| Abdomen 2 views (74019) |
$192.92 |
$260 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,701.41 |
$2,293 |
4.0× |
| Angiography extremity bilateral rs&i (75716) |
$5,967.91 |
$4,117 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$4,420.84 |
$5,719.50 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,696.77 |
$10,373 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,565 |
$7,500 |
1.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,218.40 |
$5,717.50 |
1.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,021.42 |
$1,804 |
0.9× |
| Ankle 2 views (73600) |
$97.58 |
$131.50 |
1.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$757.59 |
$1,021 |
2.0× |
| Aortogram thoracic (75605) |
$5,286.75 |
$7,125 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,667.71 |
$2,569 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$4,527.69 |
$6,102 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$5,018.89 |
$6,764 |
1.5× |
| Arthrogram elbow (73085) |
$658.16 |
$887 |
1.8× |
| Arthrogram hip (73525) |
$908.21 |
$1,224 |
2.4× |
| Arthrogram shoulder (73040) |
$899.31 |
$1,212 |
2.4× |
| Arthrogram wrist (73115) |
$658.16 |
$887 |
1.8× |
| Arthrography knee lt (73580) |
$908.21 |
$1,224 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$914.89 |
$1,233 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$2,887.50 |
$3,891.50 |
6.8× |
| Bone age studies (77072) |
$190.70 |
$257 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$4,165.59 |
$5,614 |
9.8× |
| Bone survey complete (77075) |
$192.18 |
$259 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,687.22 |
$6,317 |
3.1× |
| Brain Imaging Vascular Flow Only (78610) |
$1,311.12 |
$1,767 |
2.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$100.17 |
$135 |
0.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$979.44 |
$1,320 |
2.6× |
| Cardiac shunt detection (78428) |
$993.54 |
$1,339 |
2.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,150.85 |
$1,551 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$105.74 |
$142.50 |
1.1× |
| Chest 1 view (71045) |
$91.27 |
$123 |
1.0× |
| Chest 3 views (71047) |
$123.18 |
$166 |
1.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$834.01 |
$1,124 |
4.5× |
| Clavicle complete (73000) |
$125.40 |
$169 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$140.98 |
$190 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,173.11 |
$1,581 |
3.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,725 |
$3,672.50 |
10.7× |
| CT abdomen w contrast (74160) |
$670.77 |
$904 |
3.6× |
| CT abdomen w wo contrast (74170) |
$847.37 |
$1,142 |
4.5× |
| CT abdomen w/o contrast (74150) |
$458.56 |
$618 |
4.1× |
| CT angio hrt w/3d image (75574) |
$190.70 |
$257 |
0.5× |
| CT angiography upper extremity lt (73206) |
$951.25 |
$1,282 |
5.1× |
| CT c-spine w/o contrast (72125) |
$1,362.32 |
$1,836 |
12.2× |
| CT cervical spine w&w/o contrast (72127) |
$855.53 |
$1,153 |
4.6× |
| CT cervical spine with contrast (72126) |
$734.58 |
$990 |
2.0× |
| CT chest w/wo contrast (71270) |
$785.78 |
$1,059 |
4.2× |
| CT chest with contrast (71260) |
$558.73 |
$753 |
3.0× |
| CT head/brain with contrast (70460) |
$559.47 |
$754 |
3.0× |
| CT head/brain without and with contrast (70470) |
$382.50 |
$515.50 |
2.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,356.38 |
$1,828 |
3.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$195.89 |
$264 |
2.1× |
| CT hrt w/3d image congen (75573) |
$1,442.45 |
$1,944 |
3.9× |
| CT iac w contrast (70481) |
$593.60 |
$800 |
3.2× |
| CT lower ext w/o (73700) |
$481.93 |
$649.50 |
4.3× |
| CT lower extremity w wo contrast (73702) |
$1,679.15 |
$2,263 |
9.0× |
| CT lower extremity with contrast (73701) |
$607.70 |
$819 |
3.2× |
| CT lumbar spine w & w/o contrast (72133) |
$719 |
$969 |
3.8× |
| CT lumbar spine w/o contrast (72131) |
$1,537.06 |
$2,071.50 |
13.8× |
| CT lumbar spine with contrast (72132) |
$586.18 |
$790 |
1.6× |
| CT maxillofacial w contrast (70487) |
$546.86 |
$737 |
2.9× |
| CT maxillofacial w/o contrast (70486) |
$307.19 |
$414 |
2.8× |
| CT maxillofacial w/wo contrast (70488) |
$807.30 |
$1,088 |
4.3× |
| CT neck soft tissue w contrast (70491) |
$651.48 |
$878 |
3.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$951.25 |
$1,282 |
5.1× |
| CT orbits w/o contrast (70480) |
$353.20 |
$476 |
3.2× |
| CT pelvis w & w/o contrast (72194) |
$826.59 |
$1,114 |
4.4× |
| CT pelvis w/o contrast (72192) |
$319.81 |
$431 |
2.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$888.18 |
$1,197 |
4.7× |
| CT soft tissue neck w/o contrast (70490) |
$355.42 |
$479 |
3.2× |
| CT thoracic spine w/contrast (72129) |
$520.15 |
$701 |
2.8× |
| CT thoracic spine w/o contrast (72128) |
$1,321.50 |
$1,781 |
11.8× |
| CT thoracic spine w/wo contrast (72130) |
$758.33 |
$1,022 |
4.1× |
| CT thorax w/o contrast (71250) |
$304.97 |
$411 |
2.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,780.80 |
$2,400 |
9.5× |
| CT upper extremity w/o contrast rt (73200) |
$844.40 |
$1,138 |
7.6× |
| CT upper extremity with contrast (73201) |
$1,001.70 |
$1,350 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$382.50 |
$515.50 |
2.0× |
| Cta Abdomen (74175) |
$518.66 |
$699 |
2.8× |
| CTA abdomen pelvis (74174) |
$990.57 |
$1,335 |
2.7× |
| CTA chest (71275) |
$523.86 |
$706 |
2.8× |
| Cta Head (70496) |
$568.38 |
$766 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,314.83 |
$1,772 |
7.0× |
| Cta Neck (70498) |
$578.02 |
$779 |
3.1× |
| Cta Pelvis (72191) |
$547.60 |
$738 |
2.9× |
| Cystography minimum 3 views rs&i (74430) |
$756.84 |
$1,020 |
2.0× |
| Diskography lumbar (72295) |
$6,467.28 |
$8,716 |
3.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$316.10 |
$426 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$183.28 |
$247 |
2.0× |
| Echoencephalography real time imaging (76506) |
$304.97 |
$411 |
2.7× |
| Esophagus (74220) |
$475.63 |
$641 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$463.76 |
$625 |
4.2× |
| Fluoroscopy up to 1 hr (76000) |
$409.59 |
$552 |
1.6× |
| Foot 2 views (73620) |
$91.27 |
$123 |
1.0× |
| Forearm 2 views (73090) |
$88.67 |
$119.50 |
1.0× |
| Gated Heart Planar Single (78472) |
$77.91 |
$105 |
0.2× |
| Hand 2 views (73120) |
$297.18 |
$400.50 |
2.7× |
| Hand 3 views (73130) |
$110.56 |
$149 |
1.2× |
| Heart Infarct Image (78466) |
$689.32 |
$929 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,768.41 |
$3,731 |
4.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$3,377.59 |
$4,552 |
7.9× |
| Ht muscle image spect sing (78451) |
$1,151.58 |
$1,552 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$98.32 |
$132.50 |
1.1× |
| Hysterosalpingogram (74740) |
$1,026.19 |
$1,383 |
4.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,415.96 |
$3,256 |
4.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,229.34 |
$3,004.50 |
3.8× |
| Knee 3 views (73562) |
$137.64 |
$185.50 |
1.5× |
| Liver & spleen imaging static only (78215) |
$1,489.94 |
$2,008 |
3.5× |
| Lung perf&ventilat diferentl (78598) |
$1,201.30 |
$1,619 |
2.1× |
| Lung perfusion differential (78597) |
$932.70 |
$1,257 |
2.2× |
| Lymphoscintigraphy (78195) |
$2,566.58 |
$3,459 |
4.4× |
| Mammary ductogram or galactogram multiple (77054) |
$1,028.42 |
$1,386 |
4.0× |
| Mammary ductogram or galactogram single (77053) |
$669.66 |
$902.50 |
2.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$101.28 |
$136.50 |
1.1× |
| Meckels Diverticulum (78290) |
$1,861.68 |
$2,509 |
4.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$182.16 |
$245.50 |
5.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$145.44 |
$196 |
1.4× |
| MRA head w & w/o contrast (70546) |
$2,157.74 |
$2,908 |
5.8× |
| MRA head w/o contrast (70544) |
$1,889.88 |
$2,547 |
7.4× |
| MRA head with contrast (70545) |
$1,360.09 |
$1,833 |
3.7× |
| MRA neck w contrast (70548) |
$1,080.36 |
$1,456 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,543.36 |
$2,080 |
4.1× |
| MRA neck w/o contrast (70547) |
$987.61 |
$1,331 |
3.9× |
| MRI abdomen w contrast (74182) |
$1,311.86 |
$1,768 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,420.19 |
$1,914 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$883.72 |
$1,191 |
3.5× |
| MRI any jnt lwr ext with con lt (73722) |
$1,544.84 |
$2,082 |
1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,063.29 |
$1,433 |
1.3× |
| MRI breast w/o contrast bilateral (77047) |
$2,072.41 |
$2,793 |
8.1× |
| MRI breast w/o contrast unilat (77046) |
$2,421.15 |
$3,263 |
9.5× |
| MRI c-spine with contrast (72142) |
$1,268.08 |
$1,709 |
3.4× |
| MRI cardiac w/o contrast (75557) |
$742.75 |
$1,001 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$983.90 |
$1,326 |
3.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,089.63 |
$1,468.50 |
2.9× |
| MRI chest w/o contrast (71550) |
$3,061.87 |
$4,126.50 |
12.0× |
| MRI chest with contrast (71551) |
$1,511.46 |
$2,037 |
1.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,380.50 |
$1,860.50 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,225.26 |
$2,999 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,917.33 |
$2,584 |
7.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$997.25 |
$1,344 |
3.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,462.12 |
$1,970.50 |
3.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,208.72 |
$1,629 |
3.2× |
| MRI pelvis w contrast (72196) |
$1,410.18 |
$1,900.50 |
3.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,687.31 |
$2,274 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,156.04 |
$1,558 |
4.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,408.32 |
$1,898 |
3.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,996.72 |
$2,691 |
5.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,508.49 |
$2,033 |
4.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,153.81 |
$1,555 |
3.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,418.71 |
$1,912 |
3.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,049.93 |
$1,415 |
2.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,344.51 |
$1,812 |
3.6× |
| MRI thoracic spine w/o contrast (72146) |
$974.62 |
$1,313.50 |
3.8× |
| MRI tmj (70336) |
$953.47 |
$1,285 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$977.22 |
$1,317 |
3.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,681.38 |
$2,266 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,179.78 |
$1,590 |
4.6× |
| Myelogram Cervical (72240) |
$748.68 |
$1,009 |
0.9× |
| Myelogram Lumbar (72265) |
$748.68 |
$1,009 |
0.9× |
| Myelogram thoracic (72255) |
$748.68 |
$1,009 |
0.9× |
| Myelography 2 or more regions (72270) |
$748.68 |
$1,009 |
0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,931.12 |
$5,298 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$126.89 |
$171 |
0.1× |
| Neck soft tissue (70360) |
$129.85 |
$175 |
1.4× |
| Nm adrenal scan (78075) |
$2,499.80 |
$3,369 |
1.8× |
| Nm bone marrow multiple (78103) |
$730.87 |
$985 |
1.7× |
| Nm cisternogram (78630) |
$1,911.40 |
$2,576 |
3.3× |
| Nm csf leak detection (78650) |
$1,794.16 |
$2,418 |
1.3× |
| Nm gastric emptying study (78264) |
$2,617.04 |
$3,527 |
6.1× |
| Nm gastroesophageal reflux study (78262) |
$1,938.11 |
$2,612 |
4.5× |
| Nm whole blood volume (78122) |
$1,221.34 |
$1,646 |
2.1× |
| Nuclear medicine of heart pumping function (78473) |
$108.34 |
$146 |
0.3× |
| Nuclear medicine study of digestive tracts (78299) |
$1,826.81 |
$2,462 |
4.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$74.20 |
$100 |
0.1× |
| Nuclear Rx Oral Admin (79005) |
$1,935.14 |
$2,608 |
7.8× |
| Osseous survey infant (77076) |
$187.36 |
$252.50 |
1.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,836.45 |
$2,475 |
3.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,836.45 |
$2,475 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$110.94 |
$149.50 |
1.0× |
| Peritoneogram rs&i (74190) |
$1,595.30 |
$2,150 |
2.7× |
| PET image w/CT, skull-thigh (78815) |
$5,146.52 |
$6,936 |
3.4× |
| PET imaging for CT attenuation whole body (78816) |
$5,521.97 |
$7,442 |
3.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,806.99 |
$3,783 |
7.5× |
| Pr red cell survival study (78130) |
$907.47 |
$1,223 |
2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,279.55 |
$8,463 |
1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,360.09 |
$1,833 |
3.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,297.98 |
$3,097 |
4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$876.31 |
$1,181 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$232.99 |
$314 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$120.58 |
$162.50 |
1.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$204.05 |
$275 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$221.12 |
$298 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$215.92 |
$291 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$105.37 |
$142 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$327.97 |
$442 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$474.88 |
$640 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$293.10 |
$395 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$102.40 |
$138 |
1.1× |
| Radiological examination surgical specimen (76098) |
$840.32 |
$1,025 |
1.4× |
| Radiopharm Dacryocystography (78660) |
$703.42 |
$948 |
1.6× |
| Ribs bilateral 3 views (71110) |
$185.50 |
$250 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,358.08 |
$3,178 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,102.31 |
$4,181 |
5.4× |
| Scanogram (77073) |
$156.94 |
$211.50 |
1.4× |
| Scapula complete (73010) |
$348.38 |
$469.50 |
3.1× |
| Screening digital breast tomosynthesis (77063) |
$63.82 |
$86 |
2.7× |
| Sella turcica (70240) |
$113.53 |
$153 |
1.2× |
| Small bowel series (74250) |
$488.98 |
$659 |
2.6× |
| Spine thoracic 3 views (72072) |
$129.48 |
$174.50 |
1.2× |
| Splenoportograpy rs&i (75810) |
$2,553.97 |
$3,442 |
0.8× |
| Therapeutic Enema (74283) |
$401.43 |
$541 |
2.1× |
| Thoracolumbar 2 views (72080) |
$77.91 |
$105 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,018.24 |
$2,720 |
3.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$697.48 |
$940 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,483.26 |
$1,999 |
3.5× |
| Tomogram (76100) |
$1,197.59 |
$1,614 |
10.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,847.27 |
$5,185 |
6.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,458.03 |
$1,965 |
3.4× |
| Ultrasound elastography first target lesion (76982) |
$207.40 |
$279.50 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$260.82 |
$351.50 |
2.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$141.73 |
$191 |
1.5× |
| Upper Extremity Infant (73092) |
$204.05 |
$275 |
1.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,079.83 |
$2,803 |
4.9× |
| Urethrocystography retrograde rs&i (74450) |
$658.53 |
$887.50 |
2.6× |
| Urethrocystography voiding (74455) |
$661.87 |
$892 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$399.94 |
$539 |
2.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,548.56 |
$2,087 |
8.3× |
| Us abdl aorta screen aaa (76706) |
$43.78 |
$59 |
0.4× |
| Us breast unilateral complete (76641) |
$229.28 |
$309 |
2.1× |
| Us breast unilateral limited (76642) |
$255.25 |
$344 |
2.7× |
| Us chest (76604) |
$186.24 |
$251 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$344.29 |
$464 |
3.1× |
| Us elastography parenchyma (76981) |
$464.50 |
$626 |
4.2× |
| Us infant hips dynamic (76885) |
$190.70 |
$257 |
2.1× |
| Us infant hips limited static (76886) |
$190.70 |
$257 |
2.1× |
| Us kidney transplant (76776) |
$365.81 |
$493 |
3.3× |
| Us ob transvaginal (76817) |
$417.75 |
$563 |
3.7× |
| Us pelvic non ob complete (76856) |
$343.92 |
$463.50 |
3.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$343.92 |
$463.50 |
3.1× |
| Us pregnancy ltd (76815) |
$448.17 |
$604 |
4.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$391.78 |
$528 |
3.5× |
| Us retroperitoneal complete (76770) |
$272.32 |
$367 |
2.4× |
| Us retroperitoneal limited (76775) |
$179.57 |
$242 |
1.6× |
| Us scrotum and contents (76870) |
$350.23 |
$472 |
3.1× |
| Us soft tissue head/neck (76536) |
$345.78 |
$466 |
3.1× |
| Us spinal canal and contents (76800) |
$286.42 |
$386 |
2.6× |
| Us transrectal (76872) |
$50.46 |
$68 |
0.5× |
| Us transrectal prostate volume (76873) |
$118.72 |
$160 |
1.1× |
| Us xtr non-vasc lmtd (76882) |
$212.58 |
$286.50 |
1.9× |
| Us, eye b-scan (76512) |
$199.60 |
$269 |
1.8× |
| Venogram extremity bilateral (75822) |
$1,002.82 |
$1,351.50 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$5,425.51 |
$7,312 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$1,289.23 |
$1,737.50 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$2,262.36 |
$2,729 |
1.3× |
| Venography Renal Bilateral (75833) |
$5,565 |
$7,500 |
1.7× |
| Venography renal unilateral selective rs&i (75831) |
$5,286.75 |
$7,125 |
1.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,019.42 |
$5,417 |
1.2× |
| Wrist 2 views (73100) |
$156.20 |
$210.50 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$423.68 |
$571 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$106.85 |
$144 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$108.71 |
$146.50 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$327.97 |
$442 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$99.80 |
$134.50 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$96.46 |
$130 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$88.30 |
$119 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$96.84 |
$130.50 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$83.11 |
$112 |
0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$159.16 |
$214.50 |
1.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,235.43 |
$1,665 |
6.6× |
| X-ray eye for foreign body (70030) |
$113.53 |
$153 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$227.80 |
$307 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$104.26 |
$140.50 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$108.34 |
$146 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$128.37 |
$173 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$202.20 |
$272.50 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$146.18 |
$197 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$113.53 |
$153 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$113.53 |
$153 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$165.47 |
$223 |
1.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$148.40 |
$200 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$145.44 |
$196 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$128.37 |
$173 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$192.18 |
$259 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$143.95 |
$194 |
1.3× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$1,599.01 |
$2,155 |
2.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$435.19 |
$586.50 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$146.18 |
$197 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$265.64 |
$358 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$265.64 |
$358 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$242.64 |
$327 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$94.24 |
$127 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$102.40 |
$138 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$159.53 |
$215 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$146.92 |
$198 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$266.38 |
$359 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$212.96 |
$287 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$57.88 |
$78 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$158.05 |
$213 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$147.66 |
$199 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$105.74 |
$142.50 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$232.25 |
$313 |
2.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$88.67 |
$119.50 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$120.58 |
$162.50 |
1.3× |
| Xr arthrogram ankle (73615) |
$697.48 |
$940 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$181.42 |
$244.50 |
1.6× |
| Xr chest 4+ views (71048) |
$221.12 |
$298 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$111.68 |
$150.50 |
1.2× |
| Xr internal auditory meati complete (70134) |
$716.03 |
$937.50 |
1.2× |
| Xr optic foramina (70190) |
$113.53 |
$153 |
1.2× |
| Xr shoulder 1 view (73020) |
$88.68 |
$119.50 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$147.66 |
$199 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$95.35 |
$128.50 |
1.0× |
| Xr tmj bilateral (70330) |
$123.18 |
$166 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$99.43 |
$134 |
1.1× |