| Abdomen 2 views (74019) |
$198.90 |
$306 |
2.1× |
| Ankle 2 views (73600) |
$223.60 |
$344 |
2.8× |
| Arthrogram hip (73525) |
$1,985.75 |
$3,055 |
6.2× |
| Arthrogram shoulder (73040) |
$1,985.75 |
$3,055 |
6.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$679.25 |
$1,045 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$1,292.20 |
$1,988 |
3.5× |
| Bone age studies (77072) |
$162.18 |
$249.50 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,160.25 |
$1,785 |
3.2× |
| Bone survey complete (77075) |
$1,144.65 |
$1,761 |
11.9× |
| Cervical spine 2 or 3 views (72040) |
$282.75 |
$435 |
3.5× |
| Chest 1 view (71045) |
$152.10 |
$234 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$591.50 |
$910 |
3.7× |
| Clavicle complete (73000) |
$215.80 |
$332 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$353.60 |
$544 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,966.25 |
$3,025 |
6.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,257.75 |
$1,935 |
5.7× |
| CT abdomen w contrast (74160) |
$1,527.50 |
$2,350 |
9.5× |
| CT abdomen w wo contrast (74170) |
$1,803.75 |
$2,775 |
11.2× |
| CT abdomen w/o contrast (74150) |
$1,153.75 |
$1,775 |
12.0× |
| CT angiography upper extremity lt (73206) |
$1,803.75 |
$2,775 |
11.2× |
| CT c-spine w/o contrast (72125) |
$1,257.75 |
$1,935 |
13.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,803.75 |
$2,775 |
11.2× |
| CT cervical spine with contrast (72126) |
$1,153.75 |
$1,775 |
3.6× |
| CT chest w/wo contrast (71270) |
$1,803.75 |
$2,775 |
11.2× |
| CT chest with contrast (71260) |
$1,665.30 |
$2,562 |
10.3× |
| CT head/brain with contrast (70460) |
$1,527.50 |
$2,350 |
9.5× |
| CT head/brain without and with contrast (70470) |
$1,803.75 |
$2,775 |
11.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$65 |
$100 |
0.8× |
| CT iac w contrast (70481) |
$1,527.50 |
$2,350 |
9.5× |
| CT lower ext w/o (73700) |
$1,153.75 |
$1,775 |
12.0× |
| CT lower extremity w wo contrast (73702) |
$1,803.75 |
$2,775 |
11.2× |
| CT lower extremity with contrast (73701) |
$1,527.50 |
$2,350 |
9.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,803.75 |
$2,775 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$1,153.75 |
$1,775 |
12.0× |
| CT lumbar spine with contrast (72132) |
$1,527.50 |
$2,350 |
4.8× |
| CT maxillofacial w contrast (70487) |
$1,527.50 |
$2,350 |
9.5× |
| CT maxillofacial w/o contrast (70486) |
$1,257.75 |
$1,935 |
13.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,803.75 |
$2,775 |
11.2× |
| CT neck soft tissue w contrast (70491) |
$1,527.50 |
$2,350 |
9.5× |
| CT orbits w/o contrast (70480) |
$1,153.75 |
$1,775 |
12.0× |
| CT pelvis w & w/o contrast (72194) |
$1,803.75 |
$2,775 |
11.2× |
| CT pelvis w/o contrast (72192) |
$1,153.75 |
$1,775 |
12.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,803.75 |
$2,775 |
11.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,153.75 |
$1,775 |
12.0× |
| CT thoracic spine w/contrast (72129) |
$1,527.50 |
$2,350 |
9.5× |
| CT thoracic spine w/o contrast (72128) |
$1,153.75 |
$1,775 |
12.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,803.75 |
$2,775 |
11.2× |
| CT thorax w/o contrast (71250) |
$1,257.75 |
$1,935 |
13.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,153.75 |
$1,775 |
12.0× |
| CT upper extremity with contrast (73201) |
$1,527.50 |
$2,350 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,803.75 |
$2,775 |
11.2× |
| Cta Abdomen (74175) |
$1,803.75 |
$2,775 |
11.2× |
| CTA abdomen pelvis (74174) |
$1,803.75 |
$2,775 |
5.6× |
| CTA chest (71275) |
$2,393.30 |
$3,682 |
14.8× |
| Cta Head (70496) |
$2,245.75 |
$3,455 |
13.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,803.75 |
$2,775 |
11.2× |
| Cta Neck (70498) |
$2,245.75 |
$3,455 |
13.9× |
| Cta Pelvis (72191) |
$1,803.75 |
$2,775 |
11.2× |
| Cystography minimum 3 views rs&i (74430) |
$633.10 |
$974 |
2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$195 |
$300 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$419.25 |
$645 |
4.4× |
| Esophagus (74220) |
$461.50 |
$710 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$457.60 |
$704 |
4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$412.75 |
$635 |
4.3× |
| Fluoroscopy up to 1 hr (76000) |
$375.05 |
$577 |
1.7× |
| Foot 2 views (73620) |
$238.55 |
$367 |
3.0× |
| Forearm 2 views (73090) |
$234.65 |
$361 |
2.9× |
| Hand 2 views (73120) |
$227.50 |
$350 |
2.4× |
| Hand 3 views (73130) |
$265.20 |
$408 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,155.05 |
$1,777 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$920.40 |
$1,416 |
2.5× |
| Ht muscle image spect sing (78451) |
$910 |
$1,400 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$233.35 |
$359 |
2.9× |
| Hysterosalpingogram (74740) |
$426.40 |
$656 |
1.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$372.45 |
$573 |
3.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,365.65 |
$2,101 |
2.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,275.95 |
$1,963 |
2.6× |
| Knee 3 views (73562) |
$220.35 |
$339 |
2.8× |
| Lymphoscintigraphy (78195) |
$1,121.90 |
$1,726 |
2.2× |
| MRA head w & w/o contrast (70546) |
$2,275 |
$3,500 |
7.1× |
| MRA head w/o contrast (70544) |
$1,677 |
$2,580 |
7.6× |
| MRA neck w contrast (70548) |
$1,985.75 |
$3,055 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,275 |
$3,500 |
7.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,275 |
$3,500 |
7.1× |
| MRI abdomen w/o contrast (74181) |
$1,677 |
$2,580 |
7.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,985.75 |
$3,055 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,677 |
$2,580 |
2.3× |
| MRI c-spine with contrast (72142) |
$1,985.75 |
$3,055 |
6.2× |
| MRI cervical spine w/o contrast (72141) |
$1,677 |
$2,580 |
7.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,275 |
$3,500 |
7.1× |
| MRI chest w/o contrast (71550) |
$1,677 |
$2,580 |
7.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,677 |
$2,580 |
7.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,677 |
$2,580 |
7.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,677 |
$2,580 |
5.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,275 |
$3,500 |
7.1× |
| MRI pelvis w/o contrast (72195) |
$1,677 |
$2,580 |
7.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,275 |
$3,500 |
7.1× |
| MRI scan of leg joint before and after contrast (73723) |
$2,275 |
$3,500 |
7.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,275 |
$3,500 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,985.75 |
$3,055 |
6.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,275 |
$3,500 |
7.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,985.75 |
$3,055 |
6.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,275 |
$3,500 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,677 |
$2,580 |
7.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,677 |
$2,580 |
7.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,275 |
$3,500 |
7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,677 |
$2,580 |
7.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,020.20 |
$3,108 |
1.7× |
| Neck soft tissue (70360) |
$234.65 |
$361 |
2.9× |
| Nm gastric emptying study (78264) |
$1,647.75 |
$2,535 |
4.5× |
| Nuclear Rx Oral Admin (79005) |
$956.80 |
$1,472 |
4.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$481 |
$740 |
5.0× |
| Osseous survey infant (77076) |
$357.50 |
$550 |
3.7× |
| Parathyroid imaging (78070) |
$1,070.55 |
$1,647 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$185.90 |
$286 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$3,869.45 |
$5,953 |
2.9× |
| PET imaging for CT attenuation whole body (78816) |
$3,997.50 |
$6,150 |
3.0× |
| PET imaging limited area chest head/neck (78811) |
$780 |
$1,200 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,275 |
$3,500 |
7.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$908.70 |
$1,398 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,511.25 |
$2,325 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$375.05 |
$577 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$306.80 |
$472 |
3.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$232.70 |
$358 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$333.45 |
$513 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$178.10 |
$274 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$250.25 |
$385 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$198.90 |
$306 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$992.55 |
$1,527 |
6.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$601.25 |
$925 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$543.40 |
$836 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$579.15 |
$891 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$320.45 |
$493 |
4.0× |
| Radiological examination surgical specimen (76098) |
$351.65 |
$541 |
0.7× |
| Ribs bilateral 3 views (71110) |
$375.70 |
$578 |
3.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,019.55 |
$3,107 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$263.25 |
$405 |
2.7× |
| Scanogram (77073) |
$274.95 |
$423 |
2.9× |
| Scapula complete (73010) |
$221 |
$340 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$73.45 |
$113 |
3.1× |
| Small bowel series (74250) |
$588.25 |
$905 |
3.6× |
| Spine thoracic 3 views (72072) |
$339.95 |
$523 |
3.5× |
| Thoracolumbar 2 views (72080) |
$337.35 |
$519 |
4.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$511.55 |
$787 |
1.4× |
| Thyroid uptake measurement (78012) |
$431.60 |
$664 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$774.80 |
$1,192 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$498.55 |
$767 |
5.2× |
| Umbilical-artery Doppler (OB) (76820) |
$195 |
$300 |
2.0× |
| Upper Extremity Infant (73092) |
$154.70 |
$238 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$345.15 |
$531 |
3.6× |
| Us breast unilateral complete (76641) |
$339.30 |
$522 |
3.5× |
| Us breast unilateral limited (76642) |
$248.30 |
$382 |
3.1× |
| Us chest (76604) |
$379.60 |
$584 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$107.25 |
$165 |
1.1× |
| Us infant hips dynamic (76885) |
$417.95 |
$643 |
5.2× |
| Us infant hips limited static (76886) |
$81.25 |
$125 |
1.0× |
| Us ob detailed single fetus (76811) |
$433.55 |
$667 |
2.0× |
| Us ob transvaginal (76817) |
$436.15 |
$671 |
4.5× |
| Us pelvic non ob complete (76856) |
$597.35 |
$919 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$315.90 |
$486 |
3.3× |
| Us pregnancy ltd (76815) |
$337.35 |
$519 |
3.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$602.55 |
$927 |
6.3× |
| Us retroperitoneal complete (76770) |
$544.70 |
$838 |
5.7× |
| Us retroperitoneal limited (76775) |
$431.60 |
$664 |
4.5× |
| Us scrotum and contents (76870) |
$505.05 |
$777 |
5.3× |
| Us soft tissue head/neck (76536) |
$681.85 |
$1,049 |
7.1× |
| Us spinal canal and contents (76800) |
$302.90 |
$466 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$413.40 |
$636 |
4.3× |
| Wrist 2 views (73100) |
$237.90 |
$366 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$277.55 |
$427 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$171.60 |
$264 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$962.65 |
$1,481 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$260 |
$400 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$298.35 |
$459 |
3.7× |
| X-ray exam hip uni 1 view (73501) |
$186.55 |
$287 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$280.15 |
$431 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$321.10 |
$494 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$161.85 |
$249 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$390.65 |
$601 |
4.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$202.80 |
$312 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$324.68 |
$499.50 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$175.50 |
$270 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$145.60 |
$224 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$215.80 |
$332 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$627.90 |
$966 |
6.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$374.40 |
$576 |
3.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$245.70 |
$378 |
3.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$159.25 |
$245 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$315.25 |
$485 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$190.45 |
$293 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$221 |
$340 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$357.50 |
$550 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$500.50 |
$770 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$241.80 |
$372 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$312 |
$480 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$266.50 |
$410 |
3.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$182.65 |
$281 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$300.30 |
$462 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$244.40 |
$376 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$242.45 |
$373 |
2.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$187.85 |
$289 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$277.55 |
$427 |
3.5× |
| Xr c-spine 6 or more views (72052) |
$552.50 |
$850 |
5.7× |
| Xr chest 4+ views (71048) |
$400.40 |
$616 |
4.2× |
| Xr finger(s) 2+ views (73140) |
$193.70 |
$298 |
2.4× |
| Xr shoulder 1 view (73020) |
$182.65 |
$281 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$414.70 |
$638 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$256.10 |
$394 |
3.2× |
| Xr tmj bilateral (70330) |
$361.40 |
$556 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$154.70 |
$238 |
1.9× |