| Abdomen 2 views (74019) |
$265.59 |
$408.60 |
2.9× |
| Arthrogram elbow (73085) |
$547.30 |
$842 |
1.8× |
| Arthrogram hip (73525) |
$632.60 |
$973.23 |
2.0× |
| Arthrogram shoulder (73040) |
$904.62 |
$1,391.72 |
2.9× |
| Arthrogram wrist (73115) |
$430.36 |
$662.09 |
1.4× |
| Arthrography knee lt (73580) |
$262.70 |
$404.16 |
0.8× |
| Bone age studies (77072) |
$179.86 |
$276.70 |
1.9× |
| Bone survey complete (77075) |
$299.52 |
$460.80 |
3.2× |
| Cervical spine 2 or 3 views (72040) |
$172.58 |
$265.50 |
2.2× |
| Chest 1 view (71045) |
$462.15 |
$711 |
6.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$176.08 |
$270.90 |
1.1× |
| Clavicle complete (73000) |
$355.09 |
$546.30 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,553.18 |
$2,389.50 |
16.7× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$269.10 |
$414 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,145.68 |
$4,839.50 |
10.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,967.25 |
$4,565 |
14.0× |
| CT abdomen w contrast (74160) |
$2,744.29 |
$4,221.99 |
17.6× |
| CT abdomen w wo contrast (74170) |
$3,118 |
$4,796.93 |
20.0× |
| CT abdomen w/o contrast (74150) |
$2,152.67 |
$3,311.80 |
23.1× |
| CT angio hrt w/3d image (75574) |
$4,608.50 |
$7,090 |
14.8× |
| CT angiography upper extremity lt (73206) |
$1,953.25 |
$3,005 |
12.5× |
| CT c-spine w/o contrast (72125) |
$2,632.50 |
$4,050 |
28.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,847.95 |
$2,843 |
11.8× |
| CT cervical spine with contrast (72126) |
$1,816.75 |
$2,795 |
5.8× |
| CT chest w/wo contrast (71270) |
$2,402.46 |
$3,696.10 |
15.4× |
| CT chest with contrast (71260) |
$2,848.28 |
$4,381.97 |
18.2× |
| CT head/brain with contrast (70460) |
$838.66 |
$1,290.24 |
5.4× |
| CT head/brain without and with contrast (70470) |
$2,655.65 |
$4,085.62 |
17.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$715 |
$1,100 |
9.2× |
| CT iac w contrast (70481) |
$1,729.80 |
$2,661.23 |
11.1× |
| CT lower ext w/o (73700) |
$1,708.84 |
$2,628.98 |
18.4× |
| CT lower extremity w wo contrast (73702) |
$1,741.35 |
$2,679 |
11.1× |
| CT lower extremity with contrast (73701) |
$1,977.98 |
$3,043.04 |
12.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,088.10 |
$1,674 |
7.0× |
| CT lumbar spine w/o contrast (72131) |
$1,949.35 |
$2,999 |
20.9× |
| CT lumbar spine with contrast (72132) |
$1,596.40 |
$2,456 |
5.1× |
| CT maxillofacial w contrast (70487) |
$1,018.10 |
$1,566.30 |
6.5× |
| CT maxillofacial w/o contrast (70486) |
$1,418.95 |
$2,183 |
15.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,645.15 |
$2,531 |
10.5× |
| CT neck soft tissue w contrast (70491) |
$1,595.88 |
$2,455.20 |
10.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,099.80 |
$1,692 |
7.0× |
| CT orbits w/o contrast (70480) |
$680.88 |
$1,047.50 |
7.3× |
| CT pelvis w & w/o contrast (72194) |
$1,994.85 |
$3,069 |
12.8× |
| CT pelvis w/o contrast (72192) |
$2,418.26 |
$3,720.40 |
26.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,190.90 |
$1,832.16 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$729.87 |
$1,122.87 |
7.8× |
| CT thoracic spine w/contrast (72129) |
$1,599 |
$2,460 |
10.2× |
| CT thoracic spine w/o contrast (72128) |
$1,323.56 |
$2,036.25 |
14.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,761.50 |
$2,710 |
11.3× |
| CT thorax w/o contrast (71250) |
$1,844.05 |
$2,837 |
19.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,578.55 |
$3,967 |
16.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,896.18 |
$2,917.20 |
20.4× |
| CT upper extremity with contrast (73201) |
$1,896.18 |
$2,917.20 |
6.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,048.15 |
$3,151 |
13.1× |
| Cta Abdomen (74175) |
$2,216.80 |
$3,410.46 |
14.2× |
| CTA abdomen pelvis (74174) |
$4,679.68 |
$7,199.50 |
15.1× |
| CTA chest (71275) |
$4,487.92 |
$6,904.50 |
28.7× |
| Cta Head (70496) |
$2,748.85 |
$4,229 |
17.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,220.32 |
$1,877.41 |
7.8× |
| Cta Neck (70498) |
$593.78 |
$913.50 |
3.8× |
| Cta Pelvis (72191) |
$2,475.43 |
$3,808.35 |
15.8× |
| Esophagus (74220) |
$1,030.91 |
$1,586.01 |
6.6× |
| Fluoroscopy up to 1 hr (76000) |
$979.58 |
$1,507.05 |
4.6× |
| Foot 2 views (73620) |
$389.02 |
$598.50 |
5.0× |
| Forearm 2 views (73090) |
$86.58 |
$133.20 |
1.1× |
| Hand 2 views (73120) |
$172.80 |
$265.85 |
1.9× |
| Hand 3 views (73130) |
$288.40 |
$443.70 |
3.7× |
| Humerus Min 2 Views Left (73060) |
$606.12 |
$932.50 |
7.8× |
| Knee 3 views (73562) |
$667.22 |
$1,026.50 |
8.6× |
| MRA head w & w/o contrast (70546) |
$2,624.05 |
$4,037 |
8.4× |
| MRA head w/o contrast (70544) |
$1,405.74 |
$2,162.68 |
6.6× |
| MRA head with contrast (70545) |
$1,729.65 |
$2,661 |
5.6× |
| MRA neck w contrast (70548) |
$2,068.30 |
$3,182 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,302.30 |
$3,542 |
7.4× |
| MRA neck w/o contrast (70547) |
$1,343.55 |
$2,067 |
6.3× |
| MRI abdomen w contrast (74182) |
$1,957.15 |
$3,011 |
6.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,150.05 |
$7,923.15 |
16.6× |
| MRI abdomen w/o contrast (74181) |
$788.87 |
$1,213.65 |
3.7× |
| MRI any jnt lwr ext with con lt (73722) |
$3,299.72 |
$5,076.50 |
4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,057.40 |
$4,703.69 |
4.4× |
| MRI breast w/o contrast bilateral (77047) |
$4,829.50 |
$7,430 |
22.7× |
| MRI breast w/o contrast unilat (77046) |
$2,606.50 |
$4,010 |
12.3× |
| MRI c-spine with contrast (72142) |
$2,269.80 |
$3,492 |
7.3× |
| MRI cervical spine w/o contrast (72141) |
$3,042.28 |
$4,680.43 |
14.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,541.50 |
$3,910 |
8.2× |
| MRI chest w/o contrast (71550) |
$1,738.75 |
$2,675 |
8.2× |
| MRI chest with contrast (71551) |
$1,972.10 |
$3,034 |
2.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,977.95 |
$3,043 |
6.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,709.50 |
$2,630 |
5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,612.30 |
$4,018.93 |
12.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$826.80 |
$1,272 |
3.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,725.75 |
$2,655 |
5.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,944.80 |
$2,992 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,957.15 |
$3,011 |
6.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,714.05 |
$2,637 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$2,684.44 |
$4,129.90 |
12.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,547 |
$2,380 |
5.0× |
| MRI scan of leg joint before and after contrast (73723) |
$3,147.95 |
$4,843 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,852.50 |
$2,850 |
6.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,401.18 |
$3,694.13 |
7.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,724.58 |
$2,653.20 |
5.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,154.10 |
$3,314 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,792.75 |
$2,758.08 |
5.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,333.52 |
$5,128.50 |
15.7× |
| MRI tmj (70336) |
$1,513.20 |
$2,328 |
7.1× |
| MRI upper ext joint w/o contrast (73221) |
$3,188.25 |
$4,905 |
15.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,938 |
$4,520 |
9.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,709.50 |
$2,630 |
8.0× |
| Myelogram Lumbar (72265) |
$1,356.14 |
$2,086.37 |
1.9× |
| Myelogram thoracic (72255) |
$942.50 |
$1,450 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$6,705.43 |
$10,316.05 |
5.8× |
| Neck soft tissue (70360) |
$214.70 |
$330.30 |
2.8× |
| Osseous survey infant (77076) |
$391.95 |
$603 |
4.2× |
| Osseous survey limited (77074) |
$624 |
$960 |
6.7× |
| Pelvis 1 or 2 views (72170) |
$631.16 |
$971.02 |
6.8× |
| PET image w/CT, skull-thigh (78815) |
$9,708.72 |
$14,936.50 |
7.6× |
| PET imaging for CT attenuation whole body (78816) |
$5,880.02 |
$9,046.18 |
4.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,818.39 |
$5,874.44 |
12.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$324.35 |
$499 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$227.56 |
$350.10 |
2.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$156.65 |
$241 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$192.82 |
$296.64 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$207.97 |
$319.95 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$549.75 |
$845.77 |
7.1× |
| Radiologic exam colon single contrast study (74270) |
$826.15 |
$1,271 |
5.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$877.45 |
$1,349.92 |
5.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,059.82 |
$1,630.50 |
6.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$531.38 |
$817.50 |
6.9× |
| Radiological examination surgical specimen (76098) |
$32.50 |
$50 |
0.1× |
| Ribs bilateral 3 views (71110) |
$151.94 |
$233.76 |
1.6× |
| Scanogram (77073) |
$269.56 |
$414.70 |
2.9× |
| Scapula complete (73010) |
$369.52 |
$568.50 |
4.0× |
| Sella turcica (70240) |
$127.40 |
$196 |
1.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$353.60 |
$544 |
3.8× |
| Small bowel series (74250) |
$564.52 |
$868.50 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$333.45 |
$513 |
3.6× |
| Upper Extremity Infant (73092) |
$151.45 |
$233 |
1.6× |
| Urethrocystography voiding (74455) |
$455.65 |
$701 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$370.50 |
$570 |
4.0× |
| Us breast unilateral limited (76642) |
$861.90 |
$1,326 |
11.1× |
| Us chest (76604) |
$429.91 |
$661.40 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$744.54 |
$1,145.45 |
8.0× |
| Us infant hips dynamic (76885) |
$299 |
$460 |
3.9× |
| Us infant hips limited static (76886) |
$122.85 |
$189 |
1.6× |
| Us ob transvaginal (76817) |
$289.28 |
$445.05 |
3.1× |
| Us pelvic non ob complete (76856) |
$548.44 |
$843.75 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$401.21 |
$617.25 |
4.3× |
| Us pregnancy ltd (76815) |
$61.42 |
$94.50 |
0.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$203.58 |
$313.20 |
2.2× |
| Us retroperitoneal complete (76770) |
$680.88 |
$1,047.50 |
7.3× |
| Us retroperitoneal limited (76775) |
$604.89 |
$930.60 |
6.5× |
| Us scrotum and contents (76870) |
$324.38 |
$499.05 |
3.5× |
| Us soft tissue head/neck (76536) |
$680.88 |
$1,047.50 |
7.3× |
| Us spinal canal and contents (76800) |
$295.75 |
$455 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$680.88 |
$1,047.50 |
7.3× |
| Wrist 2 views (73100) |
$295.51 |
$454.63 |
3.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$115.24 |
$177.30 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$169.42 |
$260.64 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$214.70 |
$330.30 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$477.36 |
$734.40 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$287.22 |
$441.87 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$214.70 |
$330.30 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$154.44 |
$237.60 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$562.77 |
$865.80 |
7.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$546.96 |
$841.48 |
5.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$81.12 |
$124.80 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$214.70 |
$330.30 |
2.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$306.74 |
$471.90 |
4.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$637.64 |
$980.98 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$143.65 |
$221 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$142.21 |
$218.79 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$161.85 |
$249 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$482.14 |
$741.75 |
5.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$703.03 |
$1,081.59 |
7.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$360.21 |
$554.17 |
4.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$141.05 |
$217 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$484.42 |
$745.26 |
5.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,119.95 |
$1,723 |
3.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$540.64 |
$831.75 |
7.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$231.58 |
$356.28 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$259.35 |
$399 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$411.38 |
$632.89 |
4.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$298.84 |
$459.75 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$674.05 |
$1,037 |
8.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$502.35 |
$772.85 |
6.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$600.68 |
$924.13 |
6.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$423.62 |
$651.72 |
4.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$218.40 |
$336 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$263.25 |
$405 |
3.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$126.36 |
$194.40 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$289.28 |
$445.05 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$391.62 |
$602.50 |
5.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$150.64 |
$231.75 |
1.9× |
| Xr arthrogram ankle (73615) |
$547.30 |
$842 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$551.28 |
$848.13 |
5.9× |
| Xr chest 4+ views (71048) |
$440.34 |
$677.44 |
4.7× |
| Xr finger(s) 2+ views (73140) |
$188.03 |
$289.28 |
2.4× |
| Xr optic foramina (70190) |
$127.40 |
$196 |
1.6× |
| Xr shoulder 1 view (73020) |
$232.70 |
$358 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$770.58 |
$1,185.50 |
8.3× |
| Xr tibia/fibula 2 views (73590) |
$203.58 |
$313.20 |
2.6× |
| Xr tmj bilateral (70330) |
$380.17 |
$584.87 |
4.9× |
| Xray knee 1 or 2 views rt (73560) |
$465.66 |
$716.40 |
6.0× |