| Abdomen 2 views (74019) |
$249.31 |
$249.31 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,290.05 |
$1,290.05 |
3.2× |
| Ankle 2 views (73600) |
$249.31 |
$249.31 |
2.8× |
| Arthrogram shoulder (73040) |
$1,520.27 |
$1,520.27 |
4.3× |
| Bone &/joint imaging whole body (78306) |
$1,290.05 |
$1,290.05 |
3.2× |
| Bone Imaging 3 Phase (78315) |
$1,290.05 |
$1,290.05 |
3.2× |
| Bone survey complete (77075) |
$417.99 |
$417.99 |
3.9× |
| Cervical spine 2 or 3 views (72040) |
$387.23 |
$387.23 |
4.4× |
| Chest 1 view (71045) |
$234.46 |
$234.46 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$289.63 |
$289.63 |
1.6× |
| Clavicle complete (73000) |
$234.46 |
$234.46 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,163.18 |
$2,163.18 |
6.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,507.54 |
$1,507.54 |
6.2× |
| CT abdomen w contrast (74160) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT abdomen w wo contrast (74170) |
$1,739.88 |
$1,739.88 |
9.8× |
| CT abdomen w/o contrast (74150) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT angiography upper extremity lt (73206) |
$457.25 |
$457.25 |
2.6× |
| CT c-spine w/o contrast (72125) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT cervical spine with contrast (72126) |
$1,856.58 |
$1,856.58 |
5.2× |
| CT chest w/wo contrast (71270) |
$1,951.53 |
$1,951.53 |
11.0× |
| CT chest with contrast (71260) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT head/brain with contrast (70460) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT head/brain without and with contrast (70470) |
$1,739.88 |
$1,739.88 |
9.8× |
| CT iac w contrast (70481) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT lower ext w/o (73700) |
$1,083.18 |
$1,083.18 |
10.2× |
| CT lower extremity w wo contrast (73702) |
$1,739.88 |
$1,739.88 |
9.8× |
| CT lower extremity with contrast (73701) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,016.34 |
$1,016.34 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT lumbar spine with contrast (72132) |
$2,163.18 |
$2,163.18 |
6.1× |
| CT maxillofacial w contrast (70487) |
$1,407.81 |
$1,407.81 |
7.9× |
| CT maxillofacial w/o contrast (70486) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,123.49 |
$1,123.49 |
6.3× |
| CT neck soft tissue w contrast (70491) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,697.44 |
$1,697.44 |
9.5× |
| CT orbits w/o contrast (70480) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT pelvis w & w/o contrast (72194) |
$1,739.88 |
$1,739.88 |
9.8× |
| CT pelvis w/o contrast (72192) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,739.88 |
$1,739.88 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT thoracic spine w/contrast (72129) |
$1,549.97 |
$1,549.97 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT thoracic spine w/wo contrast (72130) |
$1,016.34 |
$1,016.34 |
5.7× |
| CT thorax w/o contrast (71250) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,016.34 |
$1,016.34 |
5.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,016.34 |
$1,016.34 |
9.6× |
| CT upper extremity with contrast (73201) |
$2,163.18 |
$2,163.18 |
6.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,922.35 |
$1,922.35 |
10.8× |
| Cta Abdomen (74175) |
$1,605.67 |
$1,605.67 |
9.0× |
| CTA abdomen pelvis (74174) |
$1,604.08 |
$1,604.08 |
4.5× |
| CTA chest (71275) |
$1,633.79 |
$1,633.79 |
9.2× |
| Cta Head (70496) |
$1,607.26 |
$1,607.26 |
9.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,549.97 |
$1,549.97 |
8.7× |
| Cta Neck (70498) |
$1,607.26 |
$1,607.26 |
9.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$379.80 |
$379.80 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$403.14 |
$403.14 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$591.98 |
$591.98 |
2.4× |
| Foot 2 views (73620) |
$234.46 |
$234.46 |
2.7× |
| Forearm 2 views (73090) |
$234.46 |
$234.46 |
2.7× |
| Hand 2 views (73120) |
$295.99 |
$295.99 |
2.8× |
| Hand 3 views (73130) |
$234.46 |
$234.46 |
2.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,521.33 |
$1,521.33 |
2.8× |
| Ht muscle image spect sing (78451) |
$4,039.91 |
$4,039.91 |
3.1× |
| Humerus Min 2 Views Left (73060) |
$234.46 |
$234.46 |
2.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,695.32 |
$1,695.32 |
3.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,695.32 |
$1,695.32 |
3.1× |
| Knee 3 views (73562) |
$249.31 |
$249.31 |
2.8× |
| Liver & spleen imaging static only (78215) |
$1,518.15 |
$1,518.15 |
3.7× |
| Liver imaging w/vascular flow (78202) |
$1,518.15 |
$1,518.15 |
2.8× |
| Lung Ventilation Imaging (78579) |
$872.06 |
$872.06 |
2.1× |
| MRA head w & w/o contrast (70546) |
$2,793.35 |
$2,793.35 |
7.9× |
| MRA head w/o contrast (70544) |
$1,824.75 |
$1,824.75 |
7.5× |
| MRA neck w/o contrast (70547) |
$1,823.69 |
$1,823.69 |
7.5× |
| MRI abdomen w contrast (74182) |
$2,793.35 |
$2,793.35 |
7.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,793.35 |
$2,793.35 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$1,696.38 |
$1,696.38 |
7.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,919.17 |
$1,919.17 |
2.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,823.69 |
$1,823.69 |
2.3× |
| MRI c-spine with contrast (72142) |
$2,164.24 |
$2,164.24 |
6.1× |
| MRI cervical spine w/o contrast (72141) |
$2,657 |
$2,657 |
11.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,823.69 |
$1,823.69 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,823.69 |
$1,823.69 |
7.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,823.69 |
$1,823.69 |
7.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,793.35 |
$2,793.35 |
7.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,792.29 |
$2,792.29 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$1,823.69 |
$1,823.69 |
7.5× |
| MRI scan of arm joint before and after contrast (73223) |
$2,793.35 |
$2,793.35 |
7.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,792.29 |
$2,792.29 |
7.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,793.35 |
$2,793.35 |
7.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,211.98 |
$2,211.98 |
6.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,068 |
$4,068 |
11.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,823.69 |
$1,823.69 |
5.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,660.11 |
$3,660.11 |
10.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,657 |
$2,657 |
11.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,657 |
$2,657 |
11.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,652.25 |
$2,652.25 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,823.69 |
$1,823.69 |
7.5× |
| Myocardial Spect Multiple Studies (78452) |
$4,039.91 |
$4,039.91 |
3.1× |
| Neck soft tissue (70360) |
$234.46 |
$234.46 |
2.7× |
| Nm gastric emptying study (78264) |
$1,458.74 |
$1,458.74 |
3.6× |
| Nuclear medicine of heart pumping function (78473) |
$978.15 |
$978.15 |
2.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,986.43 |
$2,986.43 |
2.3× |
| Parathyroid imaging (78070) |
$1,157.44 |
$1,157.44 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$344.79 |
$344.79 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$8,593.29 |
$8,593.29 |
5.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,792.29 |
$2,792.29 |
7.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$949.50 |
$949.50 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,687.89 |
$1,687.89 |
3.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$234.46 |
$234.46 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$234.46 |
$234.46 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$234.46 |
$234.46 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$234.46 |
$234.46 |
2.7× |
| Ribs bilateral 3 views (71110) |
$353.28 |
$353.28 |
3.3× |
| Scanogram (77073) |
$222.79 |
$222.79 |
2.1× |
| Scapula complete (73010) |
$234.46 |
$234.46 |
2.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$475.28 |
$475.28 |
4.5× |
| Small bowel series (74250) |
$429.66 |
$429.66 |
2.4× |
| Speech evaluation complex (70371) |
$220.67 |
$220.67 |
0.9× |
| Spine thoracic 3 views (72072) |
$387.23 |
$387.23 |
3.6× |
| Thoracolumbar 2 views (72080) |
$234.46 |
$234.46 |
2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,016.88 |
$1,016.88 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$689.59 |
$689.59 |
6.5× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$872.06 |
$872.06 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$897.52 |
$897.52 |
5.0× |
| Us breast unilateral complete (76641) |
$450.88 |
$450.88 |
4.2× |
| Us breast unilateral limited (76642) |
$450.88 |
$450.88 |
5.1× |
| Us chest (76604) |
$354.34 |
$354.34 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$509.23 |
$509.23 |
4.8× |
| Us infant hips limited static (76886) |
$403.14 |
$403.14 |
4.6× |
| Us ob detailed single fetus (76811) |
$741.57 |
$741.57 |
3.1× |
| Us pelvic non ob complete (76856) |
$689.59 |
$689.59 |
6.5× |
| Us pregnancy ltd (76815) |
$503.93 |
$503.93 |
4.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$509.23 |
$509.23 |
4.8× |
| Us retroperitoneal complete (76770) |
$509.23 |
$509.23 |
4.8× |
| Us scrotum and contents (76870) |
$509.23 |
$509.23 |
4.8× |
| Us soft tissue head/neck (76536) |
$689.59 |
$689.59 |
6.5× |
| Us spinal canal and contents (76800) |
$282.20 |
$282.20 |
2.7× |
| Us xtr non-vasc lmtd (76882) |
$291.75 |
$291.75 |
2.7× |
| Wrist 2 views (73100) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$391.47 |
$391.47 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$249.31 |
$249.31 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$234.46 |
$234.46 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$503.93 |
$503.93 |
4.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$387.23 |
$387.23 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$387.23 |
$387.23 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,140.47 |
$1,140.47 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$387.23 |
$387.23 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$387.23 |
$387.23 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$249.31 |
$249.31 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$249.31 |
$249.31 |
2.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$295.99 |
$295.99 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$372.38 |
$372.38 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$264.16 |
$264.16 |
2.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$234.46 |
$234.46 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$234.46 |
$234.46 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$391.47 |
$391.47 |
3.7× |
| Xr finger(s) 2+ views (73140) |
$234.46 |
$234.46 |
2.7× |
| Xr shoulder 1 view (73020) |
$234.46 |
$234.46 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$391.47 |
$391.47 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$234.46 |
$234.46 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$234.46 |
$234.46 |
2.7× |