| Abdomen 2 views (74019) |
$268.80 |
$336 |
2.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,596.14 |
$1,995.18 |
4.2× |
| Ankle 2 views (73600) |
$153.60 |
$192 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,046.35 |
$1,307.94 |
2.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,263.55 |
$1,579.44 |
3.3× |
| Bone &/joint imaging whole body (78306) |
$1,358.54 |
$1,698.18 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$1,585.63 |
$1,982.04 |
4.1× |
| Cervical spine 2 or 3 views (72040) |
$160 |
$200 |
1.9× |
| Chest 1 view (71045) |
$156 |
$195 |
1.9× |
| Clavicle complete (73000) |
$153.60 |
$192 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$100 |
$125 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,164.80 |
$3,956 |
9.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,217.60 |
$2,772 |
9.7× |
| CT abdomen w contrast (74160) |
$1,364 |
$1,705 |
8.1× |
| CT abdomen w wo contrast (74170) |
$2,148.80 |
$2,686 |
12.7× |
| CT abdomen w/o contrast (74150) |
$1,242.40 |
$1,553 |
12.4× |
| CT c-spine w/o contrast (72125) |
$1,296 |
$1,620 |
12.9× |
| CT chest w/wo contrast (71270) |
$1,908 |
$2,385 |
11.3× |
| CT chest with contrast (71260) |
$1,548.80 |
$1,936 |
9.2× |
| CT head/brain with contrast (70460) |
$1,293.60 |
$1,617 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,617.60 |
$2,022 |
9.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$79.20 |
$99 |
0.9× |
| CT lower ext w/o (73700) |
$1,228 |
$1,535 |
12.2× |
| CT lower extremity w wo contrast (73702) |
$1,257.60 |
$1,572 |
7.5× |
| CT lower extremity with contrast (73701) |
$1,345.60 |
$1,682 |
8.0× |
| CT lumbar spine w/o contrast (72131) |
$1,292 |
$1,615 |
12.8× |
| CT lumbar spine with contrast (72132) |
$1,468 |
$1,835 |
4.4× |
| CT maxillofacial w contrast (70487) |
$1,479.20 |
$1,849 |
8.8× |
| CT maxillofacial w/o contrast (70486) |
$1,276 |
$1,595 |
12.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,032.80 |
$2,541 |
12.0× |
| CT neck soft tissue w contrast (70491) |
$2,356.80 |
$2,946 |
14.0× |
| CT orbits w/o contrast (70480) |
$788 |
$985 |
7.8× |
| CT pelvis w & w/o contrast (72194) |
$1,548.80 |
$1,936 |
9.2× |
| CT pelvis w/o contrast (72192) |
$1,230.40 |
$1,538 |
12.2× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$240 |
$300 |
2.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,726.40 |
$3,408 |
16.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,940.80 |
$2,426 |
19.3× |
| CT thoracic spine w/o contrast (72128) |
$1,293.60 |
$1,617 |
12.9× |
| CT thorax w/o contrast (71250) |
$1,293.60 |
$1,617 |
12.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,629.60 |
$2,037 |
9.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,225.60 |
$1,532 |
12.2× |
| CT upper extremity with contrast (73201) |
$960 |
$1,200 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,217.60 |
$2,772 |
13.1× |
| Cta Abdomen (74175) |
$2,056 |
$2,570 |
12.2× |
| CTA abdomen pelvis (74174) |
$3,164.80 |
$3,956 |
9.4× |
| CTA chest (71275) |
$2,924 |
$3,655 |
17.3× |
| Cta Head (70496) |
$2,924 |
$3,655 |
17.3× |
| Cta Neck (70498) |
$2,924 |
$3,655 |
17.3× |
| Echoencephalography real time imaging (76506) |
$291.20 |
$364 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$291.20 |
$364 |
2.9× |
| Foot 2 views (73620) |
$152.80 |
$191 |
1.8× |
| Forearm 2 views (73090) |
$153.60 |
$192 |
1.8× |
| Gated Heart Planar Single (78472) |
$1,055.71 |
$1,319.64 |
2.7× |
| Hand 2 views (73120) |
$260.80 |
$326 |
2.6× |
| Hand 3 views (73130) |
$264 |
$330 |
3.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,998.38 |
$2,497.98 |
3.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,486.80 |
$1,858.50 |
3.9× |
| Ht muscle image spect sing (78451) |
$1,567.63 |
$1,959.54 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$153.60 |
$192 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,071.31 |
$1,339.14 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$852.53 |
$1,065.66 |
1.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,702.27 |
$2,127.84 |
3.3× |
| Knee 3 views (73562) |
$156 |
$195 |
1.9× |
| Liver & spleen imaging static only (78215) |
$900.05 |
$1,125.06 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$1,391.86 |
$1,739.82 |
2.7× |
| Lung Ventilation Imaging (78579) |
$856.85 |
$1,071.06 |
2.2× |
| Lymphoscintigraphy (78195) |
$1,626.14 |
$2,032.68 |
3.1× |
| Meckels Diverticulum (78290) |
$1,504.75 |
$1,880.94 |
3.9× |
| MRI abdomen w contrast (74182) |
$1,848 |
$2,310 |
5.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,347.20 |
$2,934 |
7.0× |
| MRI c-spine with contrast (72142) |
$1,848 |
$2,310 |
5.5× |
| MRI cervical spine w/o contrast (72141) |
$1,663.20 |
$2,079 |
7.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,848 |
$2,310 |
5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,663.20 |
$2,079 |
7.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,663.20 |
$2,079 |
7.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,310.40 |
$2,888 |
6.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,848 |
$2,310 |
5.5× |
| MRI pelvis w contrast (72196) |
$1,848 |
$2,310 |
5.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,032.80 |
$2,541 |
6.1× |
| MRI pelvis w/o contrast (72195) |
$1,741.60 |
$2,177 |
7.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,032.80 |
$2,541 |
6.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,032.80 |
$2,541 |
6.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,848 |
$2,310 |
5.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,848 |
$2,310 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,032.80 |
$2,541 |
6.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,663.20 |
$2,079 |
7.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,663.20 |
$2,079 |
7.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,032.80 |
$2,541 |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,663.20 |
$2,079 |
7.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,480 |
$3,100 |
2.0× |
| Neck soft tissue (70360) |
$154.40 |
$193 |
1.8× |
| Nm gastric emptying study (78264) |
$1,511.86 |
$1,889.82 |
3.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,991.33 |
$2,489.16 |
1.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,011.94 |
$1,264.92 |
2.6× |
| Osseous survey infant (77076) |
$324.80 |
$406 |
3.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,608.53 |
$2,010.66 |
4.2× |
| Parathyroid imaging (78070) |
$1,341.26 |
$1,676.58 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$263.20 |
$329 |
2.6× |
| Pr heart first pass single,planar (78481) |
$830.30 |
$1,037.88 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,085.71 |
$1,357.14 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,525.97 |
$1,907.46 |
2.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$268 |
$335 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$272 |
$340 |
2.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$271.20 |
$339 |
2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297.60 |
$372 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$156 |
$195 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$273.60 |
$342 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$160 |
$200 |
1.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$156 |
$195 |
1.9× |
| Ribs bilateral 3 views (71110) |
$276 |
$345 |
2.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,758.24 |
$2,197.80 |
3.4× |
| Sacroiliac Joints < 3 Views (72200) |
$262.40 |
$328 |
2.6× |
| Scapula complete (73010) |
$263.20 |
$329 |
2.6× |
| Spine thoracic 3 views (72072) |
$267.20 |
$334 |
2.7× |
| Thoracolumbar 2 views (72080) |
$160.80 |
$201 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$886.46 |
$1,108.08 |
2.3× |
| Thyroid uptake measurement (78012) |
$385.34 |
$481.68 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,088.93 |
$1,361.16 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$388 |
$485 |
3.9× |
| Us abdl aorta screen aaa (76706) |
$93.60 |
$117 |
0.9× |
| Us chest (76604) |
$180 |
$225 |
1.8× |
| Us compl joint r-t w/image documentation (76881) |
$412.80 |
$516 |
4.1× |
| Us pelvic non ob complete (76856) |
$460.80 |
$576 |
4.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$460.80 |
$576 |
4.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$291.20 |
$364 |
2.9× |
| Us retroperitoneal complete (76770) |
$484.80 |
$606 |
4.8× |
| Us retroperitoneal limited (76775) |
$368.80 |
$461 |
3.7× |
| Us scrotum and contents (76870) |
$437.60 |
$547 |
4.4× |
| Us soft tissue head/neck (76536) |
$340 |
$425 |
3.4× |
| Us spinal canal and contents (76800) |
$272 |
$340 |
2.7× |
| Us transrectal (76872) |
$412.80 |
$516 |
4.1× |
| Us xtr non-vasc lmtd (76882) |
$277.60 |
$347 |
2.8× |
| Wrist 2 views (73100) |
$153.60 |
$192 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$280.80 |
$351 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$213.60 |
$267 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$152.80 |
$191 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$155.20 |
$194 |
1.9× |
| X-ray exam hip uni 1 view (73501) |
$156.80 |
$196 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$160.80 |
$201 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$276.80 |
$346 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$280 |
$350 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$273.60 |
$342 |
2.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$174.40 |
$218 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$154.40 |
$193 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$152.80 |
$191 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$155.20 |
$194 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$268 |
$335 |
2.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$268.80 |
$336 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$160 |
$200 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$296 |
$370 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$160.80 |
$201 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$273.60 |
$342 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$280 |
$350 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$155.20 |
$194 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$174.40 |
$218 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$196.80 |
$246 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$283.20 |
$354 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$272 |
$340 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$152 |
$190 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$158.40 |
$198 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$219.20 |
$274 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$149.60 |
$187 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$154.40 |
$193 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$285.60 |
$357 |
2.8× |
| Xr finger(s) 2+ views (73140) |
$150.40 |
$188 |
1.8× |
| Xr shoulder 1 view (73020) |
$152.80 |
$191 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$278.40 |
$348 |
2.8× |
| Xr tibia/fibula 2 views (73590) |
$152.80 |
$191 |
1.8× |
| Xray knee 1 or 2 views rt (73560) |
$153.60 |
$192 |
1.8× |