| Abdomen 2 views (74019) |
$324 |
$405 |
2.9× |
| Ankle 2 views (73600) |
$371.20 |
$464 |
4.0× |
| Bone age studies (77072) |
$444 |
$555 |
4.0× |
| Bone survey complete (77075) |
$1,179.20 |
$1,474 |
10.6× |
| Cervical spine 2 or 3 views (72040) |
$440.80 |
$551 |
4.7× |
| Chest 1 view (71045) |
$267.20 |
$334 |
2.9× |
| Clavicle complete (73000) |
$385.60 |
$482 |
4.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,139.20 |
$5,174 |
11.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,628 |
$4,535 |
14.2× |
| CT abdomen w contrast (74160) |
$2,901.60 |
$3,627 |
15.5× |
| CT abdomen w wo contrast (74170) |
$3,290.40 |
$4,113 |
17.6× |
| CT abdomen w/o contrast (74150) |
$1,916 |
$2,395 |
17.2× |
| CT c-spine w/o contrast (72125) |
$2,359.20 |
$2,949 |
21.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,314.40 |
$1,643 |
7.0× |
| CT cervical spine with contrast (72126) |
$2,063.20 |
$2,579 |
5.5× |
| CT chest w/wo contrast (71270) |
$2,336 |
$2,920 |
12.5× |
| CT chest with contrast (71260) |
$1,908 |
$2,385 |
10.2× |
| CT head/brain with contrast (70460) |
$992 |
$1,240 |
5.3× |
| CT head/brain without and with contrast (70470) |
$2,059.20 |
$2,574 |
11.0× |
| CT iac w contrast (70481) |
$1,276 |
$1,595 |
6.8× |
| CT lower ext w/o (73700) |
$1,574.80 |
$1,968.50 |
14.1× |
| CT lower extremity w wo contrast (73702) |
$2,184.80 |
$2,731 |
11.7× |
| CT lower extremity with contrast (73701) |
$1,909.60 |
$2,387 |
10.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,652.80 |
$3,316 |
14.2× |
| CT lumbar spine w/o contrast (72131) |
$1,584.80 |
$1,981 |
14.2× |
| CT lumbar spine with contrast (72132) |
$2,504.80 |
$3,131 |
6.7× |
| CT maxillofacial w contrast (70487) |
$1,877.60 |
$2,347 |
10.0× |
| CT maxillofacial w/o contrast (70486) |
$1,611.60 |
$2,014.50 |
14.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,833.60 |
$3,542 |
15.1× |
| CT neck soft tissue w contrast (70491) |
$2,142.40 |
$2,678 |
11.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,496.40 |
$1,870.50 |
8.0× |
| CT orbits w/o contrast (70480) |
$1,137.60 |
$1,422 |
10.2× |
| CT pelvis w & w/o contrast (72194) |
$2,095.20 |
$2,619 |
11.2× |
| CT pelvis w/o contrast (72192) |
$1,562.40 |
$1,953 |
14.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,705.60 |
$3,382 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,881.60 |
$2,352 |
16.9× |
| CT thoracic spine w/contrast (72129) |
$1,919.20 |
$2,399 |
10.3× |
| CT thoracic spine w/o contrast (72128) |
$1,536.80 |
$1,921 |
13.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,462.40 |
$3,078 |
13.2× |
| CT thorax w/o contrast (71250) |
$1,560 |
$1,950 |
14.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,449.60 |
$3,062 |
13.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,908.80 |
$2,386 |
17.1× |
| CT upper extremity with contrast (73201) |
$2,328 |
$2,910 |
6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$560.80 |
$701 |
3.0× |
| Cta Abdomen (74175) |
$1,893.60 |
$2,367 |
10.1× |
| CTA abdomen pelvis (74174) |
$4,699.20 |
$5,874 |
12.6× |
| CTA chest (71275) |
$3,340 |
$4,175 |
17.8× |
| Cta Head (70496) |
$3,383.60 |
$4,229.50 |
18.1× |
| CTA lwr ext w&w/o contrast (73706) |
$415.20 |
$519 |
2.2× |
| Cta Neck (70498) |
$3,379.60 |
$4,224.50 |
18.1× |
| Cystography minimum 3 views rs&i (74430) |
$228 |
$285 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$591.20 |
$739 |
5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$95.20 |
$119 |
1.0× |
| Fetal biophysical profile non-stress testing (76818) |
$735.20 |
$919 |
6.6× |
| Fluoroscopy up to 1 hr (76000) |
$516.80 |
$646 |
2.0× |
| Foot 2 views (73620) |
$371.20 |
$464 |
4.0× |
| Forearm 2 views (73090) |
$371.20 |
$464 |
4.0× |
| Hand 2 views (73120) |
$371.20 |
$464 |
3.3× |
| Hand 3 views (73130) |
$370.40 |
$463 |
4.0× |
| Humerus Min 2 Views Left (73060) |
$390.40 |
$488 |
4.2× |
| MRA head w/o contrast (70544) |
$2,028 |
$2,535 |
8.0× |
| MRA neck w contrast (70548) |
$1,700.80 |
$2,126 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,821.60 |
$4,777 |
10.3× |
| MRA neck w/o contrast (70547) |
$2,602.40 |
$3,253 |
10.2× |
| MRI abdomen w contrast (74182) |
$1,786.40 |
$2,233 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,068.80 |
$5,086 |
10.9× |
| MRI abdomen w/o contrast (74181) |
$2,332.80 |
$2,916 |
9.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,786.40 |
$2,233 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,786.40 |
$2,233 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$2,388.80 |
$2,986 |
9.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,890.40 |
$2,363 |
5.1× |
| MRI chest w/o contrast (71550) |
$2,042.40 |
$2,553 |
8.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,786.40 |
$2,233 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,763.20 |
$3,454 |
10.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,207.20 |
$2,759 |
8.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,055.20 |
$3,819 |
8.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,786.40 |
$2,233 |
4.8× |
| MRI pelvis w contrast (72196) |
$1,786.40 |
$2,233 |
4.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,045.60 |
$5,057 |
10.9× |
| MRI pelvis w/o contrast (72195) |
$2,456.40 |
$3,070.50 |
9.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,679.20 |
$3,349 |
7.2× |
| MRI scan of leg joint before and after contrast (73723) |
$4,892 |
$6,115 |
13.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,682.40 |
$4,603 |
9.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,786.40 |
$2,233 |
4.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,671.20 |
$4,589 |
9.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,771.20 |
$4,714 |
10.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,386.40 |
$2,983 |
9.4× |
| MRI tmj (70336) |
$1,588 |
$1,985 |
6.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,226.40 |
$2,783 |
8.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,984.80 |
$2,481 |
5.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,144 |
$2,680 |
8.4× |
| Neck soft tissue (70360) |
$136 |
$170 |
1.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$665.60 |
$832 |
6.0× |
| Osseous survey limited (77074) |
$700.80 |
$876 |
6.3× |
| Pelvis 1 or 2 views (72170) |
$271.20 |
$339 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,085.60 |
$5,107 |
11.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$690.40 |
$863 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$594.40 |
$743 |
6.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$690.40 |
$863 |
6.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$207.73 |
$259.66 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$777.60 |
$972 |
7.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$683.20 |
$854 |
6.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$319.20 |
$399 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$210.40 |
$263 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$336.80 |
$421 |
3.6× |
| Radiological examination surgical specimen (76098) |
$180.80 |
$226 |
0.3× |
| Ribs bilateral 3 views (71110) |
$494.40 |
$618 |
4.4× |
| Sacroiliac Joints < 3 Views (72200) |
$316 |
$395 |
2.8× |
| Scanogram (77073) |
$544 |
$680 |
4.9× |
| Scapula complete (73010) |
$371.20 |
$464 |
3.3× |
| Sella turcica (70240) |
$281.60 |
$352 |
3.0× |
| Spine thoracic 3 views (72072) |
$368 |
$460 |
3.3× |
| Thoracolumbar 2 views (72080) |
$371.20 |
$464 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$553.60 |
$692 |
5.0× |
| Us breast unilateral complete (76641) |
$676 |
$845 |
6.1× |
| Us breast unilateral limited (76642) |
$571.20 |
$714 |
6.2× |
| Us compl joint r-t w/image documentation (76881) |
$592 |
$740 |
5.3× |
| Us elastography parenchyma (76981) |
$672 |
$840 |
6.0× |
| Us ob transvaginal (76817) |
$572.80 |
$716 |
5.1× |
| Us pelvic non ob complete (76856) |
$1,032.80 |
$1,291 |
9.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$314.40 |
$393 |
2.8× |
| Us pregnancy ltd (76815) |
$491.20 |
$614 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$828.80 |
$1,036 |
7.4× |
| Us retroperitoneal complete (76770) |
$662.40 |
$828 |
5.9× |
| Us retroperitoneal limited (76775) |
$1,179.20 |
$1,474 |
10.6× |
| Us scrotum and contents (76870) |
$808.80 |
$1,011 |
7.2× |
| Us soft tissue head/neck (76536) |
$891.60 |
$1,114.50 |
8.0× |
| Us transrectal (76872) |
$666.40 |
$833 |
6.0× |
| Wrist 2 views (73100) |
$371.20 |
$464 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$738.40 |
$923 |
6.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$371.20 |
$464 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$368.80 |
$461 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$290.40 |
$363 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$444 |
$555 |
4.8× |
| X-ray exam hip uni 1 view (73501) |
$303.20 |
$379 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$461.60 |
$577 |
5.0× |
| X-ray exam of femur 1 (73551) |
$356 |
$445 |
3.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$612 |
$765 |
5.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$340.80 |
$426 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$370.40 |
$463 |
4.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$380.80 |
$476 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$374.40 |
$468 |
4.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$453.60 |
$567 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$395.20 |
$494 |
4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$734.40 |
$918 |
6.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$674.40 |
$843 |
6.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$738.40 |
$923 |
6.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$444 |
$555 |
4.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$281.60 |
$352 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$777.60 |
$972 |
7.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$444 |
$555 |
4.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$323.20 |
$404 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$380.80 |
$476 |
4.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$380.80 |
$476 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$472.80 |
$591 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$371.20 |
$464 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$371.20 |
$464 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$444 |
$555 |
4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$738.40 |
$923 |
8.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$372 |
$465 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$886.40 |
$1,108 |
7.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$371.20 |
$464 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$382.40 |
$478 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$516.80 |
$646 |
5.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$371.20 |
$464 |
4.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$444 |
$555 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$674.40 |
$843 |
6.0× |
| Xr chest 4+ views (71048) |
$886.40 |
$1,108 |
7.9× |
| Xr finger(s) 2+ views (73140) |
$395.20 |
$494 |
4.3× |
| Xr internal auditory meati complete (70134) |
$544 |
$680 |
0.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$390.40 |
$488 |
3.5× |
| Xr optic foramina (70190) |
$244 |
$305 |
2.6× |
| Xr shoulder 1 view (73020) |
$356 |
$445 |
3.8× |
| Xr spine cervical 4 or 5 views (72050) |
$886.40 |
$1,108 |
7.9× |
| Xr tibia/fibula 2 views (73590) |
$429.60 |
$537 |
4.6× |
| Xr tmj bilateral (70330) |
$591.20 |
$739 |
6.4× |
| Xray knee 1 or 2 views rt (73560) |
$429.60 |
$537 |
4.6× |