| Abdomen 2 views (74019) |
$90.30 |
$301 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$296.40 |
$988 |
0.8× |
| Ankle 2 views (73600) |
$38.10 |
$127 |
0.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$170.10 |
$567 |
0.5× |
| Bone &/joint imaging whole body (78306) |
$213.30 |
$711 |
0.6× |
| Bone age studies (77072) |
$54.90 |
$183 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$171.90 |
$573 |
0.5× |
| Bone survey complete (77075) |
$162.90 |
$543 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$80.40 |
$268 |
1.0× |
| Chest 1 view (71045) |
$87.90 |
$293 |
1.1× |
| Clavicle complete (73000) |
$43.50 |
$145 |
0.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$320.10 |
$1,067 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$896.10 |
$2,987 |
2.8× |
| CT abdomen and pelvis without contrast (74176) |
$732.30 |
$2,441 |
3.3× |
| CT abdomen w contrast (74160) |
$413.40 |
$1,378 |
2.6× |
| CT abdomen w wo contrast (74170) |
$495.90 |
$1,653 |
3.1× |
| CT abdomen w/o contrast (74150) |
$320.10 |
$1,067 |
3.3× |
| CT c-spine w/o contrast (72125) |
$463.80 |
$1,546 |
4.8× |
| CT cervical spine w&w/o contrast (72127) |
$573.60 |
$1,912 |
3.6× |
| CT cervical spine with contrast (72126) |
$510.30 |
$1,701 |
1.6× |
| CT chest w/wo contrast (71270) |
$495.90 |
$1,653 |
3.1× |
| CT chest with contrast (71260) |
$413.40 |
$1,378 |
2.6× |
| CT head/brain with contrast (70460) |
$589.20 |
$1,964 |
3.7× |
| CT head/brain without and with contrast (70470) |
$632.10 |
$2,107 |
3.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$15 |
$37.50 |
0.2× |
| CT iac w contrast (70481) |
$774.30 |
$2,581 |
4.8× |
| CT lower ext w/o (73700) |
$344.40 |
$1,148 |
3.6× |
| CT lower extremity w wo contrast (73702) |
$489 |
$1,630 |
3.0× |
| CT lower extremity with contrast (73701) |
$384.30 |
$1,281 |
2.4× |
| CT lumbar spine w & w/o contrast (72133) |
$478.80 |
$1,596 |
3.0× |
| CT lumbar spine w/o contrast (72131) |
$344.40 |
$1,148 |
3.6× |
| CT lumbar spine with contrast (72132) |
$384.30 |
$1,281 |
1.2× |
| CT maxillofacial w contrast (70487) |
$489.30 |
$1,631 |
3.0× |
| CT maxillofacial w/o contrast (70486) |
$444.90 |
$1,483 |
4.6× |
| CT neck soft tissue w contrast (70491) |
$413.40 |
$1,378 |
2.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$461.10 |
$1,537 |
2.9× |
| CT orbits w/o contrast (70480) |
$320.10 |
$1,067 |
3.3× |
| CT pelvis w & w/o contrast (72194) |
$495.90 |
$1,653 |
3.1× |
| CT pelvis w/o contrast (72192) |
$320.10 |
$1,067 |
3.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$461.10 |
$1,537 |
2.9× |
| CT soft tissue neck w/o contrast (70490) |
$320.10 |
$1,067 |
3.3× |
| CT thoracic spine w/contrast (72129) |
$450 |
$1,500 |
2.8× |
| CT thoracic spine w/o contrast (72128) |
$438.60 |
$1,462 |
4.6× |
| CT thorax w/o contrast (71250) |
$344.40 |
$1,148 |
3.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$461.10 |
$1,537 |
2.9× |
| CT upper extremity w/o contrast rt (73200) |
$344.40 |
$1,148 |
3.6× |
| CT upper extremity with contrast (73201) |
$384.30 |
$1,281 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$573.60 |
$1,912 |
3.6× |
| Cta Abdomen (74175) |
$573.60 |
$1,912 |
3.6× |
| CTA abdomen pelvis (74174) |
$805.50 |
$2,685 |
2.5× |
| CTA chest (71275) |
$573.60 |
$1,912 |
3.6× |
| Cta Head (70496) |
$616.80 |
$2,056 |
3.8× |
| Cta Neck (70498) |
$616.80 |
$2,056 |
3.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$136.80 |
$456 |
1.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$36.60 |
$122 |
0.5× |
| Dxa bone density study axial skeleton (77085) |
$102.30 |
$341 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$148.20 |
$494 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$96.30 |
$321 |
0.4× |
| Foot 2 views (73620) |
$38.10 |
$127 |
0.5× |
| Forearm 2 views (73090) |
$45.30 |
$151 |
0.6× |
| Hand 2 views (73120) |
$38.10 |
$127 |
0.4× |
| Hand 3 views (73130) |
$45.30 |
$151 |
0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$282 |
$940 |
0.8× |
| Ht muscle image spect sing (78451) |
$405.90 |
$1,353 |
0.3× |
| Humerus Min 2 Views Left (73060) |
$53.40 |
$178 |
0.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$48.90 |
$163 |
0.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$415.80 |
$1,386 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$473.10 |
$1,577 |
0.9× |
| Knee 3 views (73562) |
$95.70 |
$319 |
1.2× |
| Meckels Diverticulum (78290) |
$137.10 |
$457 |
0.4× |
| MRA head w/o contrast (70544) |
$345 |
$1,150 |
1.6× |
| MRA neck w contrast (70548) |
$336.65 |
$1,122.16 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$560.12 |
$1,867.07 |
1.7× |
| MRA neck w/o contrast (70547) |
$309.59 |
$1,031.98 |
1.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$711.60 |
$2,372 |
2.2× |
| MRI abdomen w/o contrast (74181) |
$560.40 |
$1,868 |
2.6× |
| MRI any jnt lwr ext with con lt (73722) |
$450 |
$1,500 |
0.6× |
| MRI breast w/o contrast bilateral (77047) |
$240.47 |
$801.58 |
1.1× |
| MRI breast w/o contrast unilat (77046) |
$245.01 |
$816.70 |
1.1× |
| MRI c-spine with contrast (72142) |
$650.70 |
$2,169 |
2.0× |
| MRI cervical spine w/o contrast (72141) |
$607.20 |
$2,024 |
2.8× |
| MRI chest w/o & w/contrast material (71552) |
$624.71 |
$2,082.37 |
1.9× |
| MRI chest w/o contrast (71550) |
$376.25 |
$1,254.16 |
1.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$415.20 |
$1,384 |
1.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$345 |
$1,150 |
1.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$425.10 |
$1,417 |
1.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$566.70 |
$1,889 |
1.8× |
| MRI pelvis w/o contrast (72195) |
$366 |
$1,220 |
1.7× |
| MRI scan of arm joint before and after contrast (73223) |
$540 |
$1,800 |
1.7× |
| MRI scan of leg joint before and after contrast (73723) |
$580.50 |
$1,935 |
1.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$699.60 |
$2,332 |
2.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$677.40 |
$2,258 |
2.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$624.60 |
$2,082 |
1.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$602.70 |
$2,009 |
1.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$699.60 |
$2,332 |
2.2× |
| MRI thoracic spine w/o contrast (72146) |
$602.70 |
$2,009 |
2.7× |
| MRI tmj (70336) |
$668.40 |
$2,228 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$403.20 |
$1,344 |
1.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$560.40 |
$1,868 |
1.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$560.40 |
$1,868 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$763.50 |
$2,545 |
0.6× |
| Neck soft tissue (70360) |
$39 |
$130 |
0.5× |
| Nm gastric emptying study (78264) |
$147.60 |
$492 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$183 |
$610 |
0.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$86.70 |
$289 |
0.9× |
| Osseous survey infant (77076) |
$81.60 |
$272 |
0.8× |
| Parathyroid imaging (78070) |
$210.30 |
$701 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$45.60 |
$152 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$555.90 |
$1,853 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$128.10 |
$427 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$100.80 |
$336 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$69.90 |
$233 |
0.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$80.40 |
$268 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$56.10 |
$187 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$71.70 |
$239 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$108 |
$360 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$106.50 |
$355 |
1.3× |
| Ribs bilateral 3 views (71110) |
$105.30 |
$351 |
1.1× |
| Scanogram (77073) |
$85.50 |
$285 |
0.9× |
| Scapula complete (73010) |
$69.60 |
$232 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$23.40 |
$78 |
1.0× |
| Spine thoracic 3 views (72072) |
$86.70 |
$289 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$165.60 |
$552 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$210.30 |
$701 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$89.10 |
$297 |
0.9× |
| Upper Extremity Infant (73092) |
$84.15 |
$280.50 |
0.9× |
| Us abdl aorta screen aaa (76706) |
$54 |
$180 |
0.6× |
| Us breast unilateral complete (76641) |
$62.40 |
$208 |
0.6× |
| Us breast unilateral limited (76642) |
$62.40 |
$208 |
0.8× |
| Us chest (76604) |
$207 |
$690 |
2.2× |
| Us ob transvaginal (76817) |
$89.10 |
$297 |
0.9× |
| Us pelvic non ob complete (76856) |
$89.10 |
$297 |
0.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$67.80 |
$226 |
0.7× |
| Us pregnancy ltd (76815) |
$89.10 |
$297 |
0.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$76.80 |
$256 |
0.8× |
| Us retroperitoneal complete (76770) |
$99.60 |
$332 |
1.0× |
| Us scrotum and contents (76870) |
$89.10 |
$297 |
0.9× |
| Us soft tissue head/neck (76536) |
$293.10 |
$977 |
3.0× |
| Us transrectal prostate volume (76873) |
$54 |
$180 |
0.6× |
| Us xtr non-vasc lmtd (76882) |
$89.10 |
$297 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$49.80 |
$166 |
0.6× |
| Wrist 2 views (73100) |
$38.10 |
$127 |
0.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$165.60 |
$552 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$49.20 |
$164 |
0.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$84.30 |
$281 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$38.10 |
$127 |
0.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$45.60 |
$152 |
0.6× |
| X-ray exam hip uni 1 view (73501) |
$55.50 |
$185 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$80.40 |
$268 |
1.0× |
| X-ray exam hip uni 4/> views (73503) |
$96.90 |
$323 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$106.20 |
$354 |
1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$149.70 |
$499 |
1.6× |
| X-ray eye for foreign body (70030) |
$25.24 |
$84.14 |
0.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$80.40 |
$268 |
0.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$83.10 |
$277 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$37.50 |
$125 |
0.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$42 |
$140 |
0.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$123 |
$410 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$77.40 |
$258 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$36.60 |
$122 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$86.70 |
$289 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$230.40 |
$768 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$53.10 |
$177 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$35.40 |
$118 |
0.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$77.10 |
$257 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$68.70 |
$229 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$60.60 |
$202 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$102.30 |
$341 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$71.40 |
$238 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$60.60 |
$202 |
0.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$80.70 |
$269 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$80.40 |
$268 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$35.40 |
$118 |
0.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$125.40 |
$418 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$91.50 |
$305 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$49.20 |
$164 |
0.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$43.50 |
$145 |
0.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$76.50 |
$255 |
0.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$38.10 |
$127 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$45.30 |
$151 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$118.20 |
$394 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$35.40 |
$118 |
0.4× |
| Xr shoulder 1 view (73020) |
$38.10 |
$127 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$102.30 |
$341 |
1.1× |
| Xr tibia/fibula 2 views (73590) |
$53.40 |
$178 |
0.7× |
| Xr tmj bilateral (70330) |
$73.20 |
$244 |
0.9× |
| Xray knee 1 or 2 views rt (73560) |
$75.60 |
$252 |
0.9× |