,367 |
3.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,802.24 |
$3,336 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,943.36 |
$3,504 |
0.9× |
| Arthrogram hip (73525) |
$614.88 |
$732 |
1.7× |
| Arthrogram shoulder (73040) |
$556.92 |
$663 |
1.5× |
| Arthrography knee lt (73580) |
$656.88 |
$782 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,081.92 |
$1,288 |
2.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,111.76 |
$2,514 |
5.1× |
| Bone &/joint imaging whole body (78306) |
$1,716.96 |
$2,044 |
4.1× |
| Bone age studies (77072) |
$179.76 |
$214 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,489.76 |
$2,964 |
6.0× |
| Bone Marrow Imaging Limited Area (78102) |
$496.44 |
$591 |
1.2× |
| Bone survey complete (77075) |
$378.84 |
$451 |
3.5× |
| Brain image w/flow 4 + views (78606) |
$835.80 |
$995 |
1.5× |
| Brain imaging < 4 static views (78600) |
$485.52 |
$578 |
1.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$992.04 |
$1,181 |
2.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$559.44 |
$666 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,247.04 |
$5,056 |
2.9× |
| Brain Imaging Vascular Flow Only (78610) |
$414.96 |
$494 |
0.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$600.60 |
$715 |
1.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,141.16 |
$2,549 |
5.9× |
| Cardiac shunt detection (78428) |
$563.64 |
$671 |
1.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$929.04 |
$1,106 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$213.78 |
$254.50 |
2.4× |
| Chest 1 view (71045) |
$146.16 |
$174 |
1.6× |
| Chest 3 views (71047) |
$310.80 |
$370 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$584.64 |
$696 |
3.2× |
| Clavicle complete (73000) |
$175.56 |
$209 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$180.60 |
$215 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,641.48 |
$9,097 |
21.1× |
| CT abdomen and pelvis without contrast (74176) |
$5,525.52 |
$6,578 |
22.3× |
| CT abdomen w contrast (74160) |
$2,957.64 |
$3,521 |
16.2× |
| CT abdomen w wo contrast (74170) |
$3,669.12 |
$4,368 |
20.1× |
| CT abdomen w/o contrast (74150) |
$2,736.72 |
$3,258 |
25.2× |
| CT angio hrt w/3d image (75574) |
$2,572.08 |
$3,062 |
7.1× |
| CT angiography upper extremity lt (73206) |
$2,787.96 |
$3,319 |
15.3× |
| CT c-spine w/o contrast (72125) |
$2,597.28 |
$3,092 |
23.9× |
| CT cervical spine w&w/o contrast (72127) |
$3,323.88 |
$3,957 |
18.2× |
| CT cervical spine with contrast (72126) |
$2,597.28 |
$3,092 |
7.2× |
| CT chest w/wo contrast (71270) |
$3,540.60 |
$4,215 |
19.4× |
| CT chest with contrast (71260) |
$3,000.48 |
$3,572 |
16.5× |
| CT colonography w/dye (74262) |
$2,079.84 |
$2,476 |
11.4× |
| CT colonography w/o cntrst (74261) |
$2,657.76 |
$3,164 |
24.5× |
| CT head/brain with contrast (70460) |
$2,623.32 |
$3,123 |
14.4× |
| CT head/brain without and with contrast (70470) |
$3,203.76 |
$3,814 |
17.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,053.80 |
$2,445 |
5.7× |
| CT hrt w/3d image congen (75573) |
$2,500.68 |
$2,977 |
6.9× |
| CT iac w contrast (70481) |
$2,506.56 |
$2,984 |
13.8× |
| CT limited/localized follow up study (76380) |
$1,241.52 |
$1,478 |
13.7× |
| CT lower ext w/o (73700) |
$2,704.80 |
$3,220 |
24.9× |
| CT lower extremity w wo contrast (73702) |
$3,281.04 |
$3,906 |
18.0× |
| CT lower extremity with contrast (73701) |
$2,948.40 |
$3,510 |
16.2× |
| CT lumbar spine w & w/o contrast (72133) |
$3,116.40 |
$3,710 |
17.1× |
| CT lumbar spine w/o contrast (72131) |
$2,639.28 |
$3,142 |
24.3× |
| CT lumbar spine with contrast (72132) |
$2,830.80 |
$3,370 |
7.8× |
| CT maxillofacial w contrast (70487) |
$2,516.64 |
$2,996 |
13.8× |
| CT maxillofacial w/o contrast (70486) |
$2,352 |
$2,800 |
21.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,963.52 |
$3,528 |
16.3× |
| CT neck soft tissue w contrast (70491) |
$2,794.68 |
$3,327 |
15.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,001.32 |
$3,573 |
16.5× |
| CT orbits w/o contrast (70480) |
$2,293.20 |
$2,730 |
21.1× |
| CT pelvis w & w/o contrast (72194) |
$3,212.16 |
$3,824 |
17.6× |
| CT pelvis w/o contrast (72192) |
$2,699.76 |
$3,214 |
24.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$404.04 |
$481 |
4.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,241.56 |
$3,859 |
17.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,459.52 |
$2,928 |
22.7× |
| CT thoracic spine w/contrast (72129) |
$2,718.24 |
$3,236 |
14.9× |
| CT thoracic spine w/o contrast (72128) |
$2,564.52 |
$3,053 |
23.6× |
| CT thoracic spine w/wo contrast (72130) |
$3,231.48 |
$3,847 |
17.7× |
| CT thorax w/o contrast (71250) |
$2,670.36 |
$3,179 |
24.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,882.88 |
$3,432 |
15.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,262.12 |
$2,693 |
20.8× |
| CT upper extremity with contrast (73201) |
$2,154.60 |
$2,565 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,540.60 |
$4,215 |
19.4× |
| Cta Abdomen (74175) |
$3,447.36 |
$4,104 |
18.9× |
| CTA abdomen pelvis (74174) |
$7,659.12 |
$9,118 |
21.1× |
| CTA chest (71275) |
$3,433.08 |
$4,087 |
18.8× |
| Cta Head (70496) |
$3,189.48 |
$3,797 |
17.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,763.60 |
$3,290 |
15.2× |
| Cta Neck (70498) |
$3,221.40 |
$3,835 |
17.7× |
| Cta Pelvis (72191) |
$2,588.88 |
$3,082 |
14.2× |
| Cystography minimum 3 views rs&i (74430) |
$411.60 |
$490 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$87.36 |
$104 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$252 |
$300 |
2.8× |
| Dxa bone density study axial skeleton (77085) |
$174.72 |
$208 |
1.6× |
| Esophagus (74220) |
$378.84 |
$451 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$477.96 |
$569 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$509.04 |
$606 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$443.52 |
$528 |
1.8× |
| Foot 2 views (73620) |
$166.32 |
$198 |
1.8× |
| Forearm 2 views (73090) |
$173.46 |
$206.50 |
1.9× |
| Gated Heart Planar Single (78472) |
$2,224.32 |
$2,648 |
5.4× |
| Hand 2 views (73120) |
$163.38 |
$194.50 |
1.5× |
| Hand 3 views (73130) |
$198.24 |
$236 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,443.56 |
$2,909 |
4.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,296.56 |
$2,734 |
5.5× |
| Ht muscle image spect sing (78451) |
$1,792.56 |
$2,134 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$189 |
$225 |
2.1× |
| Hysterosalpingogram (74740) |
$514.08 |
$612 |
2.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$256.20 |
$305 |
2.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$543.48 |
$647 |
1.3× |
| Kidney imaging morphology (78700) |
$605.64 |
$721 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,891.68 |
$2,252 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,085.72 |
$2,483 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,368.80 |
$2,820 |
4.2× |
| Knee 3 views (73562) |
$219.66 |
$261.50 |
2.4× |
| Liver & spleen imaging static only (78215) |
$877.80 |
$1,045 |
2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$593.04 |
$706 |
1.4× |
| Liver imaging static only (78201) |
$441 |
$525 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$3,064.32 |
$3,648 |
5.4× |
| Lung perfusion differential (78597) |
$305.76 |
$364 |
0.7× |
| Lung Ventilation Imaging (78579) |
$826.56 |
$984 |
2.0× |
| Lymphoscintigraphy (78195) |
$1,413.72 |
$1,683 |
2.5× |
| Mammary ductogram or galactogram single (77053) |
$354.48 |
$422 |
1.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$84.84 |
$101 |
0.9× |
| Meckels Diverticulum (78290) |
$1,175.16 |
$1,399 |
2.8× |
| MRA head w & w/o contrast (70546) |
$4,595.64 |
$5,471 |
12.7× |
| MRA head w/o contrast (70544) |
$3,962.28 |
$4,717 |
16.0× |
| MRA head with contrast (70545) |
$3,962.28 |
$4,717 |
10.9× |
| MRA neck w contrast (70548) |
$2,760.24 |
$3,286 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,129.84 |
$3,726 |
8.6× |
| MRA neck w/o contrast (70547) |
$2,172.24 |
$2,586 |
8.8× |
| MRI abdomen w contrast (74182) |
$3,679.20 |
$4,380 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,229.40 |
$5,035 |
11.7× |
| MRI abdomen w/o contrast (74181) |
$2,918.16 |
$3,474 |
11.8× |
| MRI any jnt lwr ext with con lt (73722) |
$3,195.36 |
$3,804 |
3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,180.24 |
$3,786 |
3.9× |
| MRI c-spine with contrast (72142) |
$3,979.08 |
$4,737 |
11.0× |
| MRI cardiac w/o contrast (75557) |
$1,973.16 |
$2,349 |
8.0× |
| MRI cervical spine w/o contrast (72141) |
$3,979.08 |
$4,737 |
16.1× |
| MRI chest w/o & w/contrast material (71552) |
$3,591.84 |
$4,276 |
9.9× |
| MRI chest w/o contrast (71550) |
$2,340.24 |
$2,786 |
9.4× |
| MRI chest with contrast (71551) |
$3,133.20 |
$3,730 |
3.8× |
| MRI fetal sngl/1st gestation (74712) |
$398.16 |
$474 |
1.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,085.72 |
$2,483 |
5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,909.76 |
$3,464 |
8.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,798.04 |
$3,331 |
11.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,495.64 |
$2,971 |
10.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,825.36 |
$4,554 |
10.6× |
| MRI orbit/face/neck w/contrast (70542) |
$3,336.48 |
$3,972 |
9.2× |
| MRI pelvis w contrast (72196) |
$2,607.36 |
$3,104 |
7.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,017.72 |
$4,783 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$3,067.68 |
$3,652 |
12.4× |
| MRI scan of arm joint before and after contrast (73223) |
$3,617.88 |
$4,307 |
10.0× |
| MRI scan of leg joint before and after contrast (73723) |
$3,634.68 |
$4,327 |
10.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,416.72 |
$5,258 |
12.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,918.60 |
$4,665 |
10.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,349.52 |
$5,178 |
12.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,041.24 |
$4,811 |
11.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,272.24 |
$5,086 |
11.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,848.88 |
$4,582 |
15.5× |
| MRI tmj (70336) |
$2,349.48 |
$2,797 |
9.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,917.32 |
$3,473 |
11.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,234 |
$3,850 |
8.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,026.92 |
$2,413 |
8.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,807.28 |
$3,342 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,225.58 |
$2,649.50 |
1.7× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,837.08 |
$2,187 |
1.2× |
| Neck soft tissue (70360) |
$286.44 |
$341 |
3.2× |
| Nm adrenal scan (78075) |
$2,249.52 |
$2,678 |
1.7× |
| Nm bone marrow multiple (78103) |
$991.20 |
$1,180 |
2.4× |
| Nm cisternogram (78630) |
$884.52 |
$1,053 |
1.6× |
| Nm csf leak detection (78650) |
$759.36 |
$904 |
0.6× |
| Nm gastric emptying study (78264) |
$2,216.76 |
$2,639 |
5.3× |
| Nm gastroesophageal reflux study (78262) |
$1,069.32 |
$1,273 |
2.6× |
| Nm peritoneal-venous shunt patency (78291) |
$914.76 |
$1,089 |
2.2× |
| Nm whole blood volume (78122) |
$647.64 |
$771 |
1.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,902.20 |
$3,455 |
2.2× |
| Nuclear medicine of heart pumping function (78473) |
$1,669.92 |
$1,988 |
4.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,066.80 |
$1,270 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,359.12 |
$1,618 |
3.3× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$733.32 |
$873 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,231.44 |
$1,466 |
3.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$872.76 |
$1,039 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$1,743 |
$2,075 |
7.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$305.76 |
$364 |
2.8× |
| Osseous survey infant (77076) |
$197.40 |
$235 |
1.8× |
| Osseous survey limited (77074) |
$529.20 |
$630 |
4.9× |
| Parathyrd planar w/spect&CT (78072) |
$394.80 |
$470 |
0.7× |
| Parathyrd planar w/wo subtrj (78071) |
$489.72 |
$583 |
1.2× |
| Parathyroid imaging (78070) |
$1,113 |
$1,325 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$189.42 |
$225.50 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$5,699.40 |
$6,785 |
3.8× |
| PET imaging CT for attenuation limited area (78814) |
$4,503.24 |
$5,361 |
3.0× |
| PET imaging for CT attenuation whole body (78816) |
$5,699.40 |
$6,785 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,469.20 |
$4,130 |
9.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,030.68 |
$1,227 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,923.60 |
$2,290 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$738.36 |
$879 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$93.24 |
$111 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$491.40 |
$585 |
4.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$190.68 |
$227 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$359.52 |
$428 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$284.76 |
$339 |
2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$411.60 |
$490 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$147.84 |
$176 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$225.12 |
$268 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$368.76 |
$439 |
2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$255.36 |
$304 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$504.42 |
$600.50 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$527.52 |
$628 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$114.24 |
$136 |
1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$225.96 |
$269 |
2.5× |
| Radiological examination surgical specimen (76098) |
$148.68 |
$177 |
0.3× |
| Ribs bilateral 3 views (71110) |
$376.32 |
$448 |
3.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,519.56 |
$1,809 |
3.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,743.84 |
$2,076 |
3.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,668.24 |
$1,986 |
3.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,928.64 |
$2,296 |
8.0× |
| Rp Therapy Intravenous Administration (79101) |
$1,813.56 |
$2,159 |
7.5× |
| Sacroiliac Joints < 3 Views (72200) |
$191.52 |
$228 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$493.08 |
$587 |
2.0× |
| Scanogram (77073) |
$196.56 |
$234 |
1.8× |
| Scapula complete (73010) |
$253.68 |
$302 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$113.40 |
$135 |
4.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$514.08 |
$612 |
4.7× |
| Small bowel series (74250) |
$328.44 |
$391 |
1.8× |
| Speech evaluation complex (70371) |
$471.24 |
$561 |
1.9× |
| Spine thoracic 3 views (72072) |
$231.42 |
$275.50 |
2.1× |
| Testicular Imaging With Vascular Flow (78761) |
$1,206.24 |
$1,436 |
2.9× |
| Thoracolumbar 2 views (72080) |
$325.08 |
$387 |
3.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,885.80 |
$2,245 |
3.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$576.24 |
$686 |
1.4× |
| Thyroid uptake measurement (78012) |
$786.24 |
$936 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,292.76 |
$1,539 |
3.1× |
| Tmj unilateral (70328) |
$204.96 |
$244 |
2.3× |
| Tomogram (76100) |
$410.76 |
$489 |
3.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,743.84 |
$2,076 |
3.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$754.32 |
$898 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$511.56 |
$609 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$297.36 |
$354 |
2.7× |
| Unlisted Ultrasound Procedure (76999) |
$268.80 |
$320 |
3.0× |
| Upper Extremity Infant (73092) |
$185.64 |
$221 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$504 |
$600 |
2.0× |
| Urethrocystography voiding (74455) |
$420.84 |
$501 |
1.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$632.52 |
$753 |
3.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$641.76 |
$764 |
3.5× |
| Us abdl aorta screen aaa (76706) |
$197.40 |
$235 |
1.8× |
| Us breast unilateral complete (76641) |
$179.76 |
$214 |
1.7× |
| Us breast unilateral limited (76642) |
$179.76 |
$214 |
2.0× |
| Us chest (76604) |
$462 |
$550 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$672.84 |
$801 |
6.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$378.84 |
$451 |
3.5× |
| Us infant hips dynamic (76885) |
$314.16 |
$374 |
3.5× |
| Us ob detailed single fetus (76811) |
$1,241.52 |
$1,478 |
5.0× |
| Us ob transvaginal (76817) |
$679.56 |
$809 |
6.3× |
| Us pelvic non ob complete (76856) |
$827.40 |
$985 |
7.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$513.24 |
$611 |
4.7× |
| Us pregnancy ltd (76815) |
$441.84 |
$526 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,093.68 |
$1,302 |
10.1× |
| Us retroperitoneal complete (76770) |
$827.40 |
$985 |
7.6× |
| Us retroperitoneal limited (76775) |
$620.76 |
$739 |
5.7× |
| Us scrotum and contents (76870) |
$517.44 |
$616 |
4.8× |
| Us soft tissue head/neck (76536) |
$598.92 |
$713 |
5.5× |
| Us spinal canal and contents (76800) |
$1,366.68 |
$1,627 |
12.6× |
| Us transrectal (76872) |
$602.70 |
$717.50 |
5.6× |
| Us xtr non-vasc lmtd (76882) |
$600.60 |
$715 |
5.5× |
| Vascular flow imaging (78445) |
$813.12 |
$968 |
2.0× |
| Venogram extremity bilateral (75822) |
$1,367.52 |
$1,628 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$992.04 |
$1,181 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$378.84 |
$451 |
4.2× |
| Wrist 2 views (73100) |
$170.10 |
$202.50 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$389.76 |
$464 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$144.06 |
$171.50 |
1.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$212.10 |
$252.50 |
2.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$612.36 |
$729 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$172.62 |
$205.50 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$196.56 |
$234 |
2.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$284.76 |
$339 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$267.96 |
$319 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$114.24 |
$136 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$190.68 |
$227 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$190.68 |
$227 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$360.36 |
$429 |
3.3× |
| X-ray exam of femur 1 (73551) |
$114.24 |
$136 |
1.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$514.08 |
$612 |
2.8× |
| X-ray eye for foreign body (70030) |
$173.88 |
$207 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$268.80 |
$320 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$186.48 |
$222 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$202.44 |
$241 |
2.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,272.60 |
$1,515 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$152.88 |
$182 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$208.32 |
$248 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$262.08 |
$312 |
2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$278.88 |
$332 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$141.12 |
$168 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$243.60 |
$290 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$557.76 |
$664 |
5.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$1,302 |
$1,550 |
12.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$283.08 |
$337 |
3.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$363.72 |
$433 |
4.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$299.04 |
$356 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$380.52 |
$453 |
3.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$700.56 |
$834 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$220.92 |
$263 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$437.64 |
$521 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$559.44 |
$666 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$336.84 |
$401 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$257.04 |
$306 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$190.26 |
$226.50 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$204.96 |
$244 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$183.12 |
$218 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$410.76 |
$489 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$197.82 |
$235.50 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$160.86 |
$191.50 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$246.12 |
$293 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$138.60 |
$165 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$227.22 |
$270.50 |
2.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$458.64 |
$546 |
4.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$216.72 |
$258 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$203.70 |
$242.50 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$261.24 |
$311 |
2.4× |
| Xr chest 4+ views (71048) |
$356.16 |
$424 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$129.78 |
$154.50 |
1.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$233.52 |
$278 |
2.2× |
| Xr optic foramina (70190) |
$231 |
$275 |
2.6× |
| Xr shoulder 1 view (73020) |
$175.14 |
$208.50 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$296.10 |
$352.50 |
2.7× |
| Xr tibia/fibula 2 views (73590) |
$138.18 |
$164.50 |
1.5× |
| Xr tmj bilateral (70330) |
$275.52 |
$328 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$150.78 |
$179.50 |
1.7× |