| Abdomen 2 views (74019) |
$108.55 |
$167 |
1.1× |
| Ankle 2 views (73600) |
$69.55 |
$107 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$500.18 |
$769.50 |
1.4× |
| Bone age studies (77072) |
$110.50 |
$170 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$530.72 |
$816.50 |
1.5× |
| Bone survey complete (77075) |
$174.20 |
$268 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$109.85 |
$169 |
1.4× |
| Chest 1 view (71045) |
$73.12 |
$112.50 |
0.9× |
| Chest 3 views (71047) |
$115.38 |
$177.50 |
1.5× |
| Clavicle complete (73000) |
$69.55 |
$107 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$734.50 |
$1,130 |
7.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,421.90 |
$3,726 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$693.55 |
$1,067 |
3.2× |
| CT abdomen w contrast (74160) |
$1,575.60 |
$2,424 |
9.9× |
| CT abdomen w wo contrast (74170) |
$2,185.30 |
$3,362 |
13.8× |
| CT abdomen w/o contrast (74150) |
$677.95 |
$1,043 |
7.2× |
| CT angiography upper extremity lt (73206) |
$1,936.35 |
$2,979 |
12.2× |
| CT c-spine w/o contrast (72125) |
$717.60 |
$1,104 |
7.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,782.30 |
$2,742 |
11.2× |
| CT cervical spine with contrast (72126) |
$1,531.40 |
$2,356 |
4.8× |
| CT chest w/wo contrast (71270) |
$1,779.70 |
$2,738 |
11.2× |
| CT chest with contrast (71260) |
$1,461.85 |
$2,249 |
9.2× |
| CT head/brain with contrast (70460) |
$1,311.70 |
$2,018 |
8.3× |
| CT head/brain without and with contrast (70470) |
$1,445.60 |
$2,224 |
9.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$85.80 |
$132 |
1.1× |
| CT iac w contrast (70481) |
$1,792.70 |
$2,758 |
11.3× |
| CT lower ext w/o (73700) |
$710.12 |
$1,092.50 |
7.5× |
| CT lower extremity w wo contrast (73702) |
$1,909.70 |
$2,938 |
12.0× |
| CT lower extremity with contrast (73701) |
$1,438.45 |
$2,213 |
9.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,779.70 |
$2,738 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$712.72 |
$1,096.50 |
7.5× |
| CT lumbar spine with contrast (72132) |
$1,431.95 |
$2,203 |
4.5× |
| CT maxillofacial w contrast (70487) |
$1,491.10 |
$2,294 |
9.4× |
| CT maxillofacial w/o contrast (70486) |
$754.65 |
$1,161 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,851.85 |
$2,849 |
11.7× |
| CT neck soft tissue w contrast (70491) |
$1,419.60 |
$2,184 |
8.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,017.60 |
$3,104 |
12.7× |
| CT orbits w/o contrast (70480) |
$839.15 |
$1,291 |
8.9× |
| CT pelvis w & w/o contrast (72194) |
$1,944.80 |
$2,992 |
12.2× |
| CT pelvis w/o contrast (72192) |
$675.68 |
$1,039.50 |
7.1× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$104.32 |
$160.50 |
1.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,765.40 |
$2,716 |
11.1× |
| CT soft tissue neck w/o contrast (70490) |
$727.68 |
$1,119.50 |
7.7× |
| CT thoracic spine w/contrast (72129) |
$1,435.85 |
$2,209 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$697.12 |
$1,072.50 |
7.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,782.30 |
$2,742 |
11.2× |
| CT thorax w/o contrast (71250) |
$716.62 |
$1,102.50 |
7.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,890.85 |
$2,909 |
11.9× |
| CT upper extremity w/o contrast rt (73200) |
$709.15 |
$1,091 |
7.5× |
| CT upper extremity with contrast (73201) |
$779.68 |
$1,199.50 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,290.90 |
$1,986 |
8.1× |
| Cta Abdomen (74175) |
$2,131.35 |
$3,279 |
13.4× |
| CTA abdomen pelvis (74174) |
$3,045.25 |
$4,685 |
9.6× |
| CTA chest (71275) |
$2,165.80 |
$3,332 |
13.6× |
| Cta Head (70496) |
$2,407.60 |
$3,704 |
15.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,998.50 |
$7,690 |
15.8× |
| CTA lwr ext w&w/o contrast (73706) |
$2,185.30 |
$3,362 |
13.8× |
| Cta Neck (70498) |
$1,358.50 |
$2,090 |
8.6× |
| Cta Pelvis (72191) |
$2,048.80 |
$3,152 |
12.9× |
| Cystography minimum 3 views rs&i (74430) |
$128.70 |
$198 |
0.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$155.35 |
$239 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$72.15 |
$111 |
0.9× |
| Esophagus (74220) |
$138.78 |
$213.50 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$259.35 |
$399 |
1.2× |
| Foot 2 views (73620) |
$69.55 |
$107 |
0.9× |
| Forearm 2 views (73090) |
$69.55 |
$107 |
0.9× |
| Gated Heart Planar Single (78472) |
$654.22 |
$1,006.50 |
1.8× |
| Hand 2 views (73120) |
$69.55 |
$107 |
0.7× |
| Hand 3 views (73130) |
$78 |
$120 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$672.42 |
$1,034.50 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$445.90 |
$686 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$73.12 |
$112.50 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$992.22 |
$1,526.50 |
2.0× |
| Knee 3 views (73562) |
$79.95 |
$123 |
1.0× |
| Lung Ventilation Imaging (78579) |
$656.82 |
$1,010.50 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,680.58 |
$2,585.50 |
5.3× |
| MRA head w/o contrast (70544) |
$1,185.92 |
$1,824.50 |
5.5× |
| MRA neck w/o contrast (70547) |
$1,153.10 |
$1,774 |
5.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,651 |
$2,540 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$1,521.32 |
$2,340.50 |
7.0× |
| MRI cervical spine w/o contrast (72141) |
$1,333.15 |
$2,051 |
6.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,069.58 |
$1,645.50 |
5.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,069.58 |
$1,645.50 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,562.92 |
$2,404.50 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,024.08 |
$1,575.50 |
4.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,603.22 |
$2,466.50 |
5.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,625 |
$2,500 |
5.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,634.42 |
$2,514.50 |
5.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,644.50 |
$2,530 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,079.65 |
$1,661 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,404.32 |
$2,160.50 |
6.5× |
| Myelogram thoracic (72255) |
$371.15 |
$571 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,519.38 |
$2,337.50 |
1.3× |
| Neck soft tissue (70360) |
$73.78 |
$113.50 |
0.9× |
| Nm gastric emptying study (78264) |
$657.48 |
$1,011.50 |
1.8× |
| Osseous survey limited (77074) |
$152.42 |
$234.50 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$501.48 |
$771.50 |
1.4× |
| Parathyroid imaging (78070) |
$763.42 |
$1,174.50 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$69.22 |
$106.50 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$2,830.10 |
$4,354 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,792.70 |
$2,758 |
5.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$441.02 |
$678.50 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$742.62 |
$1,142.50 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$98.48 |
$151.50 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$109.85 |
$169 |
1.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$139.42 |
$214.50 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$97.18 |
$149.50 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$92.30 |
$142 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$122.52 |
$188.50 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$78 |
$120 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$230.10 |
$354 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$205.08 |
$315.50 |
1.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$186.22 |
$286.50 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$76.05 |
$117 |
1.0× |
| Ribs bilateral 3 views (71110) |
$140.08 |
$215.50 |
1.5× |
| Sacroiliac Joints < 3 Views (72200) |
$85.15 |
$131 |
0.9× |
| Scapula complete (73010) |
$69.88 |
$107.50 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$70.20 |
$108 |
3.0× |
| Sella turcica (70240) |
$49.40 |
$76 |
0.6× |
| Small bowel series (74250) |
$167.70 |
$258 |
1.1× |
| Thoracolumbar 2 views (72080) |
$70.52 |
$108.50 |
0.9× |
| Thyroid uptake measurement (78012) |
$476.12 |
$732.50 |
1.3× |
| Tmj unilateral (70328) |
$61.42 |
$94.50 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$169.65 |
$261 |
1.8× |
| Urethrocystography voiding (74455) |
$204.75 |
$315 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$248.95 |
$383 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$201.50 |
$310 |
2.1× |
| Us breast unilateral complete (76641) |
$116.35 |
$179 |
1.2× |
| Us breast unilateral limited (76642) |
$98.48 |
$151.50 |
1.2× |
| Us chest (76604) |
$151.78 |
$233.50 |
1.6× |
| Us compl joint r-t w/image documentation (76881) |
$161.52 |
$248.50 |
1.7× |
| Us pelvic non ob complete (76856) |
$151.45 |
$233 |
1.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$138.12 |
$212.50 |
1.5× |
| Us pregnancy ltd (76815) |
$132.92 |
$204.50 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$138.12 |
$212.50 |
1.5× |
| Us retroperitoneal complete (76770) |
$167.38 |
$257.50 |
1.8× |
| Us retroperitoneal limited (76775) |
$189.80 |
$292 |
2.0× |
| Us scrotum and contents (76870) |
$144.62 |
$222.50 |
1.5× |
| Us soft tissue head/neck (76536) |
$144.95 |
$223 |
1.5× |
| Us spinal canal and contents (76800) |
$177.45 |
$273 |
1.9× |
| Us xtr non-vasc lmtd (76882) |
$147.88 |
$227.50 |
1.6× |
| Wrist 2 views (73100) |
$74.75 |
$115 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$110.18 |
$169.50 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$74.10 |
$114 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$78 |
$120 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$250.25 |
$385 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$69.55 |
$107 |
0.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$78 |
$120 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$61.42 |
$94.50 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$84.82 |
$130.50 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$97.18 |
$149.50 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$68.90 |
$106 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$78 |
$120 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$69.55 |
$107 |
0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$54.60 |
$84 |
0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$126.10 |
$194 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$65.32 |
$100.50 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$88.08 |
$135.50 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$70.52 |
$108.50 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$73.12 |
$112.50 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$100.42 |
$154.50 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$81.25 |
$125 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$162.18 |
$249.50 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$82.22 |
$126.50 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$78 |
$120 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$99.45 |
$153 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$73.12 |
$112.50 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$107.90 |
$166 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$70.52 |
$108.50 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$68.58 |
$105.50 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$77.68 |
$119.50 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$74.42 |
$114.50 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$107.58 |
$165.50 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$69.55 |
$107 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$78 |
$120 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$86.45 |
$133 |
0.9× |
| Xr chest 4+ views (71048) |
$137.80 |
$212 |
1.5× |
| Xr Cholecystography Oral Contrast (74290) |
$134.22 |
$206.50 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$77.02 |
$118.50 |
1.0× |
| Xr shoulder 1 view (73020) |
$69.55 |
$107 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$111.48 |
$171.50 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$69.55 |
$107 |
0.9× |
| Xr tmj bilateral (70330) |
$110.82 |
$170.50 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$79.62 |
$122.50 |
1.0× |