| Abdomen 2 views (74019) |
$331.21 |
$368.01 |
3.4× |
| Ankle 2 views (73600) |
$182.21 |
$202.46 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$965.24 |
$1,072.49 |
2.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,062.17 |
$1,180.19 |
2.9× |
| Bone &/joint imaging whole body (78306) |
$965.24 |
$1,072.49 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$965.24 |
$1,072.49 |
2.6× |
| Bone survey complete (77075) |
$886.63 |
$985.14 |
9.2× |
| Cervical spine 2 or 3 views (72040) |
$351.13 |
$390.14 |
4.4× |
| Chest 1 view (71045) |
$216.35 |
$240.39 |
2.7× |
| Clavicle complete (73000) |
$200.10 |
$222.33 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,125.27 |
$1,250.30 |
3.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,004.71 |
$1,116.34 |
4.6× |
| CT abdomen w contrast (74160) |
$1,004.71 |
$1,116.34 |
6.2× |
| CT abdomen w wo contrast (74170) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT abdomen w/o contrast (74150) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT c-spine w/o contrast (72125) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT cervical spine with contrast (72126) |
$1,004.71 |
$1,116.34 |
3.1× |
| CT chest w/wo contrast (71270) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT chest with contrast (71260) |
$1,004.71 |
$1,116.34 |
6.2× |
| CT head/brain without and with contrast (70470) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT lower ext w/o (73700) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT lower extremity w wo contrast (73702) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT lower extremity with contrast (73701) |
$1,004.71 |
$1,116.34 |
6.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT lumbar spine w/o contrast (72131) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT lumbar spine with contrast (72132) |
$1,004.71 |
$1,116.34 |
3.1× |
| CT maxillofacial w contrast (70487) |
$1,004.71 |
$1,116.34 |
6.2× |
| CT maxillofacial w/o contrast (70486) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT neck soft tissue w contrast (70491) |
$1,004.71 |
$1,116.34 |
6.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT orbits w/o contrast (70480) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT pelvis w & w/o contrast (72194) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT pelvis w/o contrast (72192) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT thoracic spine w/contrast (72129) |
$956.86 |
$1,063.18 |
5.9× |
| CT thoracic spine w/o contrast (72128) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT thorax w/o contrast (71250) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,125.27 |
$1,250.30 |
7.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,004.71 |
$1,116.34 |
10.4× |
| CT upper extremity with contrast (73201) |
$1,004.71 |
$1,116.34 |
3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,135.73 |
$2,373.03 |
13.2× |
| Cta Abdomen (74175) |
$2,020.90 |
$2,245.44 |
12.5× |
| CTA abdomen pelvis (74174) |
$2,870.60 |
$3,189.55 |
8.9× |
| CTA chest (71275) |
$2,020.90 |
$2,245.44 |
12.5× |
| Cta Head (70496) |
$2,020.90 |
$2,245.44 |
12.5× |
| Cta Neck (70498) |
$2,020.90 |
$2,245.44 |
12.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$572.82 |
$636.47 |
6.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$316.17 |
$351.30 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$579.14 |
$643.49 |
2.6× |
| Foot 2 views (73620) |
$179.76 |
$199.73 |
2.2× |
| Forearm 2 views (73090) |
$217.99 |
$242.21 |
2.7× |
| Gated Heart Planar Single (78472) |
$965.24 |
$1,072.49 |
2.6× |
| Hand 2 views (73120) |
$331.21 |
$368.01 |
3.4× |
| Hand 3 views (73130) |
$363.76 |
$404.18 |
4.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,239.49 |
$1,377.21 |
2.5× |
| Humerus Min 2 Views Left (73060) |
$240.76 |
$267.51 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,251.52 |
$1,390.58 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,304.52 |
$1,449.47 |
2.6× |
| Knee 3 views (73562) |
$248.04 |
$275.60 |
3.1× |
| Liver & spleen imaging static only (78215) |
$965.24 |
$1,072.49 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$1,251.52 |
$1,390.58 |
2.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$179.76 |
$199.73 |
2.2× |
| MRA head w & w/o contrast (70546) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRA head w/o contrast (70544) |
$1,108.71 |
$1,231.90 |
5.1× |
| MRA head with contrast (70545) |
$1,108.71 |
$1,231.90 |
3.5× |
| MRA neck w contrast (70548) |
$1,108.71 |
$1,231.90 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRA neck w/o contrast (70547) |
$1,108.71 |
$1,231.90 |
5.1× |
| MRI abdomen w contrast (74182) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI abdomen w/o contrast (74181) |
$976.01 |
$1,084.46 |
4.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,019.64 |
$1,132.93 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,808.48 |
$2,009.42 |
2.5× |
| MRI c-spine with contrast (72142) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$976.01 |
$1,084.46 |
4.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI chest w/o contrast (71550) |
$976.01 |
$1,084.46 |
4.4× |
| MRI chest with contrast (71551) |
$1,808.48 |
$2,009.42 |
2.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$976.01 |
$1,084.46 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$976.01 |
$1,084.46 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$976.01 |
$1,084.46 |
4.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,289.40 |
$1,432.67 |
4.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,019.64 |
$1,132.93 |
3.2× |
| MRI pelvis w contrast (72196) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI pelvis w/o contrast (72195) |
$976.01 |
$1,084.46 |
4.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,808.48 |
$2,009.42 |
5.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$976.01 |
$1,084.46 |
4.4× |
| MRI tmj (70336) |
$976.01 |
$1,084.46 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$976.01 |
$1,084.46 |
4.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,320.64 |
$1,467.38 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$976.01 |
$1,084.46 |
4.4× |
| Myocardial Spect Multiple Studies (78452) |
$3,322.10 |
$3,691.22 |
2.8× |
| Neck soft tissue (70360) |
$226.13 |
$251.26 |
2.8× |
| Nm gastric emptying study (78264) |
$965.24 |
$1,072.49 |
2.6× |
| Parathyroid imaging (78070) |
$965.24 |
$1,072.49 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$331.21 |
$368.01 |
3.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,320.64 |
$1,467.38 |
4.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$965.24 |
$1,072.49 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$331.21 |
$368.01 |
3.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$331.21 |
$368.01 |
3.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$363.76 |
$404.18 |
3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$369.30 |
$410.33 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$235.90 |
$262.11 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$237.66 |
$264.07 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$179.76 |
$199.73 |
2.2× |
| Ribs bilateral 3 views (71110) |
$331.21 |
$368.01 |
3.4× |
| Sacroiliac Joints < 3 Views (72200) |
$331.21 |
$368.01 |
3.4× |
| Scapula complete (73010) |
$331.21 |
$368.01 |
3.4× |
| Screening digital breast tomosynthesis (77063) |
$104.15 |
$115.72 |
4.5× |
| Spine thoracic 3 views (72072) |
$353.02 |
$392.24 |
3.7× |
| Thoracolumbar 2 views (72080) |
$336.75 |
$374.17 |
4.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$965.24 |
$1,072.49 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$516.71 |
$574.12 |
5.4× |
| Unlisted Ultrasound Procedure (76999) |
$171.59 |
$190.65 |
2.1× |
| Upper Extremity Infant (73092) |
$331.21 |
$368.01 |
3.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$842.70 |
$936.33 |
5.2× |
| Us abdl aorta screen aaa (76706) |
$401.89 |
$446.54 |
4.2× |
| Us breast unilateral complete (76641) |
$316.17 |
$351.30 |
3.3× |
| Us breast unilateral limited (76642) |
$459.29 |
$510.32 |
5.7× |
| Us chest (76604) |
$316.17 |
$351.30 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$516.71 |
$574.12 |
5.4× |
| Us ob transvaginal (76817) |
$316.17 |
$351.30 |
3.3× |
| Us pelvic non ob complete (76856) |
$347.24 |
$385.82 |
3.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$344.48 |
$382.75 |
3.6× |
| Us pregnancy ltd (76815) |
$316.17 |
$351.30 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$459.29 |
$510.32 |
4.8× |
| Us retroperitoneal limited (76775) |
$316.17 |
$351.30 |
3.3× |
| Us scrotum and contents (76870) |
$316.17 |
$351.30 |
3.3× |
| Us soft tissue head/neck (76536) |
$803.45 |
$892.72 |
8.4× |
| Us xtr non-vasc lmtd (76882) |
$459.29 |
$510.32 |
4.8× |
| Wrist 2 views (73100) |
$179.76 |
$199.73 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$462.01 |
$513.34 |
4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$257.03 |
$285.59 |
3.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$244.04 |
$271.15 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$198.47 |
$220.52 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$265.16 |
$294.62 |
3.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$331.21 |
$368.01 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$179.76 |
$199.73 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$179.76 |
$199.73 |
2.2× |
| X-ray exam of femur 1 (73551) |
$179.76 |
$199.73 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$331.88 |
$368.75 |
3.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$313.97 |
$348.86 |
3.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$235.90 |
$262.11 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$200.10 |
$222.33 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$179.76 |
$199.73 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$379.05 |
$421.17 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$191.96 |
$213.29 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$242.39 |
$269.32 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$331.21 |
$368.01 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$523.84 |
$582.04 |
5.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$408.33 |
$453.70 |
4.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$258.67 |
$287.41 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$196.85 |
$218.72 |
2.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$331.21 |
$368.01 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$235.90 |
$262.11 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$349.77 |
$388.63 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$429.48 |
$477.20 |
4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$331.21 |
$368.01 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$250.54 |
$278.38 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$245.66 |
$272.95 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$340.01 |
$377.79 |
4.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$187.07 |
$207.86 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$375.62 |
$417.36 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$331.21 |
$368.01 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$299.34 |
$332.60 |
3.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$179.76 |
$199.73 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$253.78 |
$281.98 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$331.21 |
$368.01 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$188.71 |
$209.68 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$250.54 |
$278.38 |
3.1× |
| Xr c-spine 6 or more views (72052) |
$475.04 |
$527.82 |
4.9× |
| Xr finger(s) 2+ views (73140) |
$185.45 |
$206.06 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$331.21 |
$368.01 |
3.4× |
| Xr optic foramina (70190) |
$179.76 |
$199.73 |
2.2× |
| Xr shoulder 1 view (73020) |
$185.45 |
$206.06 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$403.46 |
$448.29 |
4.2× |
| Xr tibia/fibula 2 views (73590) |
$248.91 |
$276.57 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$188.71 |
$209.68 |
2.4× |