| Abdomen 2 views (74019) |
$385.02 |
$481.27 |
3.7× |
| Arthrogram shoulder (73040) |
$505.60 |
$632 |
1.4× |
| Bone survey complete (77075) |
$1,227.20 |
$1,534 |
11.7× |
| Cervical spine 2 or 3 views (72040) |
$456 |
$570 |
5.2× |
| Chest 1 view (71045) |
$265.60 |
$332 |
3.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$567.20 |
$709 |
3.2× |
| Clavicle complete (73000) |
$376.80 |
$471 |
4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,705.60 |
$2,132 |
16.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,746.40 |
$4,683 |
15.6× |
| CT abdomen w contrast (74160) |
$2,823.20 |
$3,529 |
16.0× |
| CT abdomen w wo contrast (74170) |
$3,112.80 |
$3,891 |
17.7× |
| CT abdomen w/o contrast (74150) |
$2,241.60 |
$2,802 |
21.3× |
| CT c-spine w/o contrast (72125) |
$2,506.49 |
$3,133.11 |
23.9× |
| CT chest with contrast (71260) |
$2,626.40 |
$3,283 |
14.9× |
| CT head/brain with contrast (70460) |
$2,506.40 |
$3,133 |
14.2× |
| CT head/brain without and with contrast (70470) |
$2,796 |
$3,495 |
15.9× |
| CT lower ext w/o (73700) |
$1,790.40 |
$2,238 |
17.0× |
| CT lower extremity with contrast (73701) |
$2,084.80 |
$2,606 |
11.8× |
| CT lumbar spine w/o contrast (72131) |
$2,572.24 |
$3,215.30 |
24.5× |
| CT maxillofacial w contrast (70487) |
$2,658.33 |
$3,322.91 |
15.1× |
| CT maxillofacial w/o contrast (70486) |
$2,501.30 |
$3,126.62 |
23.8× |
| CT maxillofacial w/wo contrast (70488) |
$3,006.40 |
$3,758 |
17.1× |
| CT neck soft tissue w contrast (70491) |
$2,479.20 |
$3,099 |
14.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,637.60 |
$3,297 |
15.0× |
| CT orbits w/o contrast (70480) |
$1,705.60 |
$2,132 |
16.2× |
| CT pelvis w & w/o contrast (72194) |
$2,666.54 |
$3,333.18 |
15.1× |
| CT pelvis w/o contrast (72192) |
$2,269.42 |
$2,836.77 |
21.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,610.40 |
$3,263 |
14.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,984 |
$2,480 |
18.9× |
| CT thoracic spine w/o contrast (72128) |
$2,423.42 |
$3,029.28 |
23.1× |
| CT thorax w/o contrast (71250) |
$2,756.96 |
$3,446.20 |
26.3× |
| CT upper extremity w/o contrast rt (73200) |
$2,000.34 |
$2,500.43 |
19.0× |
| CT upper extremity with contrast (73201) |
$2,200 |
$2,750 |
6.3× |
| CTA chest (71275) |
$2,269.42 |
$2,836.77 |
12.9× |
| Cta Neck (70498) |
$2,269.42 |
$2,836.77 |
12.9× |
| Cystography minimum 3 views rs&i (74430) |
$624 |
$780 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$571.20 |
$714 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$186.40 |
$233 |
2.1× |
| Forearm 2 views (73090) |
$397.60 |
$497 |
4.5× |
| Hand 3 views (73130) |
$331.20 |
$414 |
3.8× |
| Humerus Min 2 Views Left (73060) |
$363.20 |
$454 |
4.2× |
| Knee 3 views (73562) |
$421.60 |
$527 |
4.8× |
| MRA head w & w/o contrast (70546) |
$2,745.60 |
$3,432 |
7.8× |
| MRA head w/o contrast (70544) |
$2,584 |
$3,230 |
10.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,320 |
$2,900 |
6.6× |
| MRA neck w/o contrast (70547) |
$2,523.20 |
$3,154 |
10.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,847.20 |
$4,809 |
11.0× |
| MRI abdomen w/o contrast (74181) |
$1,840 |
$2,300 |
7.7× |
| MRI cervical spine w/o contrast (72141) |
$3,382.94 |
$4,228.67 |
14.1× |
| MRI chest w/o & w/contrast material (71552) |
$3,477.60 |
$4,347 |
9.9× |
| MRI chest w/o contrast (71550) |
$2,080 |
$2,600 |
8.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,094.40 |
$3,868 |
12.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,645.09 |
$4,556.36 |
15.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,009.60 |
$5,012 |
11.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,140.85 |
$5,176.06 |
11.8× |
| MRI pelvis w/o contrast (72195) |
$2,240 |
$2,800 |
9.3× |
| MRI scan of arm joint before and after contrast (73223) |
$3,889.60 |
$4,862 |
11.1× |
| MRI scan of leg joint before and after contrast (73723) |
$3,636 |
$4,545 |
10.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,437.60 |
$5,547 |
12.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,395.22 |
$5,494.02 |
12.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,050.18 |
$6,312.72 |
14.4× |
| MRI thoracic spine w/o contrast (72146) |
$3,463.39 |
$4,329.24 |
14.4× |
| MRI upper ext joint w/o contrast (73221) |
$3,048.80 |
$3,811 |
12.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,159.20 |
$5,199 |
11.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,010.40 |
$3,763 |
12.6× |
| Myelogram Cervical (72240) |
$1,211.20 |
$1,514 |
1.5× |
| Myelogram Lumbar (72265) |
$1,211.20 |
$1,514 |
1.5× |
| Neck soft tissue (70360) |
$289.60 |
$362 |
3.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$348.80 |
$436 |
3.3× |
| Osseous survey infant (77076) |
$147.09 |
$183.86 |
1.4× |
| Osseous survey limited (77074) |
$842.70 |
$1,053.38 |
8.0× |
| Pelvis 1 or 2 views (72170) |
$357.60 |
$447 |
3.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,096 |
$5,120 |
11.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$368 |
$460 |
4.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$428 |
$535 |
4.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$345.60 |
$432 |
3.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$368.80 |
$461 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$892.80 |
$1,116 |
8.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$220.14 |
$275.18 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$307.20 |
$384 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$114.40 |
$143 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$654.40 |
$818 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$362.40 |
$453 |
4.1× |
| Ribs bilateral 3 views (71110) |
$384 |
$480 |
3.7× |
| Sacroiliac Joints < 3 Views (72200) |
$378.40 |
$473 |
3.6× |
| Scanogram (77073) |
$708.60 |
$885.75 |
6.7× |
| Scapula complete (73010) |
$300.80 |
$376 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$760 |
$950 |
7.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$852.80 |
$1,066 |
4.8× |
| Us abdl aorta screen aaa (76706) |
$730.23 |
$912.79 |
7.0× |
| Us breast unilateral complete (76641) |
$615.16 |
$768.95 |
5.9× |
| Us compl joint r-t w/image documentation (76881) |
$574.40 |
$718 |
5.5× |
| Us pelvic non ob complete (76856) |
$880.80 |
$1,101 |
8.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$719.20 |
$899 |
6.8× |
| Us pregnancy ltd (76815) |
$301.60 |
$377 |
2.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$596.80 |
$746 |
5.7× |
| Us retroperitoneal complete (76770) |
$744.80 |
$931 |
7.1× |
| Us retroperitoneal limited (76775) |
$579.20 |
$724 |
5.5× |
| Us scrotum and contents (76870) |
$889.42 |
$1,111.78 |
8.5× |
| Us soft tissue head/neck (76536) |
$773.60 |
$967 |
7.4× |
| Us xtr non-vasc lmtd (76882) |
$494.40 |
$618 |
4.7× |
| Venography extremity unilateral rs&i (75820) |
$807.20 |
$1,009 |
0.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$545.60 |
$682 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$306.40 |
$383 |
3.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$386.40 |
$483 |
4.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$975.08 |
$1,218.85 |
5.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$350.40 |
$438 |
4.0× |
| X-ray exam hip uni 1 view (73501) |
$186.02 |
$232.52 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$356 |
$445 |
4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$688.80 |
$861 |
6.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$428 |
$535 |
4.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$348.80 |
$436 |
4.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$306.40 |
$383 |
3.5× |
| X-ray IV pyelogram+drip infusn (74410) |
$554.40 |
$693 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$515.20 |
$644 |
4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$425.60 |
$532 |
4.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$854.40 |
$1,068 |
8.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$238.40 |
$298 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$353.60 |
$442 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$339.20 |
$424 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$373.60 |
$467 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$462.40 |
$578 |
4.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$378.40 |
$473 |
4.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$395.20 |
$494 |
4.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$388 |
$485 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$465.60 |
$582 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$300.80 |
$376 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$354.40 |
$443 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$325.60 |
$407 |
3.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$427.60 |
$534.50 |
4.9× |
| Xr c-spine 6 or more views (72052) |
$586.40 |
$733 |
5.6× |
| Xr finger(s) 2+ views (73140) |
$324 |
$405 |
3.7× |
| Xr shoulder 1 view (73020) |
$186.40 |
$233 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$368.80 |
$461 |
4.2× |
| Xr tmj bilateral (70330) |
$500.95 |
$626.19 |
5.7× |
| Xray knee 1 or 2 views rt (73560) |
$334.40 |
$418 |
3.8× |