| Abdomen 2 views (74019) |
$428.84 |
$612.62 |
4.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,759.10 |
$2,513 |
4.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,843.80 |
$2,634 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$5,531.23 |
$7,901.75 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,713.93 |
$8,162.75 |
1.8× |
| Angiography internal mammary rs&i (75756) |
$2,681.18 |
$3,830.25 |
0.8× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,843.80 |
$2,634 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,746.35 |
$6,780.50 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,333.50 |
$1,905 |
0.4× |
| Angiography Spinal Selective Rs&I (75705) |
$7,138.52 |
$10,197.88 |
1.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,172.45 |
$3,103.50 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$625.10 |
$893 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,333.50 |
$1,905 |
0.4× |
| Ankle 2 views (73600) |
$278.25 |
$397.50 |
3.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$681.45 |
$973.50 |
1.9× |
| Aortogram thoracic (75605) |
$5,531.23 |
$7,901.75 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,897.33 |
$8,424.75 |
1.9× |
| Aortography abdominal serialography rs&i (75625) |
$5,897.33 |
$8,424.75 |
1.9× |
| Artery X-Rays Adrenal Gland (75731) |
$1,843.80 |
$2,634 |
0.6× |
| Arthrogram elbow (73085) |
$855.23 |
$1,221.75 |
2.4× |
| Arthrogram hip (73525) |
$779.63 |
$1,113.75 |
2.2× |
| Arthrogram shoulder (73040) |
$894.16 |
$1,277.38 |
2.6× |
| Arthrogram wrist (73115) |
$928.12 |
$1,325.88 |
2.6× |
| Arthrography knee lt (73580) |
$1,040.46 |
$1,486.38 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$669.20 |
$956 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$1,880.90 |
$2,687 |
4.7× |
| Bone age studies (77072) |
$474.52 |
$677.88 |
4.5× |
| Bone Imaging 3 Phase (78315) |
$2,219 |
$3,170 |
5.5× |
| Bone Marrow Imaging Limited Area (78102) |
$1,754.03 |
$2,505.75 |
4.4× |
| Bone survey complete (77075) |
$772.10 |
$1,103 |
7.4× |
| Brain image w/flow 4 + views (78606) |
$1,083.16 |
$1,547.38 |
2.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$902.82 |
$1,289.75 |
2.2× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$432.60 |
$618 |
39.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,314.15 |
$4,734.50 |
9.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$645.93 |
$922.75 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$685.65 |
$979.50 |
7.8× |
| Chest 1 view (71045) |
$204.05 |
$291.50 |
2.3× |
| Chest 3 views (71047) |
$393.23 |
$561.75 |
4.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,336.56 |
$1,909.38 |
7.6× |
| Clavicle complete (73000) |
$307.83 |
$439.75 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$220.86 |
$315.50 |
2.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$481.78 |
$688.25 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,890.28 |
$9,843.25 |
19.7× |
| CT abdomen and pelvis without contrast (74176) |
$4,744.95 |
$6,778.50 |
19.8× |
| CT abdomen w contrast (74160) |
$2,718.10 |
$3,883 |
15.4× |
| CT abdomen w wo contrast (74170) |
$2,963.80 |
$4,234 |
16.8× |
| CT abdomen w/o contrast (74150) |
$2,339.40 |
$3,342 |
22.3× |
| CT angio hrt w/3d image (75574) |
$1,756.65 |
$2,509.50 |
5.0× |
| CT angiography upper extremity lt (73206) |
$1,933.40 |
$2,762 |
11.0× |
| CT c-spine w/o contrast (72125) |
$2,848.30 |
$4,069 |
27.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,418.80 |
$4,884 |
19.4× |
| CT cervical spine with contrast (72126) |
$2,944.72 |
$4,206.75 |
8.4× |
| CT chest w/wo contrast (71270) |
$4,313.93 |
$6,162.75 |
24.5× |
| CT chest with contrast (71260) |
$4,123.53 |
$5,890.75 |
23.4× |
| CT colonography screening (74263) |
$761.60 |
$1,088 |
3.2× |
| CT colonography w/dye (74262) |
$678.04 |
$968.62 |
3.8× |
| CT colonography w/o cntrst (74261) |
$442.05 |
$631.50 |
4.2× |
| CT head/brain with contrast (70460) |
$2,202.64 |
$3,146.62 |
12.5× |
| CT head/brain without and with contrast (70470) |
$2,451.14 |
$3,501.62 |
13.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,760.33 |
$2,514.75 |
5.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$87.42 |
$124.88 |
1.0× |
| CT hrt w/3d image congen (75573) |
$1,661.80 |
$2,374 |
4.7× |
| CT iac w contrast (70481) |
$1,992.72 |
$2,846.75 |
11.3× |
| CT limited/localized follow up study (76380) |
$448.18 |
$640.25 |
5.1× |
| CT lower ext w/o (73700) |
$1,229.03 |
$1,755.75 |
11.7× |
| CT lower extremity w wo contrast (73702) |
$1,683.50 |
$2,405 |
9.6× |
| CT lower extremity with contrast (73701) |
$1,566.52 |
$2,237.88 |
8.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,764.66 |
$3,949.50 |
15.7× |
| CT lumbar spine w/o contrast (72131) |
$1,243.73 |
$1,776.75 |
11.8× |
| CT lumbar spine with contrast (72132) |
$1,734.69 |
$2,478.12 |
4.9× |
| CT maxillofacial w contrast (70487) |
$2,538.20 |
$3,626 |
14.4× |
| CT maxillofacial w/o contrast (70486) |
$1,385.83 |
$1,979.75 |
13.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,369.76 |
$3,385.38 |
13.4× |
| CT neck soft tissue w contrast (70491) |
$2,230.46 |
$3,186.38 |
12.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,880.15 |
$4,114.50 |
16.3× |
| CT orbits w/o contrast (70480) |
$1,264.20 |
$1,806 |
12.0× |
| CT pelvis w & w/o contrast (72194) |
$2,882.16 |
$4,117.38 |
16.4× |
| CT pelvis w/o contrast (72192) |
$1,978.73 |
$2,826.75 |
18.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$625.63 |
$893.75 |
7.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,394.09 |
$3,420.12 |
13.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,708.36 |
$2,440.50 |
16.3× |
| CT thoracic spine w/contrast (72129) |
$3,957.72 |
$5,653.88 |
22.5× |
| CT thoracic spine w/o contrast (72128) |
$3,643.86 |
$5,205.50 |
34.7× |
| CT thoracic spine w/wo contrast (72130) |
$4,831.66 |
$6,902.38 |
27.4× |
| CT thorax w/o contrast (71250) |
$735.53 |
$1,050.75 |
7.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,971.68 |
$4,245.25 |
16.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,111.72 |
$3,016.75 |
20.1× |
| CT upper extremity with contrast (73201) |
$2,195.82 |
$3,136.88 |
6.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,788.10 |
$3,983 |
15.8× |
| Cta Abdomen (74175) |
$3,368.58 |
$4,812.25 |
19.1× |
| CTA abdomen pelvis (74174) |
$4,731.39 |
$6,759.12 |
13.5× |
| CTA chest (71275) |
$948.15 |
$1,354.50 |
5.4× |
| Cta Head (70496) |
$1,628.29 |
$2,326.12 |
9.2× |
| CTA lwr ext w&w/o contrast (73706) |
$2,884 |
$4,120 |
16.4× |
| Cta Neck (70498) |
$1,603.36 |
$2,290.50 |
9.1× |
| Cta Pelvis (72191) |
$2,000.96 |
$2,858.50 |
11.4× |
| Cystography minimum 3 views rs&i (74430) |
$874.74 |
$1,249.62 |
2.5× |
| Diskogram cervical (72285) |
$7,676.55 |
$10,966.50 |
3.9× |
| Diskography lumbar (72295) |
$7,676.55 |
$10,966.50 |
3.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$387.19 |
$553.12 |
3.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$374.15 |
$534.50 |
3.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$295.40 |
$422 |
2.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$425.86 |
$608.38 |
4.1× |
| Dxa bone density study axial skeleton (77085) |
$409.15 |
$584.50 |
3.9× |
| Echo exam of eye (76529) |
$178.85 |
$255.50 |
2.0× |
| Echo exam of fetal heart (76825) |
$1,300.78 |
$1,858.25 |
2.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,785.79 |
$2,551.12 |
7.5× |
| Echoencephalography real time imaging (76506) |
$403.38 |
$576.25 |
3.8× |
| Esophagus (74220) |
$407.75 |
$582.50 |
2.3× |
| Fetal biophysical profile non-stress testing (76818) |
$1,063.30 |
$1,519 |
10.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$811.66 |
$1,159.50 |
7.7× |
| Fluoroscopy up to 1 hr (76000) |
$293.48 |
$419.25 |
1.2× |
| Foot 2 views (73620) |
$411.08 |
$587.25 |
4.7× |
| Forearm 2 views (73090) |
$332.15 |
$474.50 |
3.8× |
| Functional MRI brain by phys/psych (70555) |
$2,163.53 |
$3,090.75 |
9.0× |
| Functional MRI brain by tech (70554) |
$2,376.50 |
$3,395 |
9.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,502.20 |
$2,146 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,772.40 |
$2,532 |
4.4× |
| Hand 2 views (73120) |
$426.39 |
$609.12 |
4.1× |
| Hand 3 views (73130) |
$459.02 |
$655.75 |
5.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,050.73 |
$5,786.75 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,558.68 |
$3,655.25 |
4.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,703.63 |
$2,433.75 |
4.2× |
| Ht muscle image spect sing (78451) |
$1,813 |
$2,590 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$338.63 |
$483.75 |
3.9× |
| Hysterosalpingogram (74740) |
$776.65 |
$1,109.50 |
3.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$320.43 |
$457.75 |
3.1× |
| Kidney imaging morphology (78700) |
$1,421.88 |
$2,031.25 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,367.80 |
$1,954 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,996.58 |
$2,852.25 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,148.88 |
$1,641.25 |
2.1× |
| Knee 3 views (73562) |
$371.35 |
$530.50 |
4.2× |
| Liver & spleen imaging static only (78215) |
$1,000.39 |
$1,429.12 |
2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,619.10 |
$2,313 |
4.0× |
| Liver imaging static only (78201) |
$639.98 |
$914.25 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$796.34 |
$1,137.62 |
1.5× |
| Lung perfusion differential (78597) |
$571.38 |
$816.25 |
1.4× |
| Lung Ventilation Imaging (78579) |
$419.82 |
$599.75 |
1.0× |
| Lymphoscintigraphy (78195) |
$872.55 |
$1,246.50 |
1.6× |
| Meckels Diverticulum (78290) |
$1,227.80 |
$1,754 |
3.1× |
| Mr elastography (76391) |
$600.25 |
$857.50 |
2.5× |
| Mr safety determination physician/other qhp (76016) |
$225.66 |
$322.38 |
2.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$152.86 |
$218.38 |
2.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$62.65 |
$89.50 |
2.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$234.42 |
$334.88 |
2.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$616.62 |
$880.88 |
2.6× |
| MRA head w & w/o contrast (70546) |
$5,416.25 |
$7,737.50 |
15.5× |
| MRA head w/o contrast (70544) |
$1,752.10 |
$2,503 |
7.3× |
| MRA head with contrast (70545) |
$2,640.58 |
$3,772.25 |
7.5× |
| MRA neck w contrast (70548) |
$2,164.84 |
$3,092.62 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,471.88 |
$3,531.25 |
7.1× |
| MRA neck w/o contrast (70547) |
$2,003.58 |
$2,862.25 |
8.4× |
| MRI abdomen w contrast (74182) |
$3,565.80 |
$5,094 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,394.96 |
$6,278.50 |
12.5× |
| MRI abdomen w/o contrast (74181) |
$3,166.36 |
$4,523.38 |
13.2× |
| MRI any jnt lwr ext with con lt (73722) |
$2,041.64 |
$2,916.62 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,961.79 |
$4,231.12 |
3.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,177.22 |
$1,681.75 |
4.9× |
| MRI breast w/o contrast unilat (77046) |
$1,624 |
$2,320 |
6.8× |
| MRI c-spine with contrast (72142) |
$3,479 |
$4,970 |
9.9× |
| MRI cardiac w/o cont stress (75559) |
$2,376.50 |
$3,395 |
4.3× |
| MRI cardiac w/o contrast (75557) |
$2,376.50 |
$3,395 |
9.9× |
| MRI cervical spine w/o contrast (72141) |
$3,027.59 |
$4,325.12 |
12.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,548.26 |
$3,640.38 |
7.3× |
| MRI chest w/o contrast (71550) |
$1,952.92 |
$2,789.88 |
8.1× |
| MRI chest with contrast (71551) |
$2,223.64 |
$3,176.62 |
2.8× |
| MRI fetal sngl/1st gestation (74712) |
$836.50 |
$1,195 |
3.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,887.06 |
$4,124.38 |
8.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,515.46 |
$3,593.50 |
7.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,680.96 |
$2,401.38 |
7.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,212.26 |
$3,160.38 |
9.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,166.76 |
$5,952.50 |
11.9× |
| MRI orbit/face/neck w/contrast (70542) |
$2,458.14 |
$3,511.62 |
7.0× |
| MRI pelvis w contrast (72196) |
$3,401.39 |
$4,859.12 |
9.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,560.64 |
$5,086.62 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$2,658.96 |
$3,798.50 |
11.1× |
| MRI scan of arm joint before and after contrast (73223) |
$3,263.92 |
$4,662.75 |
9.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$9,462.95 |
$13,518.50 |
12.0× |
| MRI scan of leg joint before and after contrast (73723) |
$2,615.12 |
$3,735.88 |
7.5× |
| MRI spectroscopy (76390) |
$4,154.33 |
$5,934.75 |
47.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,578.40 |
$5,112 |
10.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,286.15 |
$4,694.50 |
9.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,548.69 |
$6,498.12 |
13.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,330.52 |
$4,757.88 |
9.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,548.69 |
$6,498.12 |
13.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,444.49 |
$3,492.12 |
10.2× |
| MRI tmj (70336) |
$2,353.40 |
$3,362 |
9.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,826.65 |
$2,609.50 |
7.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,263.92 |
$4,662.75 |
9.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,750.09 |
$2,500.12 |
7.3× |
| Myelogram Cervical (72240) |
$1,415.23 |
$2,021.75 |
1.8× |
| Myelogram Lumbar (72265) |
$1,275.75 |
$1,822.50 |
1.6× |
| Myelogram thoracic (72255) |
$1,415.23 |
$2,021.75 |
1.8× |
| Myelography 2 or more regions (72270) |
$1,327.38 |
$1,896.25 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,040.80 |
$4,344 |
2.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,486.40 |
$3,552 |
2.9× |
| Neck soft tissue (70360) |
$302.40 |
$432 |
3.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$850.16 |
$1,214.50 |
2.1× |
| Nm adrenal scan (78075) |
$2,570.93 |
$3,672.75 |
2.0× |
| Nm cisternogram (78630) |
$1,402.02 |
$2,002.88 |
2.6× |
| Nm csf leak detection (78650) |
$1,765.40 |
$2,522 |
1.4× |
| Nm gastric emptying study (78264) |
$633.85 |
$905.50 |
1.6× |
| Nm gastroesophageal reflux study (78262) |
$728.88 |
$1,041.25 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$558.52 |
$797.88 |
1.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$3,612.62 |
$5,160.88 |
2.8× |
| Nuclear medicine of heart pumping function (78473) |
$1,823.76 |
$2,605.38 |
4.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,651.16 |
$3,787.38 |
2.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$668.68 |
$955.25 |
1.7× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,192.28 |
$1,703.25 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$547.66 |
$782.38 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$574.35 |
$820.50 |
5.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$534.54 |
$763.62 |
5.1× |
| Orthopantogram (70355) |
$201.08 |
$287.25 |
2.3× |
| Osseous survey infant (77076) |
$395.50 |
$565 |
3.8× |
| Osseous survey limited (77074) |
$221.99 |
$317.12 |
2.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,367.80 |
$1,954 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,022.88 |
$1,461.25 |
2.5× |
| Parathyroid imaging (78070) |
$885.50 |
$1,265 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$350.70 |
$501 |
3.3× |
| Perineogram (74775) |
$610.75 |
$872.50 |
2.5× |
| PET imaging for CT attenuation whole body (78816) |
$3,617.25 |
$5,167.50 |
2.5× |
| Pr MRI brain w/ dye (70558) |
$3,542.70 |
$5,061 |
20.1× |
| Pr MRI brain w/o & w/ dye (70559) |
$4,007.50 |
$5,725 |
22.7× |
| Pr MRI brain w/o dye (70557) |
$2,376.50 |
$3,395 |
4.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,169.34 |
$4,527.62 |
9.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,897.33 |
$8,424.75 |
1.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,906.10 |
$2,723 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$848.93 |
$1,212.75 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,081.63 |
$2,973.75 |
3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$293.48 |
$419.25 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$213.85 |
$305.50 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$406.70 |
$581 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$406.70 |
$581 |
3.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$361.20 |
$516 |
3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$651.52 |
$930.75 |
6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$378.35 |
$540.50 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$351.58 |
$502.25 |
4.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$473.03 |
$675.75 |
5.4× |
| Radiologic exam colon single contrast study (74270) |
$569.62 |
$813.75 |
3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$562.10 |
$803 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$562.10 |
$803 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$562.10 |
$803 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$245.88 |
$351.25 |
2.8× |
| Radiological examination surgical specimen (76098) |
$406.70 |
$581 |
0.7× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$877.10 |
$1,253 |
3.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$5,897.33 |
$8,424.75 |
1.9× |
| Ribs bilateral 3 views (71110) |
$490.96 |
$701.38 |
4.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,669.28 |
$3,813.25 |
4.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,618.88 |
$3,741.25 |
4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,189.72 |
$4,556.75 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,414.25 |
$4,877.50 |
2.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,189.72 |
$4,556.75 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,759.10 |
$2,513 |
7.5× |
| Sacroiliac Joints < 3 Views (72200) |
$241.24 |
$344.62 |
2.3× |
| Salivary gland function study (78232) |
$520.10 |
$743 |
1.3× |
| Salivary gland imaging (78230) |
$1,035.56 |
$1,479.38 |
2.6× |
| Salivary gland imaging serial images (78231) |
$1,551.03 |
$2,215.75 |
3.9× |
| Scanogram (77073) |
$319.73 |
$456.75 |
3.0× |
| Scapula complete (73010) |
$378.35 |
$540.50 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$119.35 |
$170.50 |
5.1× |
| Sella turcica (70240) |
$183.23 |
$261.75 |
2.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$586.08 |
$837.25 |
5.6× |
| Sialogram (70390) |
$776.65 |
$1,109.50 |
3.2× |
| Small bowel series (74250) |
$604.62 |
$863.75 |
3.4× |
| Speech evaluation complex (70371) |
$501.38 |
$716.25 |
2.1× |
| Spine thoracic 3 views (72072) |
$548.45 |
$783.50 |
5.2× |
| Splenoportograpy rs&i (75810) |
$5,897.33 |
$8,424.75 |
1.9× |
| Superior sagittal sinus venogram (75870) |
$776.65 |
$1,109.50 |
0.2× |
| Tbs Technical Calculation Only (77091) |
$239.75 |
$342.50 |
2.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$779.63 |
$1,113.75 |
3.3× |
| Testicular Imaging With Vascular Flow (78761) |
$1,996.58 |
$2,852.25 |
5.0× |
| Therapeutic Enema (74283) |
$555.28 |
$793.25 |
3.2× |
| Thoracolumbar 2 views (72080) |
$411.16 |
$587.38 |
4.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$920.68 |
$1,315.25 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$386.40 |
$552 |
1.0× |
| Thyroid uptake measurement (78012) |
$342.13 |
$488.75 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$481.60 |
$688 |
1.2× |
| Tmj unilateral (70328) |
$272.48 |
$389.25 |
3.1× |
| Tomogram (76100) |
$219.10 |
$313 |
2.1× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$239.75 |
$342.50 |
2.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,765.39 |
$5,379.12 |
6.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,442.83 |
$3,489.75 |
6.1× |
| Ultrasound elastography first target lesion (76982) |
$759.59 |
$1,085.12 |
7.2× |
| Ultrasound, abdomen limited (76705) |
$399.79 |
$571.12 |
3.8× |
| Umbilical-artery Doppler (OB) (76820) |
$149.63 |
$213.75 |
1.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$167.30 |
$239 |
1.9× |
| Unlisted magnetic resonance procedure (76498) |
$2,376.50 |
$3,395 |
27.2× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$938 |
$1,340 |
2.3× |
| Unlisted Ultrasound Procedure (76999) |
$121.28 |
$173.25 |
1.4× |
| Upper Extremity Infant (73092) |
$508.03 |
$725.75 |
4.8× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$325.15 |
$464.50 |
3.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,332.63 |
$1,903.75 |
3.3× |
| Urethrocystography retrograde rs&i (74450) |
$835.72 |
$1,193.88 |
3.5× |
| Urethrocystography voiding (74455) |
$971.42 |
$1,387.75 |
4.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$610.75 |
$872.50 |
3.5× |
| Us abdl aorta screen aaa (76706) |
$478.10 |
$683 |
4.6× |
| Us breast unilateral complete (76641) |
$305.38 |
$436.25 |
2.9× |
| Us breast unilateral limited (76642) |
$516.60 |
$738 |
5.9× |
| Us chest (76604) |
$353.06 |
$504.38 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$101.68 |
$145.25 |
1.0× |
| Us elastography parenchyma (76981) |
$759.59 |
$1,085.12 |
7.2× |
| Us guided compression repair (76936) |
$1,072.14 |
$1,531.62 |
4.9× |
| Us infant hips dynamic (76885) |
$405.65 |
$579.50 |
4.6× |
| Us infant hips limited static (76886) |
$517.65 |
$739.50 |
5.9× |
| Us kidney transplant (76776) |
$598.85 |
$855.50 |
5.7× |
| Us ob detailed single fetus (76811) |
$882.44 |
$1,260.62 |
3.7× |
| Us ob transvaginal (76817) |
$499.63 |
$713.75 |
4.8× |
| Us pelvic non ob complete (76856) |
$414.32 |
$591.88 |
3.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$512.05 |
$731.50 |
4.9× |
| Us pregnancy ltd (76815) |
$459.90 |
$657 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$547.58 |
$782.25 |
5.2× |
| Us retroperitoneal complete (76770) |
$472.59 |
$675.12 |
4.5× |
| Us retroperitoneal limited (76775) |
$384.13 |
$548.75 |
3.7× |
| Us scrotum and contents (76870) |
$794.33 |
$1,134.75 |
7.6× |
| Us soft tissue head/neck (76536) |
$523.60 |
$748 |
5.0× |
| Us spinal canal and contents (76800) |
$550.73 |
$786.75 |
5.2× |
| Us transrectal (76872) |
$550.55 |
$786.50 |
5.2× |
| Us transrectal prostate volume (76873) |
$251.30 |
$359 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$527.10 |
$753 |
5.0× |
| Us, eye b-scan (76512) |
$307.74 |
$439.62 |
2.9× |
| Vascular flow imaging (78445) |
$1,067.59 |
$1,525.12 |
2.7× |
| Venogram extremity bilateral (75822) |
$1,756.65 |
$2,509.50 |
1.1× |
| Venogram orbital (75880) |
$1,906.10 |
$2,723 |
3.0× |
| Venography caval inferior serialography rs&i (75825) |
$1,787.45 |
$2,553.50 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,787.45 |
$2,553.50 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$903.53 |
$1,290.75 |
0.6× |
| Venography Renal Bilateral (75833) |
$5,897.33 |
$8,424.75 |
1.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,480.63 |
$3,543.75 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,906.10 |
$2,723 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$7,203.88 |
$10,291.25 |
1.3× |
| Vertebral fracture assessment via dxa (77086) |
$255.50 |
$365 |
2.9× |
| Wrist 2 views (73100) |
$347.03 |
$495.75 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$517.83 |
$739.75 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$408.45 |
$583.50 |
4.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$368.90 |
$527 |
4.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$869.40 |
$1,242 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$287.18 |
$410.25 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$301 |
$430 |
3.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$651.52 |
$930.75 |
6.2× |
| X-ray exam hip uni 1 view (73501) |
$245.88 |
$351.25 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$245.88 |
$351.25 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$341.52 |
$487.88 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$341.52 |
$487.88 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$651.52 |
$930.75 |
6.2× |
| X-ray exam of femur 1 (73551) |
$245.88 |
$351.25 |
2.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$347.38 |
$496.25 |
2.0× |
| X-ray eye for foreign body (70030) |
$136.50 |
$195 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$521.33 |
$744.75 |
5.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$296.45 |
$423.50 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$350.35 |
$500.50 |
4.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$967.23 |
$1,381.75 |
0.5× |
| X-ray head for orthodontia (70350) |
$198.10 |
$283 |
2.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$307.13 |
$438.75 |
3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$284.38 |
$406.25 |
3.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$547.23 |
$781.75 |
5.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$418.08 |
$597.25 |
4.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$320.78 |
$458.25 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$674.10 |
$963 |
6.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$822.32 |
$1,174.75 |
7.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$356.22 |
$508.88 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$310.10 |
$443 |
3.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$282.10 |
$403 |
3.2× |
| X-ray of voice box or throat (70370) |
$210.18 |
$300.25 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$493.33 |
$704.75 |
4.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$288.23 |
$411.75 |
2.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$849.72 |
$1,213.88 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$437.68 |
$625.25 |
5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$322.88 |
$461.25 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$674.62 |
$963.75 |
6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$316.05 |
$451.50 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$244.65 |
$349.50 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$349.48 |
$499.25 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$407.75 |
$582.50 |
4.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$284.38 |
$406.25 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$644.35 |
$920.50 |
6.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$337.75 |
$482.50 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$397.78 |
$568.25 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$257.16 |
$367.38 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$332.15 |
$474.50 |
3.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$570.50 |
$815 |
5.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$272.48 |
$389.25 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$364.18 |
$520.25 |
4.2× |
| Xr arthrogram ankle (73615) |
$912.63 |
$1,303.75 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$754.69 |
$1,078.12 |
7.2× |
| Xr chest 4+ views (71048) |
$343.09 |
$490.12 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$291.03 |
$415.75 |
3.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$272.48 |
$389.25 |
2.6× |
| Xr optic foramina (70190) |
$256.55 |
$366.50 |
2.9× |
| Xr shoulder 1 view (73020) |
$258.13 |
$368.75 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$694.92 |
$992.75 |
6.6× |
| Xr tibia/fibula 2 views (73590) |
$380.45 |
$543.50 |
4.4× |
| Xr tmj bilateral (70330) |
$242.64 |
$346.62 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$447.12 |
$638.75 |
5.1× |