| Acute gi blood loss imaging (78278) |
$2,153.25 |
$2,871 |
5.2× |
| Angio adrenal bilat select (75733) |
$18,146.62 |
$24,195.50 |
5.5× |
| Angio adrenal unilat select (75731) |
$6,473.25 |
$8,631 |
2.0× |
| Angio extremity unilateral (75710) |
$7,593 |
$10,124 |
2.3× |
| Angio pulmonary unilateral (75741) |
$7,248.75 |
$9,665 |
2.2× |
| Angiogram extremity bilateral (75716) |
$8,435.25 |
$11,247 |
2.6× |
| Angiogram pelvic (75736) |
$8,712 |
$11,616 |
1.5× |
| Angiography internal mammary rs&i (75756) |
$6,109.50 |
$8,146 |
1.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$7,517.25 |
$10,023 |
2.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,476 |
$13,968 |
1.8× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$4,504.50 |
$6,006 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,212 |
$5,616 |
1.3× |
| Ankle 2 views (73600) |
$430.50 |
$574 |
4.7× |
| Arthrography knee lt (73580) |
$1,622.25 |
$2,163 |
4.5× |
| Arthrography wrist lt (73115) |
$1,287 |
$1,716 |
3.5× |
| Barium enema (74270) |
$1,191 |
$1,588 |
6.5× |
| Bilat selctv renal venogram (75833) |
$7,755.75 |
$10,341 |
2.4× |
| Bone age studies (77072) |
$502.50 |
$670 |
4.6× |
| Bone imaging limited area (78300) |
$1,749 |
$2,332 |
4.2× |
| Bone marrow imaging whole body (78104) |
$1,906.50 |
$2,542 |
4.6× |
| Bone survey complete (77075) |
$1,188.75 |
$1,585 |
10.9× |
| Bowel imaging (78290) |
$1,905.75 |
$2,541 |
4.6× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$1,755 |
$2,340 |
3.1× |
| Brain image w/flow 4 + views (78606) |
$2,613.75 |
$3,485 |
4.6× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$2,304.75 |
$3,073 |
5.5× |
| Card MRI w/stress img & dye (75563) |
$4,349.25 |
$5,799 |
5.3× |
| Cardiac MRI w/stress img (75559) |
$3,003 |
$4,004 |
5.3× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$3,843.75 |
$5,125 |
10.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$918.75 |
$1,225 |
5.0× |
| Cisternogram (78630) |
$2,826 |
$3,768 |
5.0× |
| Cisternography, positive contrast, radiological supervision and interpretation Other Diagnostic Radiology FS (70015) |
$1,815 |
$2,420 |
2.2× |
| Clavicle complete (73000) |
$471.75 |
$629 |
5.2× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$3,132 |
$4,176 |
17.1× |
| Contrast exam abdominl aorta (75625) |
$7,715.25 |
$10,287 |
2.3× |
| Contrast exam thoracic aorta (75605) |
$8,452.50 |
$11,270 |
1.5× |
| CT - st neck w&wo contr (70492) |
$3,288.75 |
$4,385 |
18.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,025.50 |
$8,034 |
16.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,456.50 |
$5,942 |
17.9× |
| CT abdomen w wo contrast (74170) |
$3,587.25 |
$4,783 |
19.6× |
| CT abdomen w/contrast (74160) |
$3,100.50 |
$4,134 |
16.9× |
| CT abdomen w/o contrast (74150) |
$2,581.50 |
$3,442 |
23.6× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$5,483.25 |
$7,311 |
15.1× |
| CT angio abdom w/o & w/dye (74175) |
$3,625.50 |
$4,834 |
19.8× |
| CT angio abdominal arteries (75635) |
$3,767.25 |
$5,023 |
20.6× |
| CT angio hrt w/3d image (75574) |
$2,942.25 |
$3,923 |
8.1× |
| CT angiograph pelv w/o&w/dye (72191) |
$3,505.50 |
$4,674 |
19.1× |
| CT cervical spine w/contrast (72126) |
$3,500.25 |
$4,667 |
9.6× |
| CT cervical spine w/o contrast (72125) |
$2,787 |
$3,716 |
25.5× |
| CT chest w/contrast (71260) |
$3,034.50 |
$4,046 |
16.6× |
| CT extremity upper w & w/o contrast (73202) |
$3,294 |
$4,392 |
18.0× |
| CT head/brain with contrast (70460) |
$2,800.50 |
$3,734 |
15.3× |
| CT head/brain without and with contrast (70470) |
$3,230.25 |
$4,307 |
17.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,488.50 |
$3,318 |
6.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$507.75 |
$677 |
5.6× |
| CT hrt w/3d image congen (75573) |
$2,725.50 |
$3,634 |
7.5× |
| CT limited/localized follow up study (76380) |
$1,286.25 |
$1,715 |
14.2× |
| CT lower ext w/wo contrast (73702) |
$3,264.75 |
$4,353 |
17.8× |
| CT lower extremity w contrast (73701) |
$2,811.75 |
$3,749 |
15.4× |
| CT lower extremity w/o contrast unilateral (73700) |
$2,298.75 |
$3,065 |
21.1× |
| CT lumbar spine w/contrast (72132) |
$3,513.75 |
$4,685 |
9.6× |
| CT lumbar spine w/o contrast (72131) |
$2,702.25 |
$3,603 |
24.8× |
| CT lumbar spine w/o then w/ con (72133) |
$3,825.75 |
$5,101 |
20.9× |
| CT maxillofacial area w/o contrast (70486) |
$2,349 |
$3,132 |
21.5× |
| CT maxillofacial w/contrast (70487) |
$2,966.25 |
$3,955 |
16.2× |
| CT maxillofacial w/o then w/ con (70488) |
$3,450.75 |
$4,601 |
18.8× |
| CT orbit sella ear w/o con (70480) |
$2,515.50 |
$3,354 |
23.0× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$3,398.25 |
$4,531 |
18.6× |
| CT pelvis w & w/o contrast (72194) |
$3,691.50 |
$4,922 |
20.2× |
| CT pelvis w/o contrast (72192) |
$2,436 |
$3,248 |
22.3× |
| CT soft tissue neck w/contrast (70491) |
$2,880.75 |
$3,841 |
15.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,412.75 |
$3,217 |
22.1× |
| CT spine cervical w/wo contrast (72127) |
$3,981.75 |
$5,309 |
21.7× |
| CT thoracic spine w/contrast (72129) |
$3,282.75 |
$4,377 |
17.9× |
| CT thoracic spine w/o contrast (72128) |
$2,658.75 |
$3,545 |
24.4× |
| CT thoracic spine w/o then w/ con (72130) |
$3,561.75 |
$4,749 |
19.4× |
| CT thorax lung cancer scr c- (71271) |
$1,069.50 |
$1,426 |
9.8× |
| CT thorax w/o contrast (71250) |
$2,463.75 |
$3,285 |
22.6× |
| CT thorax w/o then w/ contrast (71270) |
$3,633 |
$4,844 |
19.8× |
| CT upper extremity w/dye (73201) |
$2,880.75 |
$3,841 |
7.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,344.50 |
$3,126 |
21.5× |
| CTA chest w/wo contrast (71275) |
$3,584.25 |
$4,779 |
19.6× |
| CTA head w contrast (70496) |
$3,509.25 |
$4,679 |
19.2× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$3,377.25 |
$4,503 |
18.4× |
| Cta Neck (70498) |
$3,422.25 |
$4,563 |
18.7× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$3,321.75 |
$4,429 |
18.1× |
| Dilation ureters/urethra rs&i (74485) |
$3,940.50 |
$5,254 |
1.8× |
| Diskography lumbar (72295) |
$5,773.50 |
$7,698 |
2.8× |
| Esophogram (74220) |
$875.25 |
$1,167 |
4.8× |
| Fetal biophysical profile non-stress testing (76818) |
$1,149.75 |
$1,533 |
10.5× |
| Fetal biophysical profile w/o nst (76819) |
$837.75 |
$1,117 |
7.7× |
| Fetal echo complete (76825) |
$1,329.75 |
$1,773 |
2.3× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$960 |
$1,280 |
3.9× |
| Functional MRI brain by tech (70554) |
$3,756.75 |
$5,009 |
15.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$5,064 |
$6,752 |
8.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) |
$2,153.25 |
$2,871 |
5.2× |
| Gastric emptying study (78264) |
$2,407.50 |
$3,210 |
5.8× |
| Gated heart planar single (78472) |
$2,587.50 |
$3,450 |
6.2× |
| Heart infarct image (78466) |
$2,583.75 |
$3,445 |
6.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$6,891 |
$9,188 |
2.1× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$7,347.75 |
$9,797 |
2.2× |
| Hepatobil syst image w/drug (78227) |
$2,804.25 |
$3,739 |
4.9× |
| Hepatobiliary system imaging (78226) |
$2,459.25 |
$3,279 |
5.9× |
| Humerus min 2 views (73060) |
$482.25 |
$643 |
5.3× |
| Hysterosalpingography (74740) |
$1,207.50 |
$1,610 |
4.8× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$962.25 |
$1,283 |
2.3× |
| Ivp (74400) |
$1,383 |
$1,844 |
7.6× |
| Ivp w tomography (74415) |
$1,301.25 |
$1,735 |
7.1× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$2,783.25 |
$3,711 |
4.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$2,475 |
$3,300 |
4.4× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$2,561.25 |
$3,415 |
4.5× |
| Liver & spleen; static only (78215) |
$2,435.25 |
$3,247 |
5.8× |
| Liver & spleen; w vasc flow (78216) |
$2,695.50 |
$3,594 |
6.5× |
| Lung perfusion differential (78597) |
$2,106 |
$2,808 |
5.0× |
| Lung ventilat&perfus imaging (78582) |
$2,836.50 |
$3,782 |
5.0× |
| Lung ventilation imaging (78579) |
$1,609.50 |
$2,146 |
3.9× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$6,008.25 |
$8,011 |
1.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$4,981.50 |
$6,642 |
13.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$4,621.50 |
$6,162 |
12.7× |
| Mr safety determination physician/other qhp (76016) |
$360 |
$480 |
4.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$639.75 |
$853 |
10.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$47.25 |
$63 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$488.25 |
$651 |
4.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$965.25 |
$1,287 |
3.9× |
| MRA head w & w/o contrast (70546) |
$4,915.50 |
$6,554 |
13.5× |
| MRA head w/contrast (70545) |
$3,791.25 |
$5,055 |
10.4× |
| MRA head w/o contrast (70544) |
$3,412.50 |
$4,550 |
13.7× |
| MRA neck w/contrast (70548) |
$3,975 |
$5,300 |
10.9× |
| MRA neck w/o contrast (70547) |
$3,436.50 |
$4,582 |
13.8× |
| MRA neck w/wo contrast (70549) |
$4,588.50 |
$6,118 |
12.6× |
| MRI abdomen w/contrast (74182) |
$4,167.75 |
$5,557 |
11.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,927.50 |
$6,570 |
13.5× |
| MRI abdomen w/o contrast (74181) |
$3,526.50 |
$4,702 |
14.2× |
| MRI any jnt lwr ext with con lt (73722) |
$3,984.75 |
$5,313 |
4.9× |
| MRI bone marrow (77084) |
$2,967.75 |
$3,957 |
11.9× |
| MRI breast without contrast bilateral (77047) |
$3,654.75 |
$4,873 |
14.7× |
| MRI breast without contrast material unilateral (77046) |
$2,772.75 |
$3,697 |
11.1× |
| MRI cardiac w/o contrast (75557) |
$2,958.75 |
$3,945 |
11.9× |
| MRI cervical spine w/o contrast (72141) |
$3,600 |
$4,800 |
14.4× |
| MRI cervical spine with contrast (72142) |
$4,293 |
$5,724 |
11.8× |
| MRI chest w & w/o contrast (71552) |
$4,848 |
$6,464 |
13.3× |
| MRI chest w/contrast (71551) |
$3,444 |
$4,592 |
4.2× |
| MRI chest w/o contrast (71550) |
$3,459.75 |
$4,613 |
13.9× |
| MRI fetal sngl/1st gestation (74712) |
$3,289.50 |
$4,386 |
13.2× |
| MRI joint upper ext w/contrast (73222) |
$4,110.75 |
$5,481 |
5.0× |
| MRI joint upr extr w/o&w/dye (73223) |
$4,836 |
$6,448 |
13.3× |
| MRI joint upr extrem w/o dye (73221) |
$3,413.25 |
$4,551 |
13.7× |
| Mri Lower Extremity W/O Dye (73718) |
$3,346.50 |
$4,462 |
13.4× |
| MRI lumbar spine with contrast (72149) |
$4,173 |
$5,564 |
11.5× |
| MRI lumbar w/wo contrast (72158) |
$5,160 |
$6,880 |
14.2× |
| MRI lwr ext w/o jnts with con rt (73719) |
$3,882.75 |
$5,177 |
10.7× |
| MRI orbit/face/neck w/contrast (70542) |
$3,783.75 |
$5,045 |
10.4× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$4,907.25 |
$6,543 |
13.5× |
| MRI orbit/face/neck w/o contrast (70540) |
$3,433.50 |
$4,578 |
13.8× |
| MRI pelvis w/ contrast (72196) |
$4,137.75 |
$5,517 |
11.4× |
| MRI pelvis w/o contrast (72195) |
$3,453 |
$4,604 |
13.9× |
| MRI pelvis w/wo contrast (72197) |
$4,979.25 |
$6,639 |
13.7× |
| MRI spectroscopy (76390) |
$2,805 |
$3,740 |
30.9× |
| MRI spine cervical wo/w contrast (72156) |
$5,150.25 |
$6,867 |
14.1× |
| MRI spine thoracic w/contrast (72147) |
$3,963.75 |
$5,285 |
10.9× |
| MRI thoracic spine w wo contrast (72157) |
$5,166.75 |
$6,889 |
14.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,567.75 |
$4,757 |
14.3× |
| MRI tmj (70336) |
$3,346.50 |
$4,462 |
13.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,311.25 |
$4,415 |
13.3× |
| Mri Upper Extremity W/Dye (73219) |
$3,976.50 |
$5,302 |
10.9× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$4,653 |
$6,204 |
12.8× |
| Myelogram thoracic (72255) |
$2,501.25 |
$3,335 |
3.1× |
| Myelography 2 or more regions (72270) |
$3,454.50 |
$4,606 |
4.2× |
| Myelography lumbosacral (72265) |
$2,895.75 |
$3,861 |
3.5× |
| Myocardial perfusion planar 1 study rest/stress (78453) |
$3,758.25 |
$5,011 |
2.8× |
| Myocardial perfusion planar multiple studies (78454) |
$6,509.25 |
$8,679 |
4.8× |
| Myocardial spect single study at rest or stress (78451) |
$4,683 |
$6,244 |
3.5× |
| Myocrd img PET metab eval single study (78459) |
$6,825 |
$9,100 |
5.0× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$4,977 |
$6,636 |
5.5× |
| Nm adrenal imaging (78075) |
$4,095.75 |
$5,461 |
3.0× |
| Nm bone 3 phase (78315) |
$2,852.25 |
$3,803 |
6.8× |
| Nm bone imaging whole body (78306) |
$2,625 |
$3,500 |
6.3× |
| Nm bone multi (78305) |
$1,896.75 |
$2,529 |
4.5× |
| Nm heart perfusion spect stress rest (78452) |
$5,838 |
$7,784 |
4.3× |
| Nm liver image static only (78201) |
$2,556 |
$3,408 |
4.5× |
| Nm lymph system (78195) |
$2,598.75 |
$3,465 |
4.6× |
| Nm thyroid imaging only (78013) |
$1,310.25 |
$1,747 |
3.1× |
| Nose to rectum for fb child (76010) |
$371.25 |
$495 |
4.1× |
| Ob us < 14 wks single fetus (76801) |
$1,026.75 |
$1,369 |
9.4× |
| Ob us nuchal meas 1 gest (76813) |
$689.25 |
$919 |
6.3× |
| Oral radiopharm rx (79005) |
$2,160 |
$2,880 |
8.9× |
| Orthopantogram (70355) |
$420.75 |
$561 |
4.6× |
| Parathyroid imaging (78070) |
$1,992 |
$2,656 |
4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,362.50 |
$3,150 |
5.7× |
| Peritoneogram rs&i (74190) |
$1,506 |
$2,008 |
2.6× |
| Pulmonary perfusion imaging particulate (78580) |
$1,906.50 |
$2,542 |
4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,319.25 |
$1,759 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$436.50 |
$582 |
4.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$645.75 |
$861 |
5.9× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$813 |
$1,084 |
7.4× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$990 |
$1,320 |
9.1× |
| Radex hip unilateral with pelvis 1 view (73501) |
$418.50 |
$558 |
4.6× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$507.75 |
$677 |
5.6× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$684 |
$912 |
6.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$636.75 |
$849 |
5.8× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$909 |
$1,212 |
8.3× |
| Radex spine cervical 2 or 3 views (72040) |
$559.50 |
$746 |
6.2× |
| Radex spine cervical 4 or 5 views (72050) |
$783.75 |
$1,045 |
7.2× |
| Radex spine cervical 6 or more views (72052) |
$912 |
$1,216 |
8.4× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$532.50 |
$710 |
5.9× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$720 |
$960 |
6.6× |
| Radiologic exam esophagus double contrast study (74221) |
$813 |
$1,084 |
4.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,147.50 |
$1,530 |
6.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,078.50 |
$1,438 |
5.9× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$417 |
$556 |
4.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$480.75 |
$641 |
5.3× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$750 |
$1,000 |
6.9× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$1,041 |
$1,388 |
9.5× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$699 |
$932 |
6.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,965.75 |
$2,621 |
4.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,609.25 |
$3,479 |
6.3× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$4,455.75 |
$5,941 |
7.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,057.50 |
$5,410 |
7.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,696.75 |
$4,929 |
6.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,848 |
$6,464 |
3.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,542 |
$2,056 |
6.3× |
| Saline infused sonohysterogram (76831) |
$1,058.25 |
$1,411 |
4.2× |
| Selective spinal angiogram (75705) |
$9,441 |
$12,588 |
1.6× |
| Shoulder arthrogram (73040) |
$1,488 |
$1,984 |
4.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$813.75 |
$1,085 |
7.5× |
| Small bowel series (74250) |
$1,120.50 |
$1,494 |
6.1× |
| Testicular imaging w/flow (78761) |
$4,456.50 |
$5,942 |
10.7× |
| Thyroid met imaging body (78018) |
$2,805.75 |
$3,741 |
4.9× |
| Thyroid uptake single/multiple quant measurement (78012) |
$1,578.75 |
$2,105 |
3.8× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,872 |
$2,496 |
4.5× |
| Ultrasound breast limited (76642) |
$603 |
$804 |
6.6× |
| Ultrasound, abdomen limited (76705) |
$1,031.25 |
$1,375 |
9.4× |
| Ultrasound, elastography; first target lesion (76982) |
$463.50 |
$618 |
4.2× |
| Umbilical-artery Doppler (OB) (76820) |
$551.25 |
$735 |
5.0× |
| Unlisted diagnostic radiographic procedure (76499) |
$685.50 |
$914 |
7.5× |
| Unlisted magnetic resonance procedure (76498) |
$2,879.25 |
$3,839 |
31.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,122.75 |
$1,497 |
4.5× |
| Urethrocystography voiding (74455) |
$1,227 |
$1,636 |
4.9× |
| Urography antegrade (74425) |
$1,281.75 |
$1,709 |
3.5× |
| Urography retrograde w/wo kub (74420) |
$1,545 |
$2,060 |
4.2× |
| Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) |
$1,437 |
$1,916 |
7.8× |
| Us abdominal aorta real time screen study aaa (76706) |
$634.50 |
$846 |
5.8× |
| Us breast uni real time with image complete (76641) |
$772.50 |
$1,030 |
7.1× |
| Us chest (76604) |
$768.75 |
$1,025 |
7.0× |
| Us compl joint r-t w/image documentation (76881) |
$938.25 |
$1,251 |
8.6× |
| Us elastography parenchyma (76981) |
$624 |
$832 |
5.7× |
| Us encephalogram (76506) |
$831 |
$1,108 |
7.6× |
| Us guided compression repair (76936) |
$1,422 |
$1,896 |
6.3× |
| Us kidney transplanted (76776) |
$1,124.25 |
$1,499 |
10.3× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$643.50 |
$858 |
5.9× |
| Us ob detailed single fetus (76811) |
$1,242 |
$1,656 |
5.0× |
| Us ob followup per fetus (76816) |
$695.25 |
$927 |
6.4× |
| Us ob limited 1 or more fetuses (76815) |
$786.75 |
$1,049 |
7.2× |
| Us obstetric transvaginal (76817) |
$939.75 |
$1,253 |
8.6× |
| Us pelvic limited or f/u non-ob (76857) |
$741.75 |
$989 |
6.8× |
| Us pelvis complete (76856) |
$1,146 |
$1,528 |
10.5× |
| Us retroperitoneal complete (76770) |
$1,104 |
$1,472 |
10.1× |
| Us retroperitoneal limited (76775) |
$875.25 |
$1,167 |
8.0× |
| Us scrotum (76870) |
$1,050 |
$1,400 |
9.6× |
| Us soft tissue head/neck (76536) |
$945.75 |
$1,261 |
8.7× |
| Us spinal canal (76800) |
$1,066.50 |
$1,422 |
9.8× |
| Vein X-ray liver w/hemodynam (75885) |
$7,397.25 |
$9,863 |
2.2× |
| Venogram extremity bilateral (75822) |
$4,220.25 |
$5,627 |
2.6× |
| Venogram ivc w serialography (75825) |
$6,554.25 |
$8,739 |
2.0× |
| Venogram svc w serialography (75827) |
$4,377.75 |
$5,837 |
2.7× |
| Venography ext unilateral (75820) |
$3,358.50 |
$4,478 |
2.0× |
| Venography renal unilateral selective rs&i (75831) |
$6,327.75 |
$8,437 |
1.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,206.50 |
$6,942 |
1.6× |
| Venous sampling by catheter (75893) |
$9,741 |
$12,988 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$495.75 |
$661 |
5.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$530.25 |
$707 |
5.8× |
| X-ray aorta leg arteries (75630) |
$8,562.75 |
$11,417 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,527.75 |
$2,037 |
8.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$534.75 |
$713 |
5.9× |
| X-ray exam hips bi 3-4 views (73522) |
$718.50 |
$958 |
6.6× |
| X-ray exam of finger(s) (73140) |
$407.25 |
$543 |
4.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$2,080.50 |
$2,774 |
11.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$468.75 |
$625 |
5.2× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$438.75 |
$585 |
4.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$522.75 |
$697 |
5.8× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$477 |
$636 |
4.4× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$526.50 |
$702 |
5.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$420 |
$560 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$450.75 |
$601 |
5.0× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$537 |
$716 |
5.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$649.50 |
$866 |
5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$433.50 |
$578 |
4.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$594.75 |
$793 |
5.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$948 |
$1,264 |
8.7× |
| X-ray perineogram (74775) |
$1,458 |
$1,944 |
5.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$480.75 |
$641 |
5.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$828 |
$1,104 |
7.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$536.25 |
$715 |
4.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$515.25 |
$687 |
5.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$537 |
$716 |
5.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$624 |
$832 |
6.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$795.75 |
$1,061 |
7.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$561.75 |
$749 |
5.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$430.50 |
$574 |
4.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$405.75 |
$541 |
4.5× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$443.25 |
$591 |
4.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$527.25 |
$703 |
5.8× |
| Xr abdomen 1 view (74018) |
$440.25 |
$587 |
4.8× |
| Xr abdomen 2 views (74019) |
$528 |
$704 |
4.8× |
| Xr abdomen 3 views (74021) |
$639.75 |
$853 |
5.9× |
| Xr arthrogram ankle (73615) |
$1,512 |
$2,016 |
4.2× |
| Xr arthrogram elbow (73085) |
$1,251.75 |
$1,669 |
3.4× |
| Xr arthrogram hip (73525) |
$1,395.75 |
$1,861 |
3.8× |
| Xr bone density axial (77080) |
$651 |
$868 |
6.0× |
| Xr bone length study (77073) |
$572.25 |
$763 |
5.2× |
| Xr bone survey limited (77074) |
$780.75 |
$1,041 |
7.2× |
| Xr chest 1 view (71045) |
$424.50 |
$566 |
4.7× |
| Xr chest 2 views (71046) |
$489.75 |
$653 |
5.4× |
| Xr chest 3 views (71047) |
$596.25 |
$795 |
6.6× |
| Xr cystogram 3+ views (74430) |
$1,127.25 |
$1,503 |
3.1× |
| Xr eye foreign body (70030) |
$359.25 |
$479 |
4.0× |
| Xr facial bones 3 views (70150) |
$657.75 |
$877 |
6.0× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$594 |
$792 |
5.4× |
| Xr mandible 4 views (70110) |
$642.75 |
$857 |
5.9× |
| Xr myelogram c-spine (72240) |
$2,940.75 |
$3,921 |
3.6× |
| Xr nasal bones (70160) |
$525.75 |
$701 |
5.8× |
| Xr pelvis 3 views (72190) |
$583.50 |
$778 |
5.3× |
| Xr spine 1 view (72020) |
$457.50 |
$610 |
5.0× |
| Xr sternum 2 views (71120) |
$486.75 |
$649 |
5.4× |
| Xr surgical specimen (76098) |
$1,142.25 |
$1,523 |
2.0× |
| Xray elbow 2 views (73070) |
$447.75 |
$597 |
4.9× |
| Xray forearm 2 views (73090) |
$486.75 |
$649 |
5.4× |
| Xray knee 1 or 2 views rt (73560) |
$454.50 |
$606 |
5.0× |
| Xray neck soft tissue (70360) |
$459.75 |
$613 |
5.1× |
| Xray orbits complete min 4 views (70200) |
$636 |
$848 |
5.8× |
| Xray pelvis 1 or 2 views (72170) |
$482.25 |
$643 |
4.4× |
| Xray ribs bilateral 3 views (71110) |
$678 |
$904 |
6.2× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$630.75 |
$841 |
5.8× |
| Xray scapula complete (73010) |
$507 |
$676 |
4.6× |
| Xray shoulder 1 view (73020) |
$421.50 |
$562 |
4.6× |
| Xray sinuses paranasal <3 views (70210) |
$396.75 |
$529 |
4.4× |
| Xray spine thoracic 2 views (72070) |
$532.50 |
$710 |
4.9× |
| Xray spine thoracic 3 views (72072) |
$633 |
$844 |
5.8× |
| Xray tibia-fibula 2 views bil (73590) |
$502.50 |
$670 |
5.5× |
| Xray tmj open - closed unilat (70328) |
$379.50 |
$506 |
4.2× |
| Xray tmj's bilateral open-clsc (70330) |
$573.75 |
$765 |
6.3× |