| Abdomen 2 views (74019) |
$140.40 |
$234 |
1.4× |
| Arthrogram hip (73525) |
$476.40 |
$794 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$556.80 |
$928 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$954 |
$1,590 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$954 |
$1,590 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$159.60 |
$266 |
1.9× |
| Chest 1 view (71045) |
$144 |
$240 |
1.7× |
| Clavicle complete (73000) |
$140.40 |
$234 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$75 |
$125 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,650.80 |
$4,418 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,067 |
$3,445 |
9.0× |
| CT abdomen w contrast (74160) |
$1,192.20 |
$1,987 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,430.40 |
$2,384 |
8.5× |
| CT abdomen w/o contrast (74150) |
$1,113 |
$1,855 |
11.1× |
| CT angiography upper extremity lt (73206) |
$1,469.40 |
$2,449 |
8.7× |
| CT c-spine w/o contrast (72125) |
$1,113 |
$1,855 |
11.1× |
| CT chest w/wo contrast (71270) |
$1,430.40 |
$2,384 |
8.5× |
| CT chest with contrast (71260) |
$1,113 |
$1,855 |
6.6× |
| CT head/brain with contrast (70460) |
$954 |
$1,590 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,192.20 |
$1,987 |
7.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$66 |
$110 |
0.8× |
| CT iac w contrast (70481) |
$954 |
$1,590 |
5.7× |
| CT lower ext w/o (73700) |
$954 |
$1,590 |
9.5× |
| CT lower extremity w wo contrast (73702) |
$1,012.20 |
$1,687 |
6.0× |
| CT lower extremity with contrast (73701) |
$1,113 |
$1,855 |
6.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,192.20 |
$1,987 |
7.1× |
| CT lumbar spine w/o contrast (72131) |
$1,192.20 |
$1,987 |
11.9× |
| CT maxillofacial w contrast (70487) |
$954 |
$1,590 |
5.7× |
| CT maxillofacial w/o contrast (70486) |
$954 |
$1,590 |
9.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,113 |
$1,855 |
6.6× |
| CT neck soft tissue w contrast (70491) |
$1,113 |
$1,855 |
6.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,192.20 |
$1,987 |
7.1× |
| CT orbits w/o contrast (70480) |
$954 |
$1,590 |
9.5× |
| CT pelvis w & w/o contrast (72194) |
$1,272.60 |
$2,121 |
7.5× |
| CT pelvis w/o contrast (72192) |
$954 |
$1,590 |
9.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$220.80 |
$368 |
2.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,192.20 |
$1,987 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$874.80 |
$1,458 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,192.20 |
$1,987 |
11.9× |
| CT thorax w/o contrast (71250) |
$954 |
$1,590 |
9.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$954 |
$1,590 |
5.7× |
| CT upper extremity w/o contrast rt (73200) |
$954 |
$1,590 |
9.5× |
| CT upper extremity with contrast (73201) |
$954 |
$1,590 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,590 |
$2,650 |
9.4× |
| Cta Abdomen (74175) |
$1,590 |
$2,650 |
9.4× |
| CTA abdomen pelvis (74174) |
$2,650.80 |
$4,418 |
7.9× |
| CTA chest (71275) |
$1,469.40 |
$2,449 |
8.7× |
| Cta Head (70496) |
$1,469.40 |
$2,449 |
8.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,469.40 |
$2,449 |
8.7× |
| Cta Neck (70498) |
$1,469.40 |
$2,449 |
8.7× |
| Cta Pelvis (72191) |
$1,590 |
$2,650 |
9.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$90.60 |
$151 |
0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$103.80 |
$173 |
1.2× |
| Forearm 2 views (73090) |
$159.60 |
$266 |
1.9× |
| Hand 3 views (73130) |
$159.60 |
$266 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,023 |
$1,705 |
2.0× |
| Ht muscle image spect sing (78451) |
$2,106.60 |
$3,511 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$159.60 |
$266 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$700.20 |
$1,167 |
1.3× |
| Knee 3 views (73562) |
$179.40 |
$299 |
2.1× |
| MRA head w/o contrast (70544) |
$1,430.40 |
$2,384 |
6.2× |
| MRA neck w/o contrast (70547) |
$1,231.50 |
$2,052.50 |
5.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,514.40 |
$2,524 |
4.5× |
| MRI abdomen w/o contrast (74181) |
$1,192.20 |
$1,987 |
5.2× |
| MRI c-spine with contrast (72142) |
$976.80 |
$1,628 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$1,363.20 |
$2,272 |
5.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,363.20 |
$2,272 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,135.80 |
$1,893 |
4.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,818 |
$3,030 |
5.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,430.40 |
$2,384 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$1,192.20 |
$1,987 |
5.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,514.40 |
$2,524 |
4.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,514.40 |
$2,524 |
4.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,893 |
$3,155 |
5.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$976.80 |
$1,628 |
2.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,666.20 |
$2,777 |
5.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,135.80 |
$1,893 |
3.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,514.40 |
$2,524 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,430.40 |
$2,384 |
6.2× |
| MRI tmj (70336) |
$1,135.80 |
$1,893 |
4.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,363.20 |
$2,272 |
5.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,514.40 |
$2,524 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,363.20 |
$2,272 |
5.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,106.60 |
$3,511 |
1.7× |
| Neck soft tissue (70360) |
$140.40 |
$234 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$140.40 |
$234 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,514.40 |
$2,524 |
4.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$212.70 |
$354.50 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$199.80 |
$333 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$140.40 |
$234 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$223.20 |
$372 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$121.50 |
$202.50 |
1.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$169.50 |
$282.50 |
2.0× |
| Radiological examination surgical specimen (76098) |
$96.60 |
$161 |
0.2× |
| Ribs bilateral 3 views (71110) |
$199.80 |
$333 |
2.0× |
| Sacroiliac Joints < 3 Views (72200) |
$159.60 |
$266 |
1.6× |
| Scapula complete (73010) |
$140.40 |
$234 |
1.4× |
| Spine thoracic 3 views (72072) |
$219 |
$365 |
2.2× |
| Thyroid uptake measurement (78012) |
$478.50 |
$797.50 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$318.60 |
$531 |
3.2× |
| Us breast unilateral complete (76641) |
$268.80 |
$448 |
2.7× |
| Us chest (76604) |
$331.20 |
$552 |
3.3× |
| Us pelvic non ob complete (76856) |
$378 |
$630 |
3.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$378 |
$630 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$224.10 |
$373.50 |
2.2× |
| Us retroperitoneal complete (76770) |
$387.90 |
$646.50 |
3.9× |
| Us retroperitoneal limited (76775) |
$397.80 |
$663 |
4.0× |
| Us scrotum and contents (76870) |
$357.60 |
$596 |
3.6× |
| Us soft tissue head/neck (76536) |
$279 |
$465 |
2.8× |
| Us transrectal (76872) |
$337.80 |
$563 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$337.80 |
$563 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$238.20 |
$397 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$121.80 |
$203 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$140.40 |
$234 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$159.60 |
$266 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$159.60 |
$266 |
1.9× |
| X-ray exam hip uni 1 view (73501) |
$259.20 |
$432 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$259.20 |
$432 |
3.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$199.80 |
$333 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$135 |
$225 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$159.60 |
$266 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$120 |
$200 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$238.20 |
$397 |
2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$159.60 |
$266 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$179.40 |
$299 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$334.20 |
$557 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$140.40 |
$234 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$199.80 |
$333 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$199.80 |
$333 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$203.40 |
$339 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$159.60 |
$266 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$179.40 |
$299 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$162.60 |
$271 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$310.20 |
$517 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$127.20 |
$212 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$120 |
$200 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$159.60 |
$266 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$279 |
$465 |
2.8× |
| Xr finger(s) 2+ views (73140) |
$120 |
$200 |
1.4× |
| Xr shoulder 1 view (73020) |
$159.60 |
$266 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$294.60 |
$491 |
2.9× |
| Xr tibia/fibula 2 views (73590) |
$159.60 |
$266 |
1.9× |
| Xr tmj bilateral (70330) |
$199.80 |
$333 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$159.60 |
$266 |
1.9× |