| Abdomen 2 views (74019) |
$370.98 |
$458 |
3.4× |
| Ankle 2 views (73600) |
$137.70 |
$170 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,183.41 |
$1,461 |
2.9× |
| Bone &/joint imaging whole body (78306) |
$1,613.52 |
$1,992 |
3.9× |
| Bone age studies (77072) |
$179.01 |
$221 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$370.98 |
$458 |
4.1× |
| Chest 1 view (71045) |
$302.94 |
$374 |
3.4× |
| Chest xray 3 views (71047) |
$289.17 |
$357 |
3.2× |
| Clavicle complete (73000) |
$310.23 |
$383 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,094.31 |
$1,351 |
10.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,596.40 |
$4,440 |
10.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,649.05 |
$4,505 |
14.8× |
| CT abdomen w contrast (74160) |
$2,903.85 |
$3,585 |
16.0× |
| CT abdomen w wo contrast (74170) |
$3,138.75 |
$3,875 |
17.3× |
| CT abdomen w/o contrast (74150) |
$2,345.76 |
$2,896 |
21.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,321.92 |
$1,632 |
7.3× |
| CT angiography upper extremity lt (73206) |
$643.95 |
$795 |
3.6× |
| CT c-spine w/o contrast (72125) |
$2,345.76 |
$2,896 |
21.7× |
| CT chest w contrast (71260) |
$2,905.47 |
$3,587 |
16.0× |
| CT chest w/wo contrast (71270) |
$978.48 |
$1,208 |
5.4× |
| CT colonography screening (74263) |
$2,833.38 |
$3,498 |
11.5× |
| CT head/brain with contrast (70460) |
$2,890.89 |
$3,569 |
16.0× |
| CT head/brain without and with contrast (70470) |
$3,123.36 |
$3,856 |
17.3× |
| CT iac w contrast (70481) |
$906.39 |
$1,119 |
5.0× |
| CT lower ext w/o (73700) |
$2,345.76 |
$2,896 |
21.7× |
| CT lower extremity w wo contrast (73702) |
$1,050.57 |
$1,297 |
5.8× |
| CT lower extremity w/contrast material (73701) |
$2,289.06 |
$2,826 |
12.6× |
| CT lumbar spine w & w/o contrast (72133) |
$3,645 |
$4,500 |
20.1× |
| CT lumbar spine w/contrast (72132) |
$2,833.38 |
$3,498 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$2,345.76 |
$2,896 |
21.7× |
| CT maxillofacial w contrast (70487) |
$2,835 |
$3,500 |
15.7× |
| CT maxillofacial wo contrast (70486) |
$2,345.76 |
$2,896 |
21.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,190.70 |
$1,470 |
6.6× |
| CT orbits w/o contrast (70480) |
$2,345.76 |
$2,896 |
21.7× |
| CT pelvis w/o contrast (72192) |
$2,334.42 |
$2,882 |
21.6× |
| CT soft tissue neck w contrast (70491) |
$2,905.47 |
$3,587 |
16.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$978.48 |
$1,208 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$604.26 |
$746 |
5.6× |
| CT thoracic spine w/contrast (72129) |
$1,783.62 |
$2,202 |
9.9× |
| CT thoracic spine w/o contrast (72128) |
$2,345.76 |
$2,896 |
21.7× |
| CT thorax w/o contrast (71250) |
$2,345.76 |
$2,896 |
21.7× |
| CT unlisted procedure (76497) |
$4,467.15 |
$5,515 |
49.7× |
| CT upper ext wo (73200) |
$2,345.76 |
$2,896 |
21.7× |
| CT upper extremity with contrast (73201) |
$2,345.76 |
$2,896 |
6.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,498.04 |
$3,084 |
13.8× |
| Cta Abdomen (74175) |
$3,559.95 |
$4,395 |
19.7× |
| CTA abdomen pelvis (74174) |
$2,345.76 |
$2,896 |
6.5× |
| CTA chest (71275) |
$3,138.75 |
$3,875 |
17.3× |
| Cta Head (70496) |
$3,139.56 |
$3,876 |
17.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$644.76 |
$796 |
1.8× |
| Cta Neck (70498) |
$3,139.56 |
$3,876 |
17.3× |
| Cta Pelvis (72191) |
$1,240.11 |
$1,531 |
6.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$489.24 |
$604 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$391.23 |
$483 |
4.4× |
| Facial bones min 3 views (70150) |
$468.18 |
$578 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$210.60 |
$260 |
2.0× |
| Fluoroscopy up to 1 hr (76000) |
$507.87 |
$627 |
2.1× |
| Foot 2 views (73620) |
$311.85 |
$385 |
3.5× |
| Forearm 2 views (73090) |
$309.42 |
$382 |
3.4× |
| Hand 2 views (73120) |
$310.23 |
$383 |
2.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,423.98 |
$1,758 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,361.96 |
$2,916 |
5.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$250.70 |
$309.50 |
2.3× |
| Knee 3 views (73562) |
$343.44 |
$424 |
3.8× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,013.20 |
$3,720 |
3.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,767.77 |
$3,417 |
7.7× |
| MRA head w & w/o contrast (70546) |
$2,910.33 |
$3,593 |
8.1× |
| MRA head w/o contrast (70544) |
$3,013.20 |
$3,720 |
12.2× |
| MRA neck w contrast (70548) |
$3,013.20 |
$3,720 |
8.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,954.07 |
$3,647 |
8.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,501.63 |
$4,323 |
9.7× |
| MRI abdomen w/o contrast (74181) |
$2,259.09 |
$2,789 |
9.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,573.83 |
$1,943 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$3,013.20 |
$3,720 |
12.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,086.91 |
$3,811 |
8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,700.54 |
$3,334 |
7.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,767.77 |
$3,417 |
11.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,838.24 |
$3,504 |
11.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,013.20 |
$3,720 |
8.4× |
| MRI pelvis w/contrast (72196) |
$2,674.62 |
$3,302 |
7.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,371.33 |
$1,693 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$2,767.77 |
$3,417 |
11.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,013.20 |
$3,720 |
8.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,370.76 |
$5,396 |
12.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,555.09 |
$4,389 |
9.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,555.09 |
$4,389 |
9.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,779.11 |
$3,431 |
11.3× |
| MRI up ext w/o contrast (73218) |
$2,767.77 |
$3,417 |
11.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,823.66 |
$3,486 |
11.5× |
| MRI, joint upper extrem combo (73223) |
$2,281.77 |
$2,817 |
6.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,701.81 |
$2,101 |
1.3× |
| Neck soft tissue (70360) |
$235.71 |
$291 |
2.6× |
| Nm gastric emptying study (78264) |
$1,069.20 |
$1,320 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$237.33 |
$293 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,220.67 |
$1,507 |
2.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$310.23 |
$383 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$310.23 |
$383 |
3.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$314.28 |
$388 |
3.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$351.54 |
$434 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$385.56 |
$476 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$239.76 |
$296 |
2.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$343.44 |
$424 |
3.8× |
| Radex Hand Minimum 3 Views (73130) |
$317.52 |
$392 |
3.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$223.56 |
$276 |
2.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$339.39 |
$419 |
3.1× |
| Radex Humerus Minimum 2 Views (73060) |
$310.23 |
$383 |
3.5× |
| Radex Kne 1/2 Views (73560) |
$257.58 |
$318 |
2.9× |
| Radex Kne Compl 4/More Views (73564) |
$417.15 |
$515 |
3.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$324 |
$400 |
3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$387.18 |
$478 |
4.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$478.71 |
$591 |
4.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$310.23 |
$383 |
3.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$413.10 |
$510 |
4.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$273.78 |
$338 |
2.5× |
| Radex Toe Minimum 2 Views (73660) |
$239.76 |
$296 |
2.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$319.14 |
$394 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$303.75 |
$375 |
3.4× |
| Radiologic exam chest 2 views (71046) |
$473.04 |
$584 |
5.3× |
| Radiologic examination femur 1 view (73551) |
$120.69 |
$149 |
1.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$310.23 |
$383 |
3.5× |
| Ribs bilateral 3 views (71110) |
$453.60 |
$560 |
4.2× |
| Sacroiliac Joints < 3 Views (72200) |
$471.42 |
$582 |
4.4× |
| Scapula (73010) |
$302.94 |
$374 |
2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$140.94 |
$174 |
6.0× |
| Shoulder 1 view (73020) |
$226.80 |
$280 |
2.5× |
| Spine thoracic 3 views (72072) |
$443.07 |
$547 |
4.1× |
| Thoracolumbar 2 views (72080) |
$260.01 |
$321 |
2.9× |
| Tmj unilateral (70328) |
$327.24 |
$404 |
3.6× |
| Ultrasound breast complete (76641) |
$283.50 |
$350 |
2.6× |
| Ultrasound Exam Aaa Screen (76706) |
$470.61 |
$581 |
4.4× |
| Ultrasound, abdomen limited (76705) |
$362.07 |
$447 |
3.4× |
| Us breast unilateral limited (76642) |
$290.79 |
$359 |
3.2× |
| Us chest (76604) |
$210.60 |
$260 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$352.35 |
$435 |
3.3× |
| Us encephalogram (76506) |
$235.71 |
$291 |
2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$356 |
$439.50 |
3.3× |
| Us ob limited (76815) |
$372.60 |
$460 |
3.5× |
| Us ob transvaginal (76817) |
$391.23 |
$483 |
3.6× |
| Us pelvic non ob complete (76856) |
$400.95 |
$495 |
3.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$255.15 |
$315 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$400.95 |
$495 |
3.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$307.80 |
$380 |
2.9× |
| Us retroperitoneal complete (76770) |
$481.14 |
$594 |
4.5× |
| Us retroperitoneal limited (76775) |
$481.14 |
$594 |
4.5× |
| Us scrotum and contents (76870) |
$387.99 |
$479 |
3.6× |
| Us soft tissue head/neck (76536) |
$353.16 |
$436 |
3.3× |
| Us, eye b-scan (76512) |
$107.73 |
$133 |
1.0× |
| Us,transplanted kidney, real time/ doppler (76776) |
$470.61 |
$581 |
4.4× |
| Wrist 2 views (73100) |
$310.23 |
$383 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$284.31 |
$351 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$440.64 |
$544 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$310.23 |
$383 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$370.98 |
$458 |
4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$324.81 |
$401 |
3.0× |
| X-ray exam of femur 2/> (73552) |
$310.23 |
$383 |
3.5× |
| X-ray eye for foreign body (70030) |
$367.74 |
$454 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$255.96 |
$316 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$294.84 |
$364 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$461.70 |
$570 |
5.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$339.39 |
$419 |
3.1× |
| X-ray optic foramen (70190) |
$55.89 |
$69 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$371.79 |
$459 |
4.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$673.92 |
$832 |
6.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$353.97 |
$437 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$242.19 |
$299 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$459.27 |
$567 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$300.51 |
$371 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$75.16 |
$92.79 |
0.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$264.06 |
$326 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$95.58 |
$118 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$127.17 |
$157 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$310.23 |
$383 |
3.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$364.50 |
$450 |
3.4× |
| Xr c-spine 4 or 5 views (72050) |
$564.57 |
$697 |
5.2× |
| Xr c-spine 6 or more views (72052) |
$564.57 |
$697 |
5.2× |