| Abdomen 2 views (74019) |
$306.74 |
$929.50 |
2.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,300.53 |
$3,941 |
3.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,346.20 |
$10,140 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,754.41 |
$11,377 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$4,350.06 |
$13,182 |
1.4× |
| Angiography internal mammary rs&i (75756) |
$1,184.04 |
$3,588 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,350.06 |
$13,182 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,366.66 |
$10,202 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,366.66 |
$10,202 |
1.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1.32 |
$4 |
0.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,350.06 |
$13,182 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$894.30 |
$2,710 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,184.04 |
$3,588 |
0.4× |
| Ankle 2 views (73600) |
$383.13 |
$1,161 |
4.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,019.37 |
$3,089 |
2.9× |
| Aortogram thoracic (75605) |
$3,463.18 |
$10,494.50 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,346.20 |
$10,140 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$4,350.06 |
$13,182 |
1.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,390.19 |
$7,243 |
0.8× |
| Arthrogram elbow (73085) |
$471.74 |
$1,429.50 |
1.3× |
| Arthrogram hip (73525) |
$404.74 |
$1,226.50 |
1.2× |
| Arthrogram shoulder (73040) |
$588.72 |
$1,784 |
1.7× |
| Arthrogram wrist (73115) |
$727.98 |
$2,206 |
2.1× |
| Arthrography knee lt (73580) |
$1,510.41 |
$4,577 |
4.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,181.07 |
$3,579 |
2.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,242.12 |
$3,764 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$1,308.12 |
$3,964 |
3.3× |
| Bone age studies (77072) |
$314.49 |
$953 |
3.0× |
| Bone Imaging 3 Phase (78315) |
$1,325.94 |
$4,018 |
3.3× |
| Bone survey complete (77075) |
$953.70 |
$2,890 |
9.1× |
| Brain image w/flow 4 + views (78606) |
$811.64 |
$2,459.50 |
1.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$452.76 |
$1,372 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,483.58 |
$7,526 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$465.63 |
$1,411 |
0.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,661.55 |
$5,035 |
4.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,278.42 |
$3,874 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$558.69 |
$1,693 |
6.4× |
| Chest 1 view (71045) |
$336.93 |
$1,021 |
3.9× |
| Chest 3 views (71047) |
$459.69 |
$1,393 |
5.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$860.31 |
$2,607 |
4.9× |
| Clavicle complete (73000) |
$285.78 |
$866 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$406.56 |
$1,232 |
3.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,957.23 |
$5,931 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,797.18 |
$5,446 |
7.5× |
| CT abdomen w contrast (74160) |
$1,031.91 |
$3,127 |
5.9× |
| CT abdomen w wo contrast (74170) |
$1,098.74 |
$3,329.50 |
6.2× |
| CT abdomen w/o contrast (74150) |
$953.70 |
$2,890 |
9.1× |
| CT angio hrt w/3d image (75574) |
$986.70 |
$2,990 |
2.8× |
| CT angiography upper extremity lt (73206) |
$796.95 |
$2,415 |
4.5× |
| CT c-spine w/o contrast (72125) |
$791.18 |
$2,397.50 |
7.5× |
| CT cervical spine w&w/o contrast (72127) |
$973.83 |
$2,951 |
5.5× |
| CT cervical spine with contrast (72126) |
$943.14 |
$2,858 |
2.7× |
| CT chest w/wo contrast (71270) |
$1,002.21 |
$3,037 |
5.7× |
| CT chest with contrast (71260) |
$871.86 |
$2,642 |
4.9× |
| CT colonography screening (74263) |
$882.42 |
$2,674 |
3.7× |
| CT colonography w/dye (74262) |
$621.39 |
$1,883 |
3.5× |
| CT colonography w/o cntrst (74261) |
$400.62 |
$1,214 |
3.8× |
| CT head/brain with contrast (70460) |
$724.02 |
$2,194 |
4.1× |
| CT head/brain without and with contrast (70470) |
$880.94 |
$2,669.50 |
5.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$673.86 |
$2,042 |
1.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$110.55 |
$335 |
1.3× |
| CT hrt w/3d image congen (75573) |
$549.12 |
$1,664 |
1.6× |
| CT iac w contrast (70481) |
$638.55 |
$1,935 |
3.6× |
| CT limited/localized follow up study (76380) |
$440.38 |
$1,334.50 |
5.0× |
| CT lower ext w/o (73700) |
$794.97 |
$2,409 |
7.6× |
| CT lower extremity w wo contrast (73702) |
$1,107.15 |
$3,355 |
6.3× |
| CT lower extremity with contrast (73701) |
$1,024.65 |
$3,105 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,045.60 |
$3,168.50 |
5.9× |
| CT lumbar spine w/o contrast (72131) |
$826.98 |
$2,506 |
7.9× |
| CT lumbar spine with contrast (72132) |
$989.67 |
$2,999 |
2.8× |
| CT maxillofacial w contrast (70487) |
$675.84 |
$2,048 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$740.52 |
$2,244 |
7.1× |
| CT maxillofacial w/wo contrast (70488) |
$741.68 |
$2,247.50 |
4.2× |
| CT neck soft tissue w contrast (70491) |
$694.16 |
$2,103.50 |
3.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$669.08 |
$2,027.50 |
3.8× |
| CT orbits w/o contrast (70480) |
$640.53 |
$1,941 |
6.1× |
| CT pelvis w & w/o contrast (72194) |
$891 |
$2,700 |
5.1× |
| CT pelvis w/o contrast (72192) |
$821.37 |
$2,489 |
7.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$819.56 |
$2,483.50 |
4.7× |
| CT soft tissue neck w/o contrast (70490) |
$604.56 |
$1,832 |
5.8× |
| CT thoracic spine w/contrast (72129) |
$751.41 |
$2,277 |
4.3× |
| CT thoracic spine w/o contrast (72128) |
$685.08 |
$2,076 |
6.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,067.88 |
$3,236 |
6.1× |
| CT thorax w/o contrast (71250) |
$797.61 |
$2,417 |
7.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$742.17 |
$2,249 |
4.2× |
| CT upper extremity w/o contrast rt (73200) |
$668.58 |
$2,026 |
6.4× |
| CT upper extremity with contrast (73201) |
$686.73 |
$2,081 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,365.87 |
$4,139 |
7.8× |
| Cta Abdomen (74175) |
$1,134.54 |
$3,438 |
6.4× |
| CTA abdomen pelvis (74174) |
$1,976.70 |
$5,990 |
5.6× |
| CTA chest (71275) |
$949.74 |
$2,878 |
5.4× |
| Cta Head (70496) |
$1,047.58 |
$3,174.50 |
5.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,092.96 |
$3,312 |
6.2× |
| Cta Neck (70498) |
$962.44 |
$2,916.50 |
5.5× |
| Cta Pelvis (72191) |
$1,022.34 |
$3,098 |
5.8× |
| Cystography minimum 3 views rs&i (74430) |
$1,274.13 |
$3,861 |
3.6× |
| Diskogram cervical (72285) |
$4,325.97 |
$13,109 |
2.2× |
| Diskography lumbar (72295) |
$3,786.75 |
$11,475 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$497.64 |
$1,508 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$691.35 |
$2,095 |
7.9× |
| Echo exam of fetal heart (76825) |
$1,651.65 |
$5,005 |
3.0× |
| Echoencephalography real time imaging (76506) |
$463.65 |
$1,405 |
4.4× |
| Esophagus (74220) |
$607.53 |
$1,841 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$911.96 |
$2,763.50 |
8.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$423.22 |
$1,282.50 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$754.05 |
$2,285 |
3.1× |
| Foot 2 views (73620) |
$378.18 |
$1,146 |
4.3× |
| Forearm 2 views (73090) |
$376.53 |
$1,141 |
4.3× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$315.15 |
$955 |
1.3× |
| Gated Heart Planar Single (78472) |
$1,408.11 |
$4,267 |
3.5× |
| Hand 2 views (73120) |
$365.31 |
$1,107 |
3.5× |
| Hand 3 views (73130) |
$454.74 |
$1,378 |
5.2× |
| Heart Infarct Image (78466) |
$481.47 |
$1,459 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,848.13 |
$11,661 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,379.07 |
$4,179 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,199.55 |
$3,635 |
3.0× |
| Ht muscle image spect sing (78451) |
$2,507.01 |
$7,597 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$379.83 |
$1,151 |
4.3× |
| Hysterosalpingogram (74740) |
$1,155.66 |
$3,502 |
4.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$1,350.03 |
$4,091 |
12.9× |
| Kidney imaging morphology (78700) |
$525.03 |
$1,591 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$866.58 |
$2,626 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,141.14 |
$3,458 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$749.76 |
$2,272 |
1.4× |
| Knee 3 views (73562) |
$323.56 |
$980.50 |
3.7× |
| Liver & spleen imaging static only (78215) |
$957.66 |
$2,902 |
2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,052.70 |
$3,190 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$2,541.99 |
$7,703 |
4.7× |
| Lung perfusion differential (78597) |
$1,099.40 |
$3,331.50 |
2.7× |
| Lung Ventilation Imaging (78579) |
$419.43 |
$1,271 |
1.0× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$643.83 |
$1,951 |
0.4× |
| Lymphoscintigraphy (78195) |
$1,550.67 |
$4,699 |
2.8× |
| Mammary ductogram or galactogram multiple (77054) |
$926.80 |
$2,808.50 |
3.9× |
| Mammary ductogram or galactogram single (77053) |
$759.16 |
$2,300.50 |
3.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$120.12 |
$364 |
1.4× |
| Meckels Diverticulum (78290) |
$662.31 |
$2,007 |
1.6× |
| MRA head w & w/o contrast (70546) |
$1,179.09 |
$3,573 |
3.4× |
| MRA head w/o contrast (70544) |
$974.82 |
$2,954 |
4.1× |
| MRA head with contrast (70545) |
$1,071.84 |
$3,248 |
3.1× |
| MRA neck w contrast (70548) |
$1,031.25 |
$3,125 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,134.21 |
$3,437 |
3.2× |
| MRA neck w/o contrast (70547) |
$937.20 |
$2,840 |
3.9× |
| MRI abdomen w contrast (74182) |
$2,778.76 |
$8,420.50 |
7.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,040.95 |
$9,215 |
8.7× |
| MRI abdomen w/o contrast (74181) |
$1,813.68 |
$5,496 |
7.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,749.56 |
$8,332 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,775.73 |
$5,381 |
2.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,845.86 |
$5,593.50 |
7.7× |
| MRI breast w/o contrast unilat (77046) |
$1,222.98 |
$3,706 |
5.1× |
| MRI c-spine with contrast (72142) |
$1,808.40 |
$5,480 |
5.2× |
| MRI cardiac w/o contrast (75557) |
$1,790.91 |
$5,427 |
7.5× |
| MRI cervical spine w/o contrast (72141) |
$1,628.55 |
$4,935 |
6.8× |
| MRI chest w/o & w/contrast material (71552) |
$3,139.62 |
$9,514 |
9.0× |
| MRI chest w/o contrast (71550) |
$1,526.91 |
$4,627 |
6.4× |
| MRI chest with contrast (71551) |
$1,614.03 |
$4,891 |
2.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,420.06 |
$7,333.50 |
6.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,812.03 |
$5,491 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,647.69 |
$4,993 |
6.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,514.04 |
$4,588 |
6.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,832.82 |
$5,554 |
5.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,666.50 |
$5,050 |
4.8× |
| MRI pelvis w contrast (72196) |
$1,930.50 |
$5,850 |
5.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,827.11 |
$8,567 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$1,895.02 |
$5,742.50 |
7.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,955.25 |
$5,925 |
5.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,848.56 |
$8,632 |
8.1× |
| MRI spectroscopy (76390) |
$879.12 |
$2,664 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,988.25 |
$6,025 |
5.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,348.61 |
$7,117 |
6.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,582.25 |
$7,825 |
7.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,045.01 |
$6,197 |
5.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,620.43 |
$10,971 |
10.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,857.90 |
$5,630 |
7.8× |
| MRI tmj (70336) |
$1,596.04 |
$4,836.50 |
6.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,543.08 |
$4,676 |
6.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,578.78 |
$7,814.50 |
7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,490.94 |
$4,518 |
6.2× |
| Myelogram Cervical (72240) |
$1,529.88 |
$4,636 |
1.9× |
| Myelogram Lumbar (72265) |
$1,845.69 |
$5,593 |
2.3× |
| Myelogram thoracic (72255) |
$1,164.57 |
$3,529 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,771.94 |
$5,369.50 |
2.3× |
| Myocardial infarct spect (78469) |
$1,504.80 |
$4,560 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,092.43 |
$9,371 |
2.4× |
| Neck soft tissue (70360) |
$384.45 |
$1,165 |
4.4× |
| Nm adrenal scan (78075) |
$1,097.58 |
$3,326 |
0.8× |
| Nm bone marrow multiple (78103) |
$785.07 |
$2,379 |
2.0× |
| Nm bone marrow wb (78104) |
$825.66 |
$2,502 |
2.1× |
| Nm cisternogram (78630) |
$481.47 |
$1,459 |
0.9× |
| Nm csf leak detection (78650) |
$622.71 |
$1,887 |
0.5× |
| Nm gastric emptying study (78264) |
$1,165.89 |
$3,533 |
2.9× |
| Nm gastroesophageal reflux study (78262) |
$903.70 |
$2,738.50 |
2.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,730.52 |
$5,244 |
1.3× |
| Nuclear medicine of heart pumping function (78473) |
$1,429.56 |
$4,332 |
3.6× |
| Nuclear medicine study of digestive tracts (78299) |
$1,007.49 |
$3,053 |
2.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,289.97 |
$3,909 |
1.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$798.60 |
$2,420 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$1,000.23 |
$3,031 |
4.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$337.26 |
$1,022 |
3.2× |
| Osseous survey infant (77076) |
$941.66 |
$2,853.50 |
9.0× |
| Osseous survey limited (77074) |
$1,146.92 |
$3,475.50 |
10.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,407.12 |
$4,264 |
3.5× |
| Parathyroid imaging (78070) |
$773.52 |
$2,344 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$361.68 |
$1,096 |
3.4× |
| Peritoneogram rs&i (74190) |
$422.07 |
$1,279 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$3,311.06 |
$10,033.50 |
2.3× |
| PET imaging CT for attenuation limited area (78814) |
$2,563.94 |
$7,769.50 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$3,700.78 |
$11,214.50 |
2.6× |
| PET whole body (78813) |
$2,879.42 |
$8,725.50 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,046.99 |
$6,203 |
5.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,346.20 |
$10,140 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$822.36 |
$2,492 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,040.49 |
$3,153 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,155.66 |
$3,502 |
2.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$407.22 |
$1,234 |
4.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$769.56 |
$2,332 |
7.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$439.23 |
$1,331 |
4.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$305.91 |
$927 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$769.56 |
$2,332 |
7.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$538.23 |
$1,631 |
5.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$231.66 |
$702 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$402.93 |
$1,221 |
3.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$284.96 |
$863.50 |
3.3× |
| Radiologic exam colon single contrast study (74270) |
$1,147.74 |
$3,478 |
6.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$465.30 |
$1,410 |
2.6× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$161.70 |
$490 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$550.11 |
$1,667 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$825.33 |
$2,501 |
4.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$476.19 |
$1,443 |
5.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$171.93 |
$521 |
2.0× |
| Radiological examination surgical specimen (76098) |
$626.67 |
$1,899 |
1.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,346.20 |
$10,140 |
1.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,346.20 |
$10,140 |
1.1× |
| Ribs bilateral 3 views (71110) |
$1,074.81 |
$3,257 |
10.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,052.70 |
$3,190 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,356.63 |
$4,111 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,167.21 |
$3,537 |
2.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$168.30 |
$510 |
0.7× |
| Sacroiliac Joints < 3 Views (72200) |
$583.11 |
$1,767 |
5.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$518.92 |
$1,572.50 |
2.2× |
| Scanogram (77073) |
$506.55 |
$1,535 |
4.8× |
| Scapula complete (73010) |
$349.80 |
$1,060 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$88.77 |
$269 |
3.8× |
| Sella turcica (70240) |
$170.28 |
$516 |
1.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$244.86 |
$742 |
2.3× |
| Sialogram (70390) |
$632.78 |
$1,917.50 |
2.6× |
| Small bowel series (74250) |
$1,033.56 |
$3,132 |
5.9× |
| Spine thoracic 3 views (72072) |
$570.57 |
$1,729 |
5.4× |
| Splenoportograpy rs&i (75810) |
$3,346.20 |
$10,140 |
1.1× |
| Superior sagittal sinus venogram (75870) |
$1,184.04 |
$3,588 |
0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$750.09 |
$2,273 |
3.1× |
| Thoracolumbar 2 views (72080) |
$498.30 |
$1,510 |
5.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,560.90 |
$4,730 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$272.25 |
$825 |
0.7× |
| Thyroid uptake measurement (78012) |
$883.41 |
$2,677 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$883.41 |
$2,677 |
2.2× |
| Tmj unilateral (70328) |
$384.62 |
$1,165.50 |
4.4× |
| Tomogram (76100) |
$713.13 |
$2,161 |
6.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,779.36 |
$5,392 |
3.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$705.54 |
$2,138 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$461.34 |
$1,398 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$311.02 |
$942.50 |
3.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$304.26 |
$922 |
3.5× |
| Upper Extremity Infant (73092) |
$348.15 |
$1,055 |
3.3× |
| Urethrocystography retrograde rs&i (74450) |
$541.86 |
$1,642 |
2.3× |
| Urethrocystography voiding (74455) |
$530.48 |
$1,607.50 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$534.93 |
$1,621 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$556.38 |
$1,686 |
5.3× |
| Us breast unilateral complete (76641) |
$151.80 |
$460 |
1.4× |
| Us breast unilateral limited (76642) |
$108.24 |
$328 |
1.2× |
| Us chest (76604) |
$566.61 |
$1,717 |
5.4× |
| Us compl joint r-t w/image documentation (76881) |
$565.62 |
$1,714 |
5.4× |
| Us fetal nuchal translucency 1st gestation (76813) |
$119.79 |
$363 |
1.1× |
| Us guided compression repair (76936) |
$612.15 |
$1,855 |
2.8× |
| Us infant hips dynamic (76885) |
$639.70 |
$1,938.50 |
7.3× |
| Us infant hips limited static (76886) |
$453.09 |
$1,373 |
5.2× |
| Us kidney transplant (76776) |
$877.96 |
$2,660.50 |
8.4× |
| Us ob detailed single fetus (76811) |
$909.81 |
$2,757 |
3.8× |
| Us ob transvaginal (76817) |
$475.20 |
$1,440 |
4.5× |
| Us pelvic non ob complete (76856) |
$994.62 |
$3,014 |
9.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$576.51 |
$1,747 |
5.5× |
| Us pregnancy ltd (76815) |
$364.98 |
$1,106 |
3.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$538.89 |
$1,633 |
5.1× |
| Us retroperitoneal complete (76770) |
$704.88 |
$2,136 |
6.7× |
| Us retroperitoneal limited (76775) |
$531.30 |
$1,610 |
5.1× |
| Us scrotum and contents (76870) |
$688.05 |
$2,085 |
6.6× |
| Us soft tissue head/neck (76536) |
$608.85 |
$1,845 |
5.8× |
| Us spinal canal and contents (76800) |
$624.20 |
$1,891.50 |
5.9× |
| Us transrectal (76872) |
$499.29 |
$1,513 |
4.8× |
| Us xtr non-vasc lmtd (76882) |
$366.63 |
$1,111 |
3.5× |
| Vascular flow imaging (78445) |
$414.48 |
$1,256 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,539.12 |
$4,664 |
1.0× |
| Venogram orbital (75880) |
$1,184.04 |
$3,588 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$4,350.06 |
$13,182 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$1,539.12 |
$4,664 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,539.12 |
$4,664 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,366.66 |
$10,202 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,184.04 |
$3,588 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,346.20 |
$10,140 |
0.6× |
| Wrist 2 views (73100) |
$399.96 |
$1,212 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$499.95 |
$1,515 |
4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$545.66 |
$1,653.50 |
6.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$499.95 |
$1,515 |
5.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,409.43 |
$4,271 |
8.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$410.52 |
$1,244 |
4.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$513.15 |
$1,555 |
5.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$769.56 |
$2,332 |
7.3× |
| X-ray exam hip uni 1 view (73501) |
$429.82 |
$1,302.50 |
4.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$573.21 |
$1,737 |
6.6× |
| X-ray exam hip uni 4/> views (73503) |
$772.20 |
$2,340 |
7.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$553.41 |
$1,677 |
5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$500.28 |
$1,516 |
4.8× |
| X-ray exam of femur 1 (73551) |
$574.04 |
$1,739.50 |
6.6× |
| X-ray eye for foreign body (70030) |
$199.32 |
$604 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$562.65 |
$1,705 |
5.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$601.42 |
$1,822.50 |
6.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$317.62 |
$962.50 |
3.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,765.07 |
$8,379 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$298.65 |
$905 |
3.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$657.86 |
$1,993.50 |
3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$376.53 |
$1,141 |
4.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$580.47 |
$1,759 |
5.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$150.15 |
$455 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$604.56 |
$1,832 |
6.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$564.63 |
$1,711 |
5.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$931.26 |
$2,822 |
8.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$600.76 |
$1,820.50 |
5.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$426.36 |
$1,292 |
4.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$247.50 |
$750 |
2.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$729.80 |
$2,211.50 |
6.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$614.79 |
$1,863 |
5.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$683.76 |
$2,072 |
1.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,158.63 |
$3,511 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$506.55 |
$1,535 |
5.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$566.94 |
$1,718 |
5.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$700.26 |
$2,122 |
6.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$714.78 |
$2,166 |
6.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$490.38 |
$1,486 |
5.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$559.52 |
$1,695.50 |
6.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$599.28 |
$1,816 |
6.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$421.74 |
$1,278 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$628.32 |
$1,904 |
6.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$349.80 |
$1,060 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$491.04 |
$1,488 |
5.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$343.36 |
$1,040.50 |
3.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$595.65 |
$1,805 |
6.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$478.17 |
$1,449 |
4.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$600.93 |
$1,821 |
5.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$347.82 |
$1,054 |
4.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$433.29 |
$1,313 |
5.0× |
| Xr arthrogram ankle (73615) |
$789.69 |
$2,393 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$792.66 |
$2,402 |
7.5× |
| Xr chest 4+ views (71048) |
$472.23 |
$1,431 |
4.5× |
| Xr finger(s) 2+ views (73140) |
$338.58 |
$1,026 |
3.9× |
| Xr internal auditory meati complete (70134) |
$213.18 |
$646 |
0.4× |
| Xr optic foramina (70190) |
$378.84 |
$1,148 |
4.3× |
| Xr shoulder 1 view (73020) |
$446.66 |
$1,353.50 |
5.1× |
| Xr spine cervical 4 or 5 views (72050) |
$769.56 |
$2,332 |
7.3× |
| Xr tibia/fibula 2 views (73590) |
$513.15 |
$1,555 |
5.9× |
| Xr tmj bilateral (70330) |
$633.10 |
$1,918.50 |
7.2× |
| Xray knee 1 or 2 views rt (73560) |
$443.52 |
$1,344 |
5.1× |