| Abdomen 2 views (74019) |
$333.50 |
$556.50 |
3.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$613 |
$1,022 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,399 |
$5,665 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,376 |
$5,626 |
1.1× |
| Ankle 2 views (73600) |
$231 |
$385 |
2.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,799 |
$6,332 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,305 |
$5,508 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$944 |
$1,574 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,025 |
$1,709 |
2.6× |
| Bone age studies (77072) |
$425 |
$709 |
4.0× |
| Bone Imaging 3 Phase (78315) |
$1,164 |
$1,940 |
2.9× |
| Bone survey complete (77075) |
$425 |
$709 |
4.0× |
| Brain image w/flow 4 + views (78606) |
$557 |
$929 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$242 |
$404 |
2.8× |
| Chest 1 view (71045) |
$231 |
$385 |
2.6× |
| Chest 3 views (71047) |
$231 |
$385 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$103 |
$171 |
0.6× |
| Clavicle complete (73000) |
$231 |
$385 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$294 |
$490 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,371 |
$3,951 |
6.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,832 |
$3,054 |
7.6× |
| CT abdomen w contrast (74160) |
$1,177 |
$1,961 |
6.7× |
| CT abdomen w wo contrast (74170) |
$1,385 |
$2,308 |
7.9× |
| CT abdomen w/o contrast (74150) |
$1,037 |
$1,728 |
9.9× |
| CT angiography upper extremity lt (73206) |
$1,762 |
$2,937 |
10.0× |
| CT c-spine w/o contrast (72125) |
$1,082 |
$1,803 |
10.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,506 |
$2,510 |
8.5× |
| CT cervical spine with contrast (72126) |
$2,144 |
$3,574 |
6.1× |
| CT chest w/wo contrast (71270) |
$1,372 |
$2,287 |
7.8× |
| CT chest with contrast (71260) |
$1,163 |
$1,939 |
6.6× |
| CT head/brain with contrast (70460) |
$1,057 |
$1,761 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,318 |
$2,197 |
7.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$32 |
$53 |
0.4× |
| CT iac w contrast (70481) |
$939 |
$1,565 |
5.3× |
| CT limited/localized follow up study (76380) |
$821 |
$1,369 |
9.4× |
| CT lower ext w/o (73700) |
$819 |
$1,365 |
7.8× |
| CT lower extremity w wo contrast (73702) |
$1,153 |
$1,922 |
6.5× |
| CT lower extremity with contrast (73701) |
$1,115 |
$1,859 |
6.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,477 |
$2,462 |
8.4× |
| CT lumbar spine w/o contrast (72131) |
$1,610 |
$2,684 |
15.3× |
| CT lumbar spine with contrast (72132) |
$1,320 |
$2,200 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,067 |
$1,779 |
6.1× |
| CT maxillofacial w/o contrast (70486) |
$995 |
$1,658 |
9.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,116 |
$1,860 |
6.3× |
| CT neck soft tissue w contrast (70491) |
$939 |
$1,565 |
5.3× |
| CT orbits w/o contrast (70480) |
$856 |
$1,426 |
8.2× |
| CT pelvis w & w/o contrast (72194) |
$1,354 |
$2,256 |
7.7× |
| CT pelvis w/o contrast (72192) |
$947 |
$1,578 |
9.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$995 |
$1,658 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,004 |
$1,674 |
9.6× |
| CT thoracic spine w/contrast (72129) |
$1,292 |
$2,153 |
7.3× |
| CT thoracic spine w/o contrast (72128) |
$1,082 |
$1,803 |
10.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,460 |
$2,434 |
8.3× |
| CT thorax w/o contrast (71250) |
$941 |
$1,568 |
9.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,180 |
$1,967 |
6.7× |
| CT upper extremity w/o contrast rt (73200) |
$920 |
$1,534 |
8.8× |
| CT upper extremity with contrast (73201) |
$1,062 |
$1,770 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,240 |
$3,733 |
12.7× |
| Cta Abdomen (74175) |
$2,510 |
$4,184 |
14.2× |
| CTA abdomen pelvis (74174) |
$1,786 |
$2,977 |
5.1× |
| CTA chest (71275) |
$1,163 |
$1,939 |
6.6× |
| Cta Head (70496) |
$1,659.50 |
$2,766 |
9.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,050 |
$3,416 |
11.6× |
| Cta Neck (70498) |
$1,934 |
$3,224 |
11.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$120 |
$200 |
1.1× |
| Esophagus (74220) |
$939 |
$1,565 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$147 |
$245 |
0.6× |
| Foot 2 views (73620) |
$231 |
$385 |
2.6× |
| Forearm 2 views (73090) |
$250 |
$416 |
2.9× |
| Gated Heart Planar Single (78472) |
$759 |
$1,265 |
1.9× |
| Hand 2 views (73120) |
$425 |
$709 |
4.0× |
| Hand 3 views (73130) |
$231 |
$385 |
2.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,586 |
$2,643 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,156 |
$1,927 |
2.9× |
| Ht muscle image spect sing (78451) |
$2,110 |
$3,516 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$231 |
$385 |
2.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$779 |
$1,298 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$610 |
$1,017 |
1.1× |
| Knee 3 views (73562) |
$231 |
$385 |
2.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$568 |
$946 |
1.4× |
| Lymphoscintigraphy (78195) |
$1,771 |
$2,951 |
3.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$301 |
$501 |
3.4× |
| Meckels Diverticulum (78290) |
$452 |
$754 |
1.1× |
| MRA head w/o contrast (70544) |
$1,837 |
$3,061 |
7.7× |
| MRA head with contrast (70545) |
$1,999 |
$3,331 |
5.7× |
| MRA neck w contrast (70548) |
$2,429 |
$4,049 |
6.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,322 |
$3,870 |
6.6× |
| MRA neck w/o contrast (70547) |
$1,846 |
$3,076 |
7.7× |
| MRI abdomen w contrast (74182) |
$1,999 |
$3,331 |
5.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,218 |
$5,364 |
9.2× |
| MRI abdomen w/o contrast (74181) |
$2,364 |
$3,940 |
9.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,534 |
$4,223 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,534 |
$4,223 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$2,252 |
$3,753 |
9.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,429 |
$4,049 |
6.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,429 |
$4,049 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,252 |
$3,753 |
9.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,945 |
$3,242 |
8.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,218 |
$5,364 |
9.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,999 |
$3,331 |
5.7× |
| MRI pelvis w contrast (72196) |
$1,696 |
$2,826 |
4.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,218 |
$5,364 |
9.2× |
| MRI pelvis w/o contrast (72195) |
$2,252 |
$3,753 |
9.4× |
| MRI scan of arm joint before and after contrast (73223) |
$3,218 |
$5,364 |
9.2× |
| MRI scan of leg joint before and after contrast (73723) |
$3,218 |
$5,364 |
9.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,218 |
$5,364 |
9.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,429 |
$4,049 |
6.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,218 |
$5,364 |
9.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,204 |
$3,673 |
6.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,218 |
$5,364 |
9.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,252 |
$3,753 |
9.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,252 |
$3,753 |
9.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,218 |
$5,364 |
9.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,252 |
$3,753 |
9.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,887 |
$3,145 |
1.5× |
| Neck soft tissue (70360) |
$231 |
$385 |
2.6× |
| Nm gastric emptying study (78264) |
$1,167 |
$1,945 |
2.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$466 |
$777 |
1.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$596 |
$994 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$466 |
$777 |
0.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,175 |
$1,958 |
2.9× |
| Parathyroid imaging (78070) |
$1,025 |
$1,709 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$425 |
$709 |
4.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,218 |
$5,364 |
9.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,328 |
$2,214 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$863 |
$1,439 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$425 |
$709 |
4.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$425 |
$709 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$425 |
$709 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$425 |
$709 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$231 |
$385 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$231 |
$385 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$335 |
$559 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$939 |
$1,565 |
5.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$231 |
$385 |
2.6× |
| Radiological examination surgical specimen (76098) |
$103.50 |
$172 |
0.2× |
| Ribs bilateral 3 views (71110) |
$425 |
$709 |
4.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,101 |
$3,501 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$425 |
$709 |
4.0× |
| Salivary gland imaging (78230) |
$358 |
$597 |
0.9× |
| Scapula complete (73010) |
$425 |
$709 |
4.0× |
| Screening digital breast tomosynthesis (77063) |
$63.50 |
$106.50 |
2.7× |
| Small bowel series (74250) |
$425 |
$709 |
2.4× |
| Spine thoracic 3 views (72072) |
$425 |
$709 |
4.0× |
| Spleen imaging only (78185) |
$397 |
$661 |
1.0× |
| Testicular Imaging With Vascular Flow (78761) |
$409 |
$682 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$435.50 |
$726.50 |
4.1× |
| Upper Extremity Infant (73092) |
$242 |
$404 |
2.3× |
| Us breast unilateral complete (76641) |
$421.50 |
$703 |
4.0× |
| Us breast unilateral limited (76642) |
$236.50 |
$394.50 |
2.7× |
| Us chest (76604) |
$425 |
$709 |
4.0× |
| Us ob detailed single fetus (76811) |
$373 |
$621 |
1.6× |
| Us ob transvaginal (76817) |
$425 |
$709 |
4.0× |
| Us pelvic non ob complete (76856) |
$425 |
$709 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$347 |
$579 |
3.3× |
| Us pregnancy ltd (76815) |
$425 |
$709 |
4.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$280 |
$467 |
2.7× |
| Us retroperitoneal complete (76770) |
$470 |
$783 |
4.5× |
| Us retroperitoneal limited (76775) |
$425 |
$709 |
4.0× |
| Us soft tissue head/neck (76536) |
$425 |
$709 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$425 |
$709 |
4.0× |
| Venogram extremity bilateral (75822) |
$1,561 |
$2,601 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$1,264 |
$2,107 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$2,092 |
$3,486 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,264 |
$2,107 |
0.8× |
| Wrist 2 views (73100) |
$231 |
$385 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$231 |
$385 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$231 |
$385 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$231 |
$385 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$615 |
$1,025 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$425 |
$709 |
4.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$250 |
$416 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$231 |
$385 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$242 |
$404 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$425 |
$709 |
4.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$231 |
$385 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$250 |
$416 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$231 |
$385 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$231 |
$385 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$425 |
$709 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$231 |
$385 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$231 |
$385 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$231 |
$385 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$425 |
$709 |
4.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$231 |
$385 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$231 |
$385 |
2.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$425 |
$709 |
4.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$425 |
$709 |
4.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$425 |
$709 |
4.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$425 |
$709 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$425 |
$709 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$425 |
$709 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$231 |
$385 |
2.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$231 |
$385 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$231 |
$385 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$242 |
$404 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$425 |
$709 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$425 |
$709 |
4.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$333.50 |
$556.50 |
3.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$231 |
$385 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$425 |
$709 |
4.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$425 |
$709 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$10 |
$16 |
0.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$231 |
$385 |
2.6× |
| Xr chest 4+ views (71048) |
$446 |
$744 |
4.2× |
| Xr finger(s) 2+ views (73140) |
$231 |
$385 |
2.6× |
| Xr shoulder 1 view (73020) |
$231 |
$385 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$425 |
$709 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$242 |
$404 |
2.8× |
| Xr tmj bilateral (70330) |
$231 |
$385 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$231 |
$385 |
2.6× |