| Abdomen 2 views (74019) |
$148.56 |
$148.56 |
1.5× |
| Ankle 2 views (73600) |
$204.75 |
$204.75 |
2.6× |
| Arthrogram hip (73525) |
$238.42 |
$238.42 |
0.7× |
| Arthrogram shoulder (73040) |
$396.36 |
$396.36 |
1.2× |
| Arthrogram wrist (73115) |
$268.86 |
$268.86 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$580.36 |
$580.36 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$678.71 |
$678.71 |
1.8× |
| Bone age studies (77072) |
$113.66 |
$113.66 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$685.38 |
$685.38 |
1.9× |
| Bone survey complete (77075) |
$358.59 |
$358.59 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$150 |
$150 |
1.9× |
| Chest 1 view (71045) |
$119.94 |
$119.94 |
1.5× |
| Chest 3 views (71047) |
$67.33 |
$67.33 |
0.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$275.29 |
$275.29 |
1.7× |
| Clavicle complete (73000) |
$238.35 |
$238.35 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,291.70 |
$2,291.70 |
7.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,770.34 |
$1,770.34 |
8.1× |
| CT abdomen w contrast (74160) |
$1,200.78 |
$1,200.78 |
7.4× |
| CT abdomen w wo contrast (74170) |
$1,333.11 |
$1,333.11 |
8.3× |
| CT abdomen w/o contrast (74150) |
$1,032.10 |
$1,032.10 |
10.7× |
| CT c-spine w/o contrast (72125) |
$1,072.15 |
$1,072.15 |
11.2× |
| CT cervical spine with contrast (72126) |
$1,218.32 |
$1,218.32 |
3.8× |
| CT chest w/wo contrast (71270) |
$1,216.76 |
$1,216.76 |
7.5× |
| CT chest with contrast (71260) |
$1,148.44 |
$1,148.44 |
7.1× |
| CT head/brain with contrast (70460) |
$1,038.70 |
$1,038.70 |
6.4× |
| CT head/brain without and with contrast (70470) |
$1,142.11 |
$1,142.11 |
7.1× |
| CT iac w contrast (70481) |
$1,073.49 |
$1,073.49 |
6.7× |
| CT lower ext w/o (73700) |
$1,877.40 |
$1,877.40 |
19.5× |
| CT lower extremity with contrast (73701) |
$1,913.10 |
$1,913.10 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$1,073.90 |
$1,073.90 |
11.2× |
| CT lumbar spine with contrast (72132) |
$1,220.90 |
$1,220.90 |
3.8× |
| CT maxillofacial w contrast (70487) |
$950.51 |
$950.51 |
5.9× |
| CT maxillofacial w/o contrast (70486) |
$827.85 |
$827.85 |
8.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,127.96 |
$1,127.96 |
7.0× |
| CT neck soft tissue w contrast (70491) |
$1,086.27 |
$1,086.27 |
6.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,218.77 |
$1,218.77 |
7.6× |
| CT orbits w/o contrast (70480) |
$997.23 |
$997.23 |
10.4× |
| CT pelvis w & w/o contrast (72194) |
$1,213.74 |
$1,213.74 |
7.5× |
| CT pelvis w/o contrast (72192) |
$1,013 |
$1,013 |
10.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,171.69 |
$1,171.69 |
7.3× |
| CT soft tissue neck w/o contrast (70490) |
$927.37 |
$927.37 |
9.6× |
| CT thoracic spine w/contrast (72129) |
$1,159 |
$1,159 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$1,060.63 |
$1,060.63 |
11.0× |
| CT thorax w/o contrast (71250) |
$1,049.04 |
$1,049.04 |
10.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,766.10 |
$1,766.10 |
18.4× |
| CT upper extremity with contrast (73201) |
$1,913.10 |
$1,913.10 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,437.64 |
$1,437.64 |
8.9× |
| Cta Abdomen (74175) |
$1,474.74 |
$1,474.74 |
9.1× |
| CTA chest (71275) |
$1,443.87 |
$1,443.87 |
9.0× |
| Cta Head (70496) |
$1,369.40 |
$1,369.40 |
8.5× |
| Cta Neck (70498) |
$1,197.01 |
$1,197.01 |
7.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$180 |
$180 |
1.9× |
| Esophagus (74220) |
$290.63 |
$290.63 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$167.22 |
$167.22 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$54.60 |
$54.60 |
0.2× |
| Foot 2 views (73620) |
$212.10 |
$212.10 |
2.7× |
| Forearm 2 views (73090) |
$231 |
$231 |
2.9× |
| Gated Heart Planar Single (78472) |
$807.77 |
$807.77 |
2.2× |
| Hand 2 views (73120) |
$287.70 |
$287.70 |
3.0× |
| Hand 3 views (73130) |
$270.90 |
$270.90 |
3.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$859.16 |
$859.16 |
1.7× |
| Ht muscle image spect sing (78451) |
$1,653.75 |
$1,653.75 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$257.25 |
$257.25 |
3.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,049.25 |
$1,049.25 |
2.1× |
| Knee 3 views (73562) |
$291.90 |
$291.90 |
3.6× |
| MRA head w/o contrast (70544) |
$1,460.97 |
$1,460.97 |
6.7× |
| MRA neck w contrast (70548) |
$1,458.59 |
$1,458.59 |
4.5× |
| MRA neck w/o contrast (70547) |
$1,367.52 |
$1,367.52 |
6.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,893.54 |
$1,893.54 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,446.42 |
$1,446.42 |
6.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,520 |
$2,520 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,481.15 |
$2,481.15 |
3.4× |
| MRI c-spine with contrast (72142) |
$1,713.64 |
$1,713.64 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$1,582.19 |
$1,582.19 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,346.50 |
$2,346.50 |
7.3× |
| MRI chest w/o contrast (71550) |
$1,178.06 |
$1,178.06 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,157.75 |
$2,157.75 |
9.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,270.21 |
$1,270.21 |
5.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,620.12 |
$1,620.12 |
5.0× |
| MRI pelvis w contrast (72196) |
$1,445.81 |
$1,445.81 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,712.41 |
$1,712.41 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$1,354.72 |
$1,354.72 |
6.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,486.60 |
$1,486.60 |
4.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,937.90 |
$2,937.90 |
9.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,848.06 |
$1,848.06 |
5.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,605.53 |
$1,605.53 |
5.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,853.32 |
$1,853.32 |
5.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,713.30 |
$1,713.30 |
5.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,901.62 |
$1,901.62 |
5.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,588.49 |
$1,588.49 |
7.2× |
| MRI tmj (70336) |
$2,157.75 |
$2,157.75 |
9.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,187.15 |
$2,187.15 |
10.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,625 |
$2,625 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,157.75 |
$2,157.75 |
9.8× |
| Myelogram Cervical (72240) |
$1,631.73 |
$1,631.73 |
2.3× |
| Myelogram Lumbar (72265) |
$1,622.88 |
$1,622.88 |
2.3× |
| Myelogram thoracic (72255) |
$1,635.86 |
$1,635.86 |
2.3× |
| Myelography 2 or more regions (72270) |
$1,642 |
$1,642 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,985.97 |
$1,985.97 |
1.7× |
| Neck soft tissue (70360) |
$132.85 |
$132.85 |
1.7× |
| Nm gastric emptying study (78264) |
$773.90 |
$773.90 |
2.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$247.18 |
$247.18 |
2.6× |
| Osseous survey infant (77076) |
$158.90 |
$158.90 |
1.7× |
| Parathyroid imaging (78070) |
$458.44 |
$458.44 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$131.40 |
$131.40 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,704.80 |
$2,704.80 |
8.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$488.12 |
$488.12 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$888.72 |
$888.72 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$132.91 |
$132.91 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$197.72 |
$197.72 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$147.82 |
$147.82 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$184.42 |
$184.42 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$129.49 |
$129.49 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$147.94 |
$147.94 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$621.11 |
$621.11 |
3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$311.72 |
$311.72 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$340.20 |
$340.20 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$340.10 |
$340.10 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$276.15 |
$276.15 |
3.5× |
| Ribs bilateral 3 views (71110) |
$193.46 |
$193.46 |
2.0× |
| Scapula complete (73010) |
$254.10 |
$254.10 |
2.6× |
| Screening digital breast tomosynthesis (77063) |
$66.92 |
$66.92 |
2.9× |
| Small bowel series (74250) |
$283.36 |
$283.36 |
1.8× |
| Spine thoracic 3 views (72072) |
$205.72 |
$205.72 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$592.47 |
$592.47 |
1.6× |
| Tmj unilateral (70328) |
$262.50 |
$262.50 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$175.35 |
$175.35 |
1.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$50 |
$50 |
0.6× |
| Upper Extremity Infant (73092) |
$183.75 |
$183.75 |
1.9× |
| Urethrocystography voiding (74455) |
$310.30 |
$310.30 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$680.40 |
$680.40 |
4.2× |
| Us breast unilateral complete (76641) |
$317.50 |
$317.50 |
3.3× |
| Us breast unilateral limited (76642) |
$189 |
$189 |
2.4× |
| Us chest (76604) |
$232.12 |
$232.12 |
2.4× |
| Us elastography parenchyma (76981) |
$314.61 |
$314.61 |
3.3× |
| Us ob transvaginal (76817) |
$281.09 |
$281.09 |
2.9× |
| Us pelvic non ob complete (76856) |
$358 |
$358 |
3.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$151.20 |
$151.20 |
1.6× |
| Us pregnancy ltd (76815) |
$236.47 |
$236.47 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$308.82 |
$308.82 |
3.2× |
| Us retroperitoneal complete (76770) |
$358.23 |
$358.23 |
3.7× |
| Us retroperitoneal limited (76775) |
$280.12 |
$280.12 |
2.9× |
| Us scrotum and contents (76870) |
$311.49 |
$311.49 |
3.2× |
| Us soft tissue head/neck (76536) |
$170.10 |
$170.10 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$264.60 |
$264.60 |
2.8× |
| Wrist 2 views (73100) |
$196.35 |
$196.35 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$240.38 |
$240.38 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$139.84 |
$139.84 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$265.65 |
$265.65 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$457.42 |
$457.42 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$220.50 |
$220.50 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$277.20 |
$277.20 |
3.5× |
| X-ray exam hip uni 1 view (73501) |
$107.98 |
$107.98 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$143.16 |
$143.16 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$198.50 |
$198.50 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$27.89 |
$27.89 |
0.3× |
| X-ray eye for foreign body (70030) |
$113.55 |
$113.55 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$198.75 |
$198.75 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$126.08 |
$126.08 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$266.70 |
$266.70 |
3.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$106.24 |
$106.24 |
1.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$178.50 |
$178.50 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$186.17 |
$186.17 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$224.62 |
$224.62 |
2.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$210.16 |
$210.16 |
2.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$147.68 |
$147.68 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$141.38 |
$141.38 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$188.07 |
$188.07 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$154.44 |
$154.44 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$139.99 |
$139.99 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$183.42 |
$183.42 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$236.41 |
$236.41 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$148.02 |
$148.02 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$140.32 |
$140.32 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$294 |
$294 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$177.59 |
$177.59 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$117.30 |
$117.30 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$198.56 |
$198.56 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$125.68 |
$125.68 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$121.50 |
$121.50 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$112.35 |
$112.35 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$138.38 |
$138.38 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$158.92 |
$158.92 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$102.22 |
$102.22 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$256.20 |
$256.20 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$248.85 |
$248.85 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$102.20 |
$102.20 |
1.3× |
| Xr shoulder 1 view (73020) |
$118.42 |
$118.42 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$227.46 |
$227.46 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$151.50 |
$151.50 |
1.9× |
| Xr tmj bilateral (70330) |
$304.50 |
$304.50 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$240.45 |
$240.45 |
3.0× |