| Abdomen 2 views (74019) |
$162 |
$162 |
1.5× |
| Ankle 2 views (73600) |
$105 |
$105 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$659 |
$659 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$914 |
$914 |
2.3× |
| Bone age studies (77072) |
$99 |
$99 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$978 |
$978 |
2.4× |
| Bone survey complete (77075) |
$429 |
$429 |
4.1× |
| Cervical spine 2 or 3 views (72040) |
$204 |
$204 |
2.3× |
| Chest 1 view (71045) |
$143 |
$143 |
1.6× |
| Chest 3 views (71047) |
$198 |
$198 |
2.3× |
| Clavicle complete (73000) |
$167 |
$167 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$578 |
$578 |
5.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,666.50 |
$2,666.50 |
7.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,150 |
$2,150 |
9.0× |
| CT abdomen w contrast (74160) |
$1,835 |
$1,835 |
10.4× |
| CT abdomen w/o contrast (74150) |
$1,035 |
$1,035 |
9.9× |
| CT angiography upper extremity lt (73206) |
$1,820 |
$1,820 |
10.3× |
| CT c-spine w/o contrast (72125) |
$1,333 |
$1,333 |
12.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,824 |
$1,824 |
10.4× |
| CT chest w/wo contrast (71270) |
$1,277 |
$1,277 |
7.2× |
| CT chest with contrast (71260) |
$1,063 |
$1,063 |
6.0× |
| CT head/brain with contrast (70460) |
$1,082 |
$1,082 |
6.1× |
| CT head/brain without and with contrast (70470) |
$1,285 |
$1,285 |
7.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$170 |
$170 |
1.9× |
| CT iac w contrast (70481) |
$1,177 |
$1,177 |
6.7× |
| CT lower ext w/o (73700) |
$969 |
$969 |
9.2× |
| CT lower extremity w wo contrast (73702) |
$1,334 |
$1,334 |
7.6× |
| CT lower extremity with contrast (73701) |
$1,103 |
$1,103 |
6.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,824 |
$1,824 |
10.4× |
| CT lumbar spine w/o contrast (72131) |
$1,333 |
$1,333 |
12.7× |
| CT lumbar spine with contrast (72132) |
$1,519 |
$1,519 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,224 |
$1,224 |
6.9× |
| CT maxillofacial w/o contrast (70486) |
$1,064 |
$1,064 |
10.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,457 |
$1,457 |
8.3× |
| CT neck soft tissue w contrast (70491) |
$1,284 |
$1,284 |
7.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,400 |
$1,400 |
7.9× |
| CT orbits w/o contrast (70480) |
$715.50 |
$715.50 |
6.8× |
| CT pelvis w & w/o contrast (72194) |
$1,534 |
$1,534 |
8.7× |
| CT pelvis w/o contrast (72192) |
$1,115 |
$1,115 |
10.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,601 |
$1,601 |
9.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,149 |
$1,149 |
10.9× |
| CT thoracic spine w/contrast (72129) |
$1,519 |
$1,519 |
8.6× |
| CT thoracic spine w/o contrast (72128) |
$1,333 |
$1,333 |
12.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,824 |
$1,824 |
10.4× |
| CT thorax w/o contrast (71250) |
$914 |
$914 |
8.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,290 |
$1,290 |
7.3× |
| CT upper extremity w/o contrast rt (73200) |
$937 |
$937 |
8.9× |
| CT upper extremity with contrast (73201) |
$1,067 |
$1,067 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,080 |
$2,080 |
11.8× |
| Cta Abdomen (74175) |
$1,820 |
$1,820 |
10.3× |
| CTA abdomen pelvis (74174) |
$1,820 |
$1,820 |
5.2× |
| CTA chest (71275) |
$597 |
$597 |
3.4× |
| Cta Head (70496) |
$1,820 |
$1,820 |
10.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,820 |
$1,820 |
10.3× |
| Cta Neck (70498) |
$1,785 |
$1,785 |
10.1× |
| Cystography minimum 3 views rs&i (74430) |
$302 |
$302 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$338 |
$338 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$338 |
$338 |
3.9× |
| Fetal biophysical profile non-stress testing (76818) |
$757 |
$757 |
7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$304 |
$304 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$509 |
$509 |
2.1× |
| Foot 2 views (73620) |
$147 |
$147 |
1.7× |
| Forearm 2 views (73090) |
$125 |
$125 |
1.4× |
| Hand 2 views (73120) |
$99 |
$99 |
0.9× |
| Hand 3 views (73130) |
$140 |
$140 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$850 |
$850 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,025 |
$1,025 |
2.6× |
| Ht muscle image spect sing (78451) |
$775 |
$775 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$146 |
$146 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$787 |
$787 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$659 |
$659 |
1.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$659 |
$659 |
1.2× |
| Knee 3 views (73562) |
$169 |
$169 |
1.9× |
| Lung Ventilation Imaging (78579) |
$787 |
$787 |
2.0× |
| Meckels Diverticulum (78290) |
$912 |
$912 |
2.3× |
| MRA head w & w/o contrast (70546) |
$2,658 |
$2,658 |
7.6× |
| MRA head w/o contrast (70544) |
$2,179 |
$2,179 |
9.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,658 |
$2,658 |
7.6× |
| MRA neck w/o contrast (70547) |
$2,179 |
$2,179 |
9.1× |
| MRI abdomen w contrast (74182) |
$2,415 |
$2,415 |
6.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,572 |
$2,572 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$2,493 |
$2,493 |
10.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,514 |
$1,514 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,423 |
$2,423 |
3.1× |
| MRI c-spine with contrast (72142) |
$2,726 |
$2,726 |
7.8× |
| MRI cervical spine w/o contrast (72141) |
$2,203 |
$2,203 |
9.2× |
| MRI chest w/o contrast (71550) |
$1,114 |
$1,114 |
4.6× |
| MRI chest with contrast (71551) |
$3,494 |
$3,494 |
4.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,010 |
$2,010 |
5.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,712 |
$2,712 |
7.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,361 |
$2,361 |
9.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,334 |
$2,334 |
9.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,812 |
$2,812 |
8.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,732 |
$2,732 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$2,254 |
$2,254 |
9.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,673 |
$2,673 |
7.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,578 |
$1,578 |
4.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,177 |
$3,177 |
9.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,609 |
$2,609 |
7.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,100 |
$3,100 |
8.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,643 |
$2,643 |
7.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,271 |
$3,271 |
9.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,403 |
$2,403 |
10.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,302 |
$2,302 |
9.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,361 |
$2,361 |
6.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,883 |
$1,883 |
7.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,824 |
$2,824 |
2.2× |
| Neck soft tissue (70360) |
$177 |
$177 |
2.0× |
| Nm gastric emptying study (78264) |
$880 |
$880 |
2.2× |
| Nuclear medicine of heart pumping function (78473) |
$1,306 |
$1,306 |
3.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$304 |
$304 |
2.9× |
| Osseous survey infant (77076) |
$429 |
$429 |
4.1× |
| Osseous survey limited (77074) |
$214 |
$214 |
2.0× |
| Parathyroid imaging (78070) |
$940 |
$940 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$241 |
$241 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,839 |
$2,839 |
8.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$787 |
$787 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$807 |
$807 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$229 |
$229 |
2.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$216 |
$216 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$216 |
$216 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$118 |
$118 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$235 |
$235 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$163 |
$163 |
1.9× |
| Scanogram (77073) |
$179 |
$179 |
1.7× |
| Scapula complete (73010) |
$87 |
$87 |
0.8× |
| Spine thoracic 3 views (72072) |
$176 |
$176 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,153 |
$1,153 |
2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,154 |
$1,154 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$333 |
$333 |
3.2× |
| Umbilical-artery Doppler (OB) (76820) |
$312 |
$312 |
3.0× |
| Upper Extremity Infant (73092) |
$117 |
$117 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$482 |
$482 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$240 |
$240 |
2.3× |
| Us breast unilateral complete (76641) |
$234 |
$234 |
2.2× |
| Us breast unilateral limited (76642) |
$182 |
$182 |
2.1× |
| Us chest (76604) |
$411 |
$411 |
3.9× |
| Us elastography parenchyma (76981) |
$276 |
$276 |
2.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$357 |
$357 |
3.4× |
| Us ob detailed single fetus (76811) |
$468 |
$468 |
2.0× |
| Us ob transvaginal (76817) |
$338 |
$338 |
3.2× |
| Us pelvic non ob complete (76856) |
$384 |
$384 |
3.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$281 |
$281 |
2.7× |
| Us pregnancy ltd (76815) |
$208 |
$208 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$304 |
$304 |
2.9× |
| Us retroperitoneal complete (76770) |
$488 |
$488 |
4.6× |
| Us retroperitoneal limited (76775) |
$240 |
$240 |
2.3× |
| Us scrotum and contents (76870) |
$328 |
$328 |
3.1× |
| Us soft tissue head/neck (76536) |
$463 |
$463 |
4.4× |
| Us transrectal (76872) |
$469 |
$469 |
4.5× |
| Us xtr non-vasc lmtd (76882) |
$261 |
$261 |
2.5× |
| Wrist 2 views (73100) |
$99 |
$99 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$215 |
$215 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$156 |
$156 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$151 |
$151 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$140 |
$140 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$223 |
$223 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$83 |
$83 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$160 |
$160 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$321 |
$321 |
3.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$193 |
$193 |
1.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$172 |
$172 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$158 |
$158 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$130 |
$130 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$108 |
$108 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$190 |
$190 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$153 |
$153 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$117 |
$117 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$156 |
$156 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$345 |
$345 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$123 |
$123 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$115 |
$115 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$199 |
$199 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$154 |
$154 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$221 |
$221 |
2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$211 |
$211 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$182 |
$182 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$262 |
$262 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$221 |
$221 |
2.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$196 |
$196 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$221 |
$221 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$166 |
$166 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$78 |
$78 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$163 |
$163 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$152 |
$152 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$164 |
$164 |
1.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$114 |
$114 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$138 |
$138 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$361 |
$361 |
3.4× |
| Xr chest 4+ views (71048) |
$198 |
$198 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$88 |
$88 |
1.0× |
| Xr shoulder 1 view (73020) |
$87 |
$87 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$265 |
$265 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$250 |
$250 |
2.9× |
| Xr tmj bilateral (70330) |
$295 |
$295 |
3.4× |
| Xray knee 1 or 2 views rt (73560) |
$115 |
$115 |
1.3× |