| Abdomen 2 views (74019) |
$100.56 |
$118.30 |
1.0× |
| Ankle 2 views (73600) |
$84.92 |
$99.90 |
1.1× |
| Bone age studies (77072) |
$42.50 |
$50 |
0.4× |
| Bone survey complete (77075) |
$748 |
$880 |
7.8× |
| Cervical spine 2 or 3 views (72040) |
$178.50 |
$210 |
2.2× |
| Chest 1 view (71045) |
$69.70 |
$82 |
0.9× |
| Chest 3 views (71047) |
$143.99 |
$169.40 |
1.8× |
| Clavicle complete (73000) |
$127.50 |
$150 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$501.50 |
$590 |
5.2× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$128.86 |
$151.60 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$595 |
$700 |
1.9× |
| CT abdomen and pelvis without contrast (74176) |
$501.50 |
$590 |
2.3× |
| CT abdomen w contrast (74160) |
$548.25 |
$645 |
3.4× |
| CT abdomen w wo contrast (74170) |
$595 |
$700 |
3.7× |
| CT abdomen w/o contrast (74150) |
$501.50 |
$590 |
5.2× |
| CT c-spine w/o contrast (72125) |
$501.50 |
$590 |
5.2× |
| CT cervical spine w&w/o contrast (72127) |
$595 |
$700 |
3.7× |
| CT cervical spine with contrast (72126) |
$548.25 |
$645 |
1.7× |
| CT chest w/wo contrast (71270) |
$595 |
$700 |
3.7× |
| CT chest with contrast (71260) |
$501.50 |
$590 |
3.1× |
| CT head/brain with contrast (70460) |
$548.25 |
$645 |
3.4× |
| CT head/brain without and with contrast (70470) |
$595 |
$700 |
3.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$501.50 |
$590 |
6.3× |
| CT iac w contrast (70481) |
$548.25 |
$645 |
3.4× |
| CT lower ext w/o (73700) |
$501.50 |
$590 |
5.2× |
| CT lower extremity w wo contrast (73702) |
$595 |
$700 |
3.7× |
| CT lower extremity with contrast (73701) |
$548.25 |
$645 |
3.4× |
| CT lumbar spine w & w/o contrast (72133) |
$595 |
$700 |
3.7× |
| CT lumbar spine w/o contrast (72131) |
$501.50 |
$590 |
5.2× |
| CT lumbar spine with contrast (72132) |
$548.25 |
$645 |
1.7× |
| CT maxillofacial w contrast (70487) |
$548.25 |
$645 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$501.50 |
$590 |
5.2× |
| CT maxillofacial w/wo contrast (70488) |
$595 |
$700 |
3.7× |
| CT neck soft tissue w contrast (70491) |
$548.25 |
$645 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$595 |
$700 |
3.7× |
| CT orbits w/o contrast (70480) |
$501.50 |
$590 |
5.2× |
| CT pelvis w & w/o contrast (72194) |
$595 |
$700 |
3.7× |
| CT pelvis w/o contrast (72192) |
$501.50 |
$590 |
5.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$595 |
$700 |
3.7× |
| CT soft tissue neck w/o contrast (70490) |
$501.50 |
$590 |
5.2× |
| CT thoracic spine w/contrast (72129) |
$548.25 |
$645 |
3.4× |
| CT thoracic spine w/o contrast (72128) |
$501.50 |
$590 |
5.2× |
| CT thoracic spine w/wo contrast (72130) |
$595 |
$700 |
3.7× |
| CT thorax w/o contrast (71250) |
$501.50 |
$590 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$595 |
$700 |
3.7× |
| CT upper extremity w/o contrast rt (73200) |
$501.50 |
$590 |
5.2× |
| CT upper extremity with contrast (73201) |
$548.25 |
$645 |
1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,224 |
$1,440 |
7.6× |
| Cta Abdomen (74175) |
$1,224 |
$1,440 |
7.6× |
| CTA abdomen pelvis (74174) |
$1,870 |
$2,200 |
5.8× |
| CTA chest (71275) |
$1,253.75 |
$1,475 |
7.8× |
| Cta Head (70496) |
$1,224 |
$1,440 |
7.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,448 |
$2,880 |
7.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,190 |
$1,400 |
7.4× |
| Cta Neck (70498) |
$1,224 |
$1,440 |
7.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$202.30 |
$238 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$225.25 |
$265 |
2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$55.25 |
$65 |
0.7× |
| Foot 2 views (73620) |
$84.92 |
$99.90 |
1.1× |
| Forearm 2 views (73090) |
$140.25 |
$165 |
1.8× |
| Hand 2 views (73120) |
$82.45 |
$97 |
0.9× |
| Hand 3 views (73130) |
$153 |
$180 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$153 |
$180 |
1.9× |
| Knee 3 views (73562) |
$165.75 |
$195 |
2.1× |
| MRA head w & w/o contrast (70546) |
$537.20 |
$632 |
1.7× |
| MRA head w/o contrast (70544) |
$537.20 |
$632 |
2.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$452.20 |
$532 |
1.4× |
| MRA neck w/o contrast (70547) |
$684.25 |
$805 |
3.1× |
| MRI abdomen w contrast (74182) |
$452.20 |
$532 |
1.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$637.50 |
$750 |
2.0× |
| MRI abdomen w/o contrast (74181) |
$452.20 |
$532 |
2.1× |
| MRI any jnt lwr ext with con lt (73722) |
$452.20 |
$532 |
0.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$452.20 |
$532 |
0.6× |
| MRI cervical spine w/o contrast (72141) |
$578 |
$680 |
2.6× |
| MRI chest w/o & w/contrast material (71552) |
$452.20 |
$532 |
1.4× |
| MRI chest with contrast (71551) |
$452.20 |
$532 |
0.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$452.20 |
$532 |
1.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$452.20 |
$532 |
2.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$578 |
$680 |
2.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$544 |
$640 |
1.7× |
| MRI pelvis w contrast (72196) |
$452.20 |
$532 |
1.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$452.20 |
$532 |
1.4× |
| MRI pelvis w/o contrast (72195) |
$452.20 |
$532 |
2.1× |
| MRI scan of arm joint before and after contrast (73223) |
$452.20 |
$532 |
1.4× |
| MRI scan of leg joint before and after contrast (73723) |
$452.20 |
$532 |
1.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$452.20 |
$532 |
1.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$459 |
$540 |
1.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$637.50 |
$750 |
2.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$452.20 |
$532 |
1.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$637.50 |
$750 |
2.0× |
| MRI thoracic spine w/o contrast (72146) |
$452.20 |
$532 |
2.1× |
| MRI upper ext joint w/o contrast (73221) |
$578 |
$680 |
2.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$452.20 |
$532 |
1.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$452.20 |
$532 |
2.1× |
| Neck soft tissue (70360) |
$70.13 |
$82.50 |
0.9× |
| Nm gastric emptying study (78264) |
$1,874.25 |
$2,205 |
5.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$123.25 |
$145 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$140.25 |
$165 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$452.20 |
$532 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$97.58 |
$114.80 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$276.34 |
$325.10 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$167.20 |
$196.70 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$314.67 |
$370.20 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$233.75 |
$275 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$70.55 |
$83 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$129.54 |
$152.40 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$191 |
$224.70 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$191.42 |
$225.20 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$80.71 |
$94.95 |
1.0× |
| Ribs bilateral 3 views (71110) |
$148.75 |
$175 |
1.5× |
| Sacroiliac Joints < 3 Views (72200) |
$123.08 |
$144.80 |
1.3× |
| Scapula complete (73010) |
$131.75 |
$155 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$34 |
$40 |
1.5× |
| Sella turcica (70240) |
$82.45 |
$97 |
1.0× |
| Small bowel series (74250) |
$185.81 |
$218.60 |
1.2× |
| Speech evaluation complex (70371) |
$1,256.47 |
$1,478.20 |
5.7× |
| Spine thoracic 3 views (72072) |
$221 |
$260 |
2.3× |
| Tmj unilateral (70328) |
$150.88 |
$177.50 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$140.25 |
$165 |
1.5× |
| Upper Extremity Infant (73092) |
$82.45 |
$97 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$306.43 |
$360.50 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$161.50 |
$190 |
1.7× |
| Us breast unilateral complete (76641) |
$123.25 |
$145 |
1.3× |
| Us breast unilateral limited (76642) |
$123.25 |
$145 |
1.5× |
| Us chest (76604) |
$170 |
$200 |
1.8× |
| Us compl joint r-t w/image documentation (76881) |
$141.10 |
$166 |
1.5× |
| Us ob detailed single fetus (76811) |
$267.75 |
$315 |
1.2× |
| Us ob transvaginal (76817) |
$233.75 |
$275 |
2.4× |
| Us pelvic non ob complete (76856) |
$161.50 |
$190 |
1.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$123.25 |
$145 |
1.3× |
| Us pregnancy ltd (76815) |
$123.25 |
$145 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$161.50 |
$190 |
1.7× |
| Us retroperitoneal complete (76770) |
$174.25 |
$205 |
1.8× |
| Us retroperitoneal limited (76775) |
$136 |
$160 |
1.4× |
| Us scrotum and contents (76870) |
$144.50 |
$170 |
1.5× |
| Us soft tissue head/neck (76536) |
$535.50 |
$630 |
5.6× |
| Us xtr non-vasc lmtd (76882) |
$141.10 |
$166 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$204.26 |
$240.30 |
0.1× |
| Wrist 2 views (73100) |
$84.92 |
$99.90 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$297.50 |
$350 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$163.71 |
$192.60 |
2.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$153 |
$180 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$343.66 |
$404.30 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$153 |
$180 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$165.75 |
$195 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$47.86 |
$56.30 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$84.96 |
$99.95 |
1.1× |
| X-ray exam of femur 1 (73551) |
$84.92 |
$99.90 |
1.1× |
| X-ray eye for foreign body (70030) |
$23.38 |
$27.50 |
0.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$208.25 |
$245 |
2.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$199.75 |
$235 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$148.75 |
$175 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$84.92 |
$99.90 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$156.74 |
$184.40 |
2.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$238 |
$280 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$123.25 |
$145 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$82.45 |
$97 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$191.25 |
$225 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$222.87 |
$262.20 |
2.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$109.14 |
$128.40 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$109.14 |
$128.40 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$148.75 |
$175 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$221 |
$260 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$272 |
$320 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$157.25 |
$185 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$82.45 |
$97 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$212.50 |
$250 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$42.93 |
$50.50 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$142.72 |
$167.90 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$106.85 |
$125.70 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$82.45 |
$97 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$97.58 |
$114.80 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$161.50 |
$190 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$148.75 |
$175 |
1.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$127.50 |
$150 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$119 |
$140 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$157.25 |
$185 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$313.48 |
$368.80 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$119 |
$140 |
1.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$156.74 |
$184.40 |
1.6× |
| Xr optic foramina (70190) |
$42.93 |
$50.50 |
0.5× |
| Xr shoulder 1 view (73020) |
$119 |
$140 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$245.06 |
$288.30 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$157.25 |
$185 |
2.0× |
| Xray knee 1 or 2 views rt (73560) |
$119 |
$140 |
1.5× |