| Abdomen 2 views (74019) |
$668.80 |
$1,337.60 |
6.4× |
| Ankle 2 views (73600) |
$511.50 |
$1,022.99 |
5.9× |
| Arthrogram shoulder (73040) |
$1,369.11 |
$2,738.22 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$1,048.32 |
$2,096.64 |
2.6× |
| Bone age studies (77072) |
$343.38 |
$686.76 |
3.3× |
| Bone Imaging 3 Phase (78315) |
$1,048.32 |
$2,096.64 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$561.50 |
$1,123 |
6.4× |
| Chest 1 view (71045) |
$622.84 |
$1,245.67 |
7.1× |
| Chest 3 views (71047) |
$469.01 |
$938.02 |
5.4× |
| Clavicle complete (73000) |
$491.84 |
$983.67 |
5.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,715.02 |
$3,430.03 |
16.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,726.71 |
$9,453.41 |
13.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,758.59 |
$9,517.18 |
19.9× |
| CT abdomen w contrast (74160) |
$2,345.59 |
$4,691.17 |
13.3× |
| CT abdomen w wo contrast (74170) |
$1,516.44 |
$3,032.88 |
8.6× |
| CT abdomen w/o contrast (74150) |
$858.45 |
$1,716.90 |
8.2× |
| CT angio hrt w/3d image (75574) |
$885.22 |
$1,770.43 |
2.5× |
| CT angiography upper extremity lt (73206) |
$4,696.54 |
$9,393.07 |
26.7× |
| CT c-spine w/o contrast (72125) |
$2,004.84 |
$4,009.67 |
19.1× |
| CT cervical spine w&w/o contrast (72127) |
$758.22 |
$1,516.44 |
4.3× |
| CT cervical spine with contrast (72126) |
$1,369.11 |
$2,738.22 |
3.9× |
| CT chest w/wo contrast (71270) |
$2,153.12 |
$4,306.23 |
12.2× |
| CT chest with contrast (71260) |
$2,301.84 |
$4,603.67 |
13.1× |
| CT head/brain with contrast (70460) |
$758.22 |
$1,516.44 |
4.3× |
| CT head/brain without and with contrast (70470) |
$2,176.03 |
$4,352.06 |
12.3× |
| CT iac w contrast (70481) |
$1,894.57 |
$3,789.13 |
10.8× |
| CT limited/localized follow up study (76380) |
$1,317.65 |
$2,635.30 |
15.1× |
| CT lower ext w/o (73700) |
$1,992.19 |
$3,984.38 |
19.0× |
| CT lower extremity w wo contrast (73702) |
$758.22 |
$1,516.44 |
4.3× |
| CT lower extremity with contrast (73701) |
$2,390.52 |
$4,781.04 |
13.6× |
| CT lumbar spine w/o contrast (72131) |
$3,736.77 |
$7,473.53 |
35.6× |
| CT lumbar spine with contrast (72132) |
$1,369.11 |
$2,738.22 |
3.9× |
| CT maxillofacial w contrast (70487) |
$2,283.02 |
$4,566.04 |
13.0× |
| CT maxillofacial w/o contrast (70486) |
$1,814.18 |
$3,628.35 |
17.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,516.44 |
$3,032.88 |
8.6× |
| CT neck soft tissue w contrast (70491) |
$2,719.75 |
$5,439.50 |
15.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,565.30 |
$7,130.59 |
20.2× |
| CT orbits w/o contrast (70480) |
$1,422.83 |
$2,845.66 |
13.5× |
| CT pelvis w & w/o contrast (72194) |
$1,516.44 |
$3,032.88 |
8.6× |
| CT pelvis w/o contrast (72192) |
$2,548.33 |
$5,096.65 |
24.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,516.44 |
$3,032.88 |
8.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,753.42 |
$3,506.84 |
16.7× |
| CT thoracic spine w/contrast (72129) |
$758.22 |
$1,516.44 |
4.3× |
| CT thoracic spine w/o contrast (72128) |
$4,414.56 |
$8,829.12 |
42.0× |
| CT thoracic spine w/wo contrast (72130) |
$3,883.06 |
$7,766.12 |
22.0× |
| CT thorax w/o contrast (71250) |
$1,911.50 |
$3,823 |
18.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,605.18 |
$5,210.35 |
14.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,283.46 |
$4,566.91 |
21.7× |
| CT upper extremity with contrast (73201) |
$758.22 |
$1,516.44 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,464.13 |
$2,928.25 |
8.3× |
| Cta Abdomen (74175) |
$1,783.15 |
$3,566.29 |
10.1× |
| CTA abdomen pelvis (74174) |
$4,798.34 |
$9,596.68 |
13.7× |
| CTA chest (71275) |
$2,491.35 |
$4,982.69 |
14.1× |
| Cta Head (70496) |
$2,459.17 |
$4,918.34 |
14.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$947.48 |
$1,894.95 |
2.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,516.44 |
$3,032.88 |
8.6× |
| Cta Neck (70498) |
$2,595.37 |
$5,190.74 |
14.7× |
| Cta Pelvis (72191) |
$758.22 |
$1,516.44 |
4.3× |
| Echo exam of fetal heart (76825) |
$1,460.07 |
$2,920.14 |
2.7× |
| Esophagus (74220) |
$1,523.88 |
$3,047.76 |
8.6× |
| Fetal biophysical profile non-stress testing (76818) |
$343.38 |
$686.76 |
3.3× |
| Foot 2 views (73620) |
$186.36 |
$372.72 |
2.1× |
| Forearm 2 views (73090) |
$663.94 |
$1,327.88 |
7.6× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$440.86 |
$881.72 |
1.8× |
| Gated Heart Planar Single (78472) |
$1,048.32 |
$2,096.64 |
2.6× |
| Hand 2 views (73120) |
$313.69 |
$627.38 |
3.0× |
| Hand 3 views (73130) |
$566.34 |
$1,132.68 |
6.5× |
| Humerus Min 2 Views Left (73060) |
$637.82 |
$1,275.64 |
7.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$425.48 |
$850.95 |
4.1× |
| Knee 3 views (73562) |
$623.93 |
$1,247.85 |
7.1× |
| MRA head w & w/o contrast (70546) |
$3,882 |
$7,764 |
11.1× |
| MRA head w/o contrast (70544) |
$1,401.87 |
$2,803.73 |
5.8× |
| MRA neck w contrast (70548) |
$1,776 |
$3,552 |
5.1× |
| MRA neck w/o contrast (70547) |
$696.93 |
$1,393.86 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI abdomen w/o contrast (74181) |
$696.93 |
$1,393.86 |
2.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,045.64 |
$4,091.28 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,376.43 |
$6,752.85 |
4.3× |
| MRI cervical spine w/o contrast (72141) |
$696.93 |
$1,393.86 |
2.9× |
| MRI chest w/o contrast (71550) |
$696.93 |
$1,393.86 |
2.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,376.38 |
$6,752.76 |
9.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,147.96 |
$4,295.92 |
9.0× |
| MRI pelvis w contrast (72196) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI pelvis w/o contrast (72195) |
$696.93 |
$1,393.86 |
2.9× |
| MRI scan of arm joint before and after contrast (73223) |
$3,714.75 |
$7,429.50 |
10.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI thoracic spine w/o contrast (72146) |
$4,355 |
$8,710 |
18.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,494.14 |
$4,988.28 |
10.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,369.11 |
$2,738.22 |
3.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,566.49 |
$7,132.97 |
14.9× |
| Neck soft tissue (70360) |
$273.60 |
$547.19 |
3.1× |
| Nm adrenal scan (78075) |
$3,608.04 |
$7,216.08 |
2.8× |
| Nm cisternogram (78630) |
$2,914 |
$5,828 |
5.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$343.38 |
$686.76 |
3.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$315.12 |
$630.24 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$429.56 |
$859.12 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$367.02 |
$734.03 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$655.30 |
$1,310.59 |
6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$454.47 |
$908.94 |
4.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$552.67 |
$1,105.34 |
6.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$424.22 |
$848.43 |
4.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$653.72 |
$1,307.44 |
7.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$549.82 |
$1,099.64 |
6.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$186.36 |
$372.72 |
2.1× |
| Ribs bilateral 3 views (71110) |
$343.38 |
$686.76 |
3.3× |
| Sacroiliac Joints < 3 Views (72200) |
$343.38 |
$686.76 |
3.3× |
| Scapula complete (73010) |
$565.83 |
$1,131.66 |
5.4× |
| Sella turcica (70240) |
$216.45 |
$432.90 |
2.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$343.38 |
$686.76 |
3.3× |
| Spine thoracic 3 views (72072) |
$576.21 |
$1,152.42 |
5.5× |
| Thoracolumbar 2 views (72080) |
$186.36 |
$372.72 |
2.1× |
| Tmj unilateral (70328) |
$305.44 |
$610.88 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$1,276.61 |
$2,553.21 |
12.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$186.36 |
$372.72 |
2.1× |
| Upper Extremity Infant (73092) |
$343.38 |
$686.76 |
3.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$758.22 |
$1,516.44 |
4.3× |
| Us abdl aorta screen aaa (76706) |
$343.38 |
$686.76 |
3.3× |
| Us breast unilateral complete (76641) |
$790.40 |
$1,580.80 |
7.5× |
| Us breast unilateral limited (76642) |
$186.36 |
$372.72 |
2.1× |
| Us chest (76604) |
$343.38 |
$686.76 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$343.38 |
$686.76 |
3.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$343.38 |
$686.76 |
3.3× |
| Us ob transvaginal (76817) |
$1,044.57 |
$2,089.13 |
9.9× |
| Us pelvic non ob complete (76856) |
$1,281.07 |
$2,562.14 |
12.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$343.38 |
$686.76 |
3.3× |
| Us pregnancy ltd (76815) |
$343.38 |
$686.76 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,141.80 |
$2,283.60 |
10.9× |
| Us retroperitoneal complete (76770) |
$658.41 |
$1,316.81 |
6.3× |
| Us retroperitoneal limited (76775) |
$1,034.50 |
$2,069 |
9.9× |
| Us scrotum and contents (76870) |
$1,142.80 |
$2,285.60 |
10.9× |
| Us soft tissue head/neck (76536) |
$343.38 |
$686.76 |
3.3× |
| Us spinal canal and contents (76800) |
$2,036.88 |
$4,073.76 |
19.4× |
| Us xtr non-vasc lmtd (76882) |
$1,319.17 |
$2,638.34 |
12.6× |
| Us, eye b-scan (76512) |
$216.06 |
$432.12 |
2.1× |
| Wrist 2 views (73100) |
$448.62 |
$897.24 |
5.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$693.52 |
$1,387.03 |
6.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$604 |
$1,208 |
6.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$522.43 |
$1,044.85 |
6.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$608.81 |
$1,217.62 |
7.0× |
| X-ray exam hip uni 1 view (73501) |
$238.67 |
$477.33 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$549.51 |
$1,099.02 |
6.3× |
| X-ray exam hip uni 4/> views (73503) |
$343.38 |
$686.76 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$343.38 |
$686.76 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$343.38 |
$686.76 |
3.3× |
| X-ray exam of femur 1 (73551) |
$474.70 |
$949.39 |
5.4× |
| X-ray eye for foreign body (70030) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$427.75 |
$855.49 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$547.72 |
$1,095.44 |
6.3× |
| X-ray head for orthodontia (70350) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$805.73 |
$1,611.45 |
7.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,488.24 |
$2,976.48 |
17.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$348.04 |
$696.07 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$683.84 |
$1,367.67 |
6.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$873.40 |
$1,746.80 |
8.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$343.38 |
$686.76 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$503.60 |
$1,007.19 |
5.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$455.08 |
$910.15 |
4.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$343.38 |
$686.76 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$372.50 |
$744.99 |
4.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$550.01 |
$1,100.02 |
5.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$814.02 |
$1,628.03 |
7.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$343.38 |
$686.76 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$394.01 |
$788.01 |
4.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$632 |
$1,264 |
7.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$275.18 |
$550.35 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$343.38 |
$686.76 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$319.48 |
$638.96 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$377.47 |
$754.93 |
4.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$186.36 |
$372.72 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$503.52 |
$1,007.03 |
4.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$399.04 |
$798.07 |
3.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$327.72 |
$655.44 |
3.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$528.33 |
$1,056.66 |
6.0× |
| Xr c-spine 6 or more views (72052) |
$824 |
$1,648 |
7.8× |
| Xr chest 4+ views (71048) |
$716.88 |
$1,433.75 |
6.8× |
| Xr finger(s) 2+ views (73140) |
$396.84 |
$793.67 |
4.5× |
| Xr shoulder 1 view (73020) |
$186.36 |
$372.72 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$493.18 |
$986.36 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$795.06 |
$1,590.11 |
9.1× |
| Xr tmj bilateral (70330) |
$134.13 |
$268.26 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$417.89 |
$835.78 |
4.8× |