| Abdomen 1 View (74018) |
$607 |
$607 |
5.6× |
| Abdomen 2 views (74019) |
$680 |
$680 |
5.2× |
| Ankle 2 views (73600) |
$481 |
$481 |
4.4× |
| Bone age studies (77072) |
$456 |
$456 |
3.5× |
| Cat Scan Follow-Up Study (76380) |
$1,692 |
$1,692 |
15.6× |
| Chest 1 view (71045) |
$365 |
$365 |
3.4× |
| Chest 2 views (71046) |
$657 |
$657 |
6.0× |
| Chest 3 views (71047) |
$907 |
$907 |
8.3× |
| Chest 4 or more views (71048) |
$731 |
$731 |
5.6× |
| Clavicle complete (73000) |
$608 |
$608 |
5.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,042 |
$2,042 |
15.6× |
| Contrast X-Ray Bladder (74430) |
$565 |
$565 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,371 |
$5,371 |
12.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,339 |
$3,339 |
11.2× |
| CT abdomen w contrast (74160) |
$3,816 |
$3,816 |
17.4× |
| CT abdomen w wo contrast (74170) |
$3,619 |
$3,619 |
16.5× |
| CT abdomen w/o contrast (74150) |
$2,250 |
$2,250 |
17.2× |
| CT Angio Abdomen and Pelvis (74174) |
$4,308 |
$4,308 |
9.9× |
| CT Angio Chest (71275) |
$4,952 |
$4,952 |
22.6× |
| CT Angio Head (70496) |
$4,308 |
$4,308 |
19.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,644 |
$3,644 |
16.6× |
| CT Angio Neck (70498) |
$4,308 |
$4,308 |
19.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,102 |
$4,102 |
18.7× |
| CT cervical spine w/ contrast (72126) |
$2,914 |
$2,914 |
6.7× |
| CT cervical spine w/o contrast (72125) |
$2,260 |
$2,260 |
17.3× |
| CT cervical spine w/wo cont (72127) |
$3,088 |
$3,088 |
14.1× |
| CT chest w contrast (71260) |
$2,571 |
$2,571 |
11.7× |
| CT chest w/wo contrast (71270) |
$2,826 |
$2,826 |
12.9× |
| CT head/brain with contrast (70460) |
$2,376 |
$2,376 |
10.9× |
| CT head/brain without and with contrast (70470) |
$3,071 |
$3,071 |
14.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$215 |
$215 |
2.0× |
| CT iac w contrast (70481) |
$3,549 |
$3,549 |
16.2× |
| CT l-spine w&w/o contrast (72133) |
$3,088 |
$3,088 |
14.1× |
| CT lower ext w/o (73700) |
$2,006 |
$2,006 |
15.4× |
| CT lower extremity w/contrast material (73701) |
$2,455 |
$2,455 |
11.2× |
| CT lumbar spine w contrast (72132) |
$2,796 |
$2,796 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$2,260 |
$2,260 |
17.3× |
| CT maxillofacial w contrast (70487) |
$2,362 |
$2,362 |
10.8× |
| CT maxillofacial wo contrast (70486) |
$2,362 |
$2,362 |
18.1× |
| CT neck tissue combo (70492) |
$3,594 |
$3,594 |
16.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,031 |
$3,031 |
13.8× |
| CT orbits w/o contrast (70480) |
$3,031 |
$3,031 |
23.2× |
| CT pelvis w&w/o contrast (72194) |
$3,967 |
$3,967 |
18.1× |
| CT pelvis w/o contrast (72192) |
$2,260 |
$2,260 |
17.3× |
| CT scan of leg combo (73702) |
$2,627 |
$2,627 |
12.0× |
| CT scans face/jaw combo (70488) |
$2,658 |
$2,658 |
12.1× |
| CT soft tissue neck w contrast (70491) |
$3,402 |
$3,402 |
15.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,006 |
$2,006 |
15.4× |
| CT thoracic spine w contrast (72129) |
$2,796 |
$2,796 |
12.8× |
| CT thoracic spine w/o contrast (72128) |
$2,260 |
$2,260 |
17.3× |
| CT thorax w/o contrast (71250) |
$2,042 |
$2,042 |
15.6× |
| CT upper ext wo (73200) |
$3,031 |
$3,031 |
23.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,397 |
$3,397 |
15.5× |
| CT upper extremity with contrast (73201) |
$2,557 |
$2,557 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,866 |
$4,866 |
22.2× |
| Cta Abdomen (74175) |
$4,308 |
$4,308 |
19.7× |
| CTA pelvis (72191) |
$1,986 |
$1,986 |
9.1× |
| Dxa Bone Density Axial (77080) |
$904 |
$904 |
6.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$323 |
$323 |
3.0× |
| Esophagram (74220) |
$969 |
$969 |
4.4× |
| Fluoroscopy up to 1 hr (76000) |
$915 |
$915 |
3.1× |
| Foot 2 views (73620) |
$421 |
$421 |
3.9× |
| Forearm 2 views (73090) |
$608 |
$608 |
5.6× |
| Hand 2 views (73120) |
$526 |
$526 |
4.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$623 |
$623 |
5.7× |
| Knee 3 Views (73562) |
$657 |
$657 |
6.0× |
| Magnetic Image Jaw Joint (70336) |
$4,290 |
$4,290 |
14.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$6,218 |
$6,218 |
14.3× |
| MRA head w/o contrast (70544) |
$4,413 |
$4,413 |
14.8× |
| MRA head with contrast (70545) |
$5,187 |
$5,187 |
11.9× |
| MRA neck w contrast (70548) |
$5,187 |
$5,187 |
11.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,218 |
$6,218 |
14.3× |
| MRA neck w/o contrast (70547) |
$4,413 |
$4,413 |
14.8× |
| MRI abdomen w contrast (74182) |
$6,176 |
$6,176 |
14.2× |
| MRI abdomen w/o contrast (74181) |
$3,661 |
$3,661 |
12.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,246 |
$3,246 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,802 |
$5,802 |
13.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,497 |
$2,497 |
2.6× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$4,234 |
$4,234 |
14.2× |
| MRI cervical spine w contrast (72142) |
$6,310 |
$6,310 |
14.5× |
| MRI cervical spine w/o cont (72141) |
$3,697 |
$3,697 |
12.4× |
| MRI chest w/o contrast (71550) |
$7,049 |
$7,049 |
23.7× |
| MRI chest with contrast (71551) |
$7,409 |
$7,409 |
7.6× |
| MRI chest wo w contrast (71552) |
$7,650 |
$7,650 |
17.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,817 |
$4,817 |
11.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,942 |
$5,942 |
13.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,571 |
$4,571 |
15.3× |
| MRI lumbar spine w contrast (72149) |
$6,535 |
$6,535 |
15.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$7,580 |
$7,580 |
17.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,446 |
$5,446 |
18.3× |
| MRI orbit face neck w contrast (70542) |
$6,265 |
$6,265 |
14.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$7,205 |
$7,205 |
16.5× |
| MRI pelvis w contrast (72196) |
$6,458 |
$6,458 |
14.8× |
| MRI pelvis w/o & w contrast (72197) |
$7,746 |
$7,746 |
17.8× |
| MRI pelvis w/o contrast (72195) |
$5,611 |
$5,611 |
18.8× |
| MRI thoracic spine w/o contrast (72146) |
$4,034 |
$4,034 |
13.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$5,433 |
$5,433 |
12.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,654 |
$3,654 |
12.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,158 |
$5,158 |
11.8× |
| MRI, abdomen, combo (74183) |
$7,283 |
$7,283 |
16.7× |
| MRI, dorsal spine combo (72157) |
$8,253 |
$8,253 |
19.0× |
| MRI, dorsal spine contrast (72147) |
$5,433 |
$5,433 |
12.5× |
| MRI, joint upper extrem (73221) |
$4,189 |
$4,189 |
14.1× |
| MRI, joint upper extrem combo (73223) |
$5,792 |
$5,792 |
13.3× |
| MRI, lumbar spine combo (72158) |
$7,847 |
$7,847 |
18.0× |
| Neck soft tissue (70360) |
$545 |
$545 |
5.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$477 |
$477 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$526 |
$526 |
4.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$788 |
$788 |
6.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$972 |
$972 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$608 |
$608 |
5.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$579 |
$579 |
5.3× |
| Radex elbow complete minimum 3 views (73080) |
$639 |
$639 |
5.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$640 |
$640 |
4.9× |
| Radex fingr minimum 2 views (73140) |
$481 |
$481 |
4.4× |
| Radex foot complete minimum 3 views (73630) |
$699 |
$699 |
6.4× |
| Radex Hand Minimum 3 Views (73130) |
$608 |
$608 |
5.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$416 |
$416 |
3.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$814 |
$814 |
6.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$545 |
$545 |
5.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$731 |
$731 |
6.7× |
| Radex shoulder complete minimum 2 views (73030) |
$671 |
$671 |
6.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$392 |
$392 |
3.6× |
| Radex Spine 1 View Specify Level (72020) |
$454 |
$454 |
4.2× |
| Radex Sternum Minimum 2 Views (71120) |
$572 |
$572 |
5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$814 |
$814 |
7.5× |
| Radex Toe Minimum 2 Views (73660) |
$481 |
$481 |
4.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$424 |
$424 |
3.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$608 |
$608 |
5.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,272 |
$1,272 |
9.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$657 |
$657 |
5.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$680 |
$680 |
5.2× |
| Radiologic exam colon double contrast study (74280) |
$1,460 |
$1,460 |
6.7× |
| Radiologic exam colon single contrast study (74270) |
$1,275 |
$1,275 |
5.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,816 |
$1,816 |
8.3× |
| Radiologic exam knee complete 4/more views (73564) |
$868 |
$868 |
6.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$640 |
$640 |
4.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$820 |
$820 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,245 |
$1,245 |
5.7× |
| Radiologic examination femur 1 view (73551) |
$482 |
$482 |
4.4× |
| Radiologic examination femur minimum 2 views (73552) |
$676 |
$676 |
6.2× |
| Radiologic examination knee 1/2 views (73560) |
$556 |
$556 |
5.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$608 |
$608 |
5.6× |
| Ribs bilateral 3 views (71110) |
$921 |
$921 |
7.1× |
| Scapula (73010) |
$689 |
$689 |
5.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$95 |
$95 |
4.1× |
| Shoulder 1 view (73020) |
$481 |
$481 |
4.4× |
| Skull less than 4 views (70250) |
$513 |
$513 |
3.9× |
| Sternoclavicular joints (71130) |
$515 |
$515 |
4.7× |
| Thoracic spine 2 views (72070) |
$820 |
$820 |
6.3× |
| Thoracic spine 3 views (72072) |
$608 |
$608 |
4.7× |
| Thoracolumbar 2 views (72080) |
$1,010 |
$1,010 |
9.3× |
| Ultrasound Breast Limited (76642) |
$421 |
$421 |
3.9× |
| Ultrasound Exam Aaa Screen (76706) |
$132 |
$132 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$731 |
$731 |
5.6× |
| Upper gi w/o kub (74240) |
$1,275 |
$1,275 |
5.8× |
| Urethrocystogram voiding (74455) |
$972 |
$972 |
3.3× |
| Us breast unilateral complete (76641) |
$820 |
$820 |
6.3× |
| Us chest (76604) |
$731 |
$731 |
5.6× |
| Us complete joint (76881) |
$820 |
$820 |
6.3× |
| Us exam, pelvic, limited (76857) |
$1,028 |
$1,028 |
7.9× |
| Us kidney transplant (76776) |
$127 |
$127 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$861 |
$861 |
6.6× |
| Us ob limited 1 or more fetuses (76815) |
$740 |
$740 |
5.7× |
| Us ob transvaginal (76817) |
$570 |
$570 |
4.4× |
| Us pelvic non ob complete (76856) |
$1,225 |
$1,225 |
9.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$570 |
$570 |
4.4× |
| Us retroperitoneal complete (76770) |
$1,231 |
$1,231 |
9.4× |
| Us retroperitoneal limited (76775) |
$1,028 |
$1,028 |
7.9× |
| Us scrotum and contents (76870) |
$915 |
$915 |
7.0× |
| Us thyroid (76536) |
$820 |
$820 |
6.3× |
| Wrist 2 views (73100) |
$608 |
$608 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$601 |
$601 |
5.5× |
| X-ray antegrade pyelogram tube (74425) |
$972 |
$972 |
2.2× |
| X-Ray Bend Only L-S Spine (72120) |
$800 |
$800 |
6.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$456 |
$456 |
4.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$458 |
$458 |
4.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$937 |
$937 |
7.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$1,143 |
$1,143 |
8.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$488 |
$488 |
4.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$912 |
$912 |
8.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$1,053 |
$1,053 |
8.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$1,177 |
$1,177 |
9.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,294 |
$1,294 |
9.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,403 |
$1,403 |
10.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,067 |
$1,067 |
8.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$512 |
$512 |
4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,162 |
$1,162 |
8.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$820 |
$820 |
6.3× |
| X-ray eye for foreign body (70030) |
$608 |
$608 |
5.6× |
| X-ray humerus (73060) |
$556 |
$556 |
5.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$454 |
$454 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$516 |
$516 |
4.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$572 |
$572 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$879 |
$879 |
8.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$892 |
$892 |
6.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$699 |
$699 |
5.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$608 |
$608 |
4.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$608 |
$608 |
5.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$724 |
$724 |
6.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$871 |
$871 |
6.7× |
| X-Ray Stress View (77071) |
$671 |
$671 |
6.2× |
| X-ray thoracic spine 4 vw (72074) |
$882 |
$882 |
6.8× |
| X-Ray Tmj Unilat (70328) |
$363 |
$363 |
3.3× |
| X-Rays Bone Length Studies (77073) |
$771 |
$771 |
5.9× |
| X-Rays Bone Survey Complete (77075) |
$1,412 |
$1,412 |
10.8× |
| Xr c-spine 4 or 5 views (72050) |
$996 |
$996 |
7.6× |
| Xr facial bones less than 3 views (70140) |
$456 |
$456 |
4.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$456 |
$456 |
3.5× |
| Xr orbits complete 4 views (70200) |
$609 |
$609 |
4.7× |