| Abdomen 1 View (74018) |
$440.25 |
$587 |
4.8× |
| Abdomen 2 views (74019) |
$528 |
$704 |
4.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,153.25 |
$2,871 |
5.2× |
| Adrenal Cortex & Medulla Img (78075) |
$4,095.75 |
$5,461 |
3.0× |
| Angio internal mammary (75756) |
$6,109.50 |
$8,146 |
1.9× |
| Angio pulmonary bilat (75743) |
$7,517.25 |
$10,023 |
2.3× |
Angiography Adrenal Bilateral Slctv Rs&I (75733)
range across 2 matching MRF lines |
$15,840–$20,453.25 |
$21,120–$27,271 |
varies |
| Angiography extremity bilateral rs&i (75716) |
$8,435.25 |
$11,247 |
2.6× |
| Angiography extremity unilateral rs&i (75710) |
$7,593 |
$10,124 |
2.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,248.75 |
$9,665 |
2.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,212 |
$5,616 |
1.3× |
| Ankle 2 views (73600) |
$430.50 |
$574 |
4.7× |
| Aortography thoracic serialography rs&i (75605) |
$8,452.50 |
$11,270 |
1.5× |
| Artery X-Rays Abdomen (75726) |
$10,476 |
$13,968 |
1.8× |
| Artery X-Rays Adrenal Gland (75731) |
$6,473.25 |
$8,631 |
2.0× |
| Artery X-Rays Pelvis (75736) |
$8,712 |
$11,616 |
1.5× |
| Artery X-Rays Spine (75705) |
$9,441 |
$12,588 |
1.6× |
| Arthrogram ankle (73615) |
$1,512 |
$2,016 |
4.2× |
| Arthrogram hip (73525) |
$1,395.75 |
$1,861 |
3.8× |
| Arthrogram Wrist (73115) |
$1,287 |
$1,716 |
3.5× |
| Bone age studies (77072) |
$502.50 |
$670 |
4.6× |
| Bone Imaging 3 Phase (78315) |
$2,852.25 |
$3,803 |
6.8× |
| Bone Imaging Limited Area (78300) |
$1,749 |
$2,332 |
4.2× |
| Bone Imaging Multiple Areas (78305) |
$1,896.75 |
$2,529 |
4.5× |
| Bone Imaging Whole Body (78306) |
$2,625 |
$3,500 |
6.3× |
| Bone marrow imaging; whole body (78104) |
$1,906.50 |
$2,542 |
4.6× |
| Brain Flow Imaging Only (78610) |
$1,755 |
$2,340 |
3.1× |
| Brain Image W/Flow < 4 Views (78601) |
$2,304.75 |
$3,073 |
5.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,613.75 |
$3,485 |
4.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,843.75 |
$5,125 |
10.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,349.25 |
$5,799 |
5.3× |
| Cat Scan Follow-Up Study (76380) |
$1,286.25 |
$1,715 |
14.2× |
| Cerebrospinal Fluid Scan (78630) |
$2,826 |
$3,768 |
5.0× |
| Chest 1 view (71045) |
$424.50 |
$566 |
4.7× |
| Chest 2 views (71046) |
$489.75 |
$653 |
5.4× |
| Chest 3 views (71047) |
$596.25 |
$795 |
6.6× |
| Chest 4 or more views (71048) |
$720 |
$960 |
6.6× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,815 |
$2,420 |
2.2× |
| Clavicle complete (73000) |
$471.75 |
$629 |
5.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,069.50 |
$1,426 |
9.8× |
| Contrast Exam Abdominl Aorta (75625) |
$7,715.25 |
$10,287 |
2.3× |
| Contrast X-Ray Bladder (74430) |
$1,127.25 |
$1,503 |
3.1× |
| Contrast X-Ray Of Elbow (73085) |
$1,251.75 |
$1,669 |
3.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,622.25 |
$2,163 |
4.5× |
| 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 contrast (74160) |
$3,100.50 |
$4,134 |
16.9× |
| CT abdomen w wo contrast (74170) |
$3,587.25 |
$4,783 |
19.6× |
| CT abdomen w/o contrast (74150) |
$2,581.50 |
$3,442 |
23.6× |
| CT Angio Abdomen and Pelvis (74174) |
$5,483.25 |
$7,311 |
15.1× |
| CT Angio Chest (71275) |
$3,584.25 |
$4,779 |
19.6× |
| CT Angio Head (70496) |
$3,509.25 |
$4,679 |
19.2× |
| CT angio hrt w/3d image (75574) |
$2,942.25 |
$3,923 |
8.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,377.25 |
$4,503 |
18.4× |
| CT Angio Neck (70498) |
$3,422.25 |
$4,563 |
18.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,321.75 |
$4,429 |
18.1× |
| 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 cervical spine w/wo cont (72127) |
$3,981.75 |
$5,309 |
21.7× |
| CT chest w contrast (71260) |
$3,034.50 |
$4,046 |
16.6× |
| CT chest w/wo contrast (71270) |
$3,633 |
$4,844 |
19.8× |
| 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 no contrast quant eval coronry calcium (75571) |
$507.75 |
$677 |
5.6× |
| CT hrt w/3d image congen (75573) |
$2,725.50 |
$3,634 |
7.5× |
| CT iac w contrast (70481) |
$3,132 |
$4,176 |
17.1× |
| CT l-spine w&w/o contrast (72133) |
$3,825.75 |
$5,101 |
20.9× |
| CT lower ext w/o (73700) |
$2,298.75 |
$3,065 |
21.1× |
| CT lower extremity w/contrast material (73701) |
$2,811.75 |
$3,749 |
15.4× |
| 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 maxillofacial w contrast (70487) |
$2,966.25 |
$3,955 |
16.2× |
| CT maxillofacial wo contrast (70486) |
$2,349 |
$3,132 |
21.5× |
| CT neck tissue combo (70492) |
$3,288.75 |
$4,385 |
18.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,398.25 |
$4,531 |
18.6× |
| CT orbits w/o contrast (70480) |
$2,515.50 |
$3,354 |
23.0× |
| 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 scan of leg combo (73702) |
$3,264.75 |
$4,353 |
17.8× |
| CT scans face/jaw combo (70488) |
$3,450.75 |
$4,601 |
18.8× |
| 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 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/wo cont (72130) |
$3,561.75 |
$4,749 |
19.4× |
| CT thorax w/o contrast (71250) |
$2,463.75 |
$3,285 |
22.6× |
| CT upper ext wo (73200) |
$2,344.50 |
$3,126 |
21.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,294 |
$4,392 |
18.0× |
| CT upper extremity with contrast (73201) |
$2,880.75 |
$3,841 |
7.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,767.25 |
$5,023 |
20.6× |
| Cta Abdomen (74175) |
$3,625.50 |
$4,834 |
19.8× |
| CTA pelvis (72191) |
$3,505.50 |
$4,674 |
19.1× |
| Dilation ureters/urethra rs&i (74485) |
$3,940.50 |
$5,254 |
1.8× |
| Diskography lumbar (72295) |
$5,773.50 |
$7,698 |
2.8× |
| Dxa Bone Density Axial (77080) |
$651 |
$868 |
6.0× |
| Echo exam of fetal heart (76825) |
$1,329.75 |
$1,773 |
2.3× |
| Echo exam uterus (76831) |
$1,058.25 |
$1,411 |
4.2× |
| Echo Guide For Artery Repair (76936) |
$1,422 |
$1,896 |
6.3× |
| Esophagram (74220) |
$875.25 |
$1,167 |
4.8× |
| Fetal Biophys Profile W/Nst (76818) |
$1,149.75 |
$1,533 |
10.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$837.75 |
$1,117 |
7.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,289.50 |
$4,386 |
13.2× |
| Fluoroscopy up to 1 hr (76000) |
$960 |
$1,280 |
3.9× |
| Follow-Up Angiography (75898) |
$4,504.50 |
$6,006 |
1.4× |
| Foot 2 views (73620) |
$438.75 |
$585 |
4.8× |
| Forearm 2 views (73090) |
$486.75 |
$649 |
5.4× |
| Gastric emptying imaging study (78264) |
$2,407.50 |
$3,210 |
5.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$2,153.25 |
$2,871 |
5.2× |
| Gated Heart Planar Single (78472) |
$2,587.50 |
$3,450 |
6.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$5,064 |
$6,752 |
8.9× |
| Hand 2 views (73120) |
$477 |
$636 |
4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$7,347.75 |
$9,797 |
2.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$6,891 |
$9,188 |
2.1× |
| Hepatobil Syst Image W/Drug (78227) |
$2,804.25 |
$3,739 |
4.9× |
| Hepatobiliary System Imaging (78226) |
$2,459.25 |
$3,279 |
5.9× |
| Ht Musc Image Planar Mult (78454) |
$6,509.25 |
$8,679 |
4.8× |
| Ht Muscle Image Spect Sing (78451) |
$4,683 |
$6,244 |
3.5× |
| Hysterosalpingogram (74740) |
$1,207.50 |
$1,610 |
4.8× |
| Infusion Ivp (74410) |
$1,437 |
$1,916 |
7.8× |
| K Flow/Funct Image Multiple (78709) |
$2,783.25 |
$3,711 |
4.9× |
| K Flow/Funct Image W/Drug (78708) |
$2,561.25 |
$3,415 |
4.5× |
| K Flow/Funct Image W/O Drug (78707) |
$2,475 |
$3,300 |
4.4× |
| Knee 3 Views (73562) |
$537 |
$716 |
5.9× |
| Liver & Spleen Imaging Static Only (78215) |
$2,435.25 |
$3,247 |
5.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,695.50 |
$3,594 |
6.5× |
| Liver imaging static only (78201) |
$2,556 |
$3,408 |
4.5× |
| 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× |
| Lymph System Imaging (78195) |
$2,598.75 |
$3,465 |
4.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$6,008.25 |
$8,011 |
1.8× |
| Magnetic Image Jaw Joint (70336) |
$3,346.50 |
$4,462 |
13.4× |
| Meckels Divert Exam (78290) |
$1,905.75 |
$2,541 |
4.6× |
| Mr safety determination physician/other qhp (76016) |
$360 |
$480 |
4.0× |
| 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 implt pos&/immoblj (76019) |
$639.75 |
$853 |
10.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$965.25 |
$1,287 |
3.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,915.50 |
$6,554 |
13.5× |
| MRA head w/o contrast (70544) |
$3,412.50 |
$4,550 |
13.7× |
| MRA head with contrast (70545) |
$3,791.25 |
$5,055 |
10.4× |
| MRA neck w contrast (70548) |
$3,975 |
$5,300 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,588.50 |
$6,118 |
12.6× |
| MRA neck w/o contrast (70547) |
$3,436.50 |
$4,582 |
13.8× |
| MRI abdomen w contrast (74182) |
$4,167.75 |
$5,557 |
11.4× |
| MRI abdomen w/o contrast (74181) |
$3,526.50 |
$4,702 |
14.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,984.75 |
$5,313 |
4.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,981.50 |
$6,642 |
13.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,110.75 |
$5,481 |
5.0× |
| MRI bone marrow blood supply (77084) |
$2,967.75 |
$3,957 |
11.9× |
| MRI brain functional w/o physician admnistration (70554) |
$3,756.75 |
$5,009 |
15.1× |
| MRI Breast W/O 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 cont stress (75559) |
$3,003 |
$4,004 |
5.3× |
| MRI cardiac w/o contrast (75557) |
$2,958.75 |
$3,945 |
11.9× |
| MRI cervical spine w contrast (72142) |
$4,293 |
$5,724 |
11.8× |
| MRI cervical spine w/o cont (72141) |
$3,600 |
$4,800 |
14.4× |
| MRI chest w/o contrast (71550) |
$3,459.75 |
$4,613 |
13.9× |
| MRI chest with contrast (71551) |
$3,444 |
$4,592 |
4.2× |
| MRI chest wo w contrast (71552) |
$4,848 |
$6,464 |
13.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,882.75 |
$5,177 |
10.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,621.50 |
$6,162 |
12.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,346.50 |
$4,462 |
13.4× |
| MRI lumbar spine w contrast (72149) |
$4,173 |
$5,564 |
11.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$5,150.25 |
$6,867 |
14.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,433.50 |
$4,578 |
13.8× |
| MRI orbit face neck w contrast (70542) |
$3,783.75 |
$5,045 |
10.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,907.25 |
$6,543 |
13.5× |
| MRI pelvis w contrast (72196) |
$4,137.75 |
$5,517 |
11.4× |
| MRI pelvis w/o & w contrast (72197) |
$4,979.25 |
$6,639 |
13.7× |
| MRI pelvis w/o contrast (72195) |
$3,453 |
$4,604 |
13.9× |
| MRI spectroscopy (76390) |
$2,805 |
$3,740 |
30.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,567.75 |
$4,757 |
14.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,976.50 |
$5,302 |
10.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,311.25 |
$4,415 |
13.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,653 |
$6,204 |
12.8× |
| MRI, abdomen, combo (74183) |
$4,927.50 |
$6,570 |
13.5× |
| MRI, dorsal spine combo (72157) |
$5,166.75 |
$6,889 |
14.2× |
| MRI, dorsal spine contrast (72147) |
$3,963.75 |
$5,285 |
10.9× |
| MRI, joint upper extrem (73221) |
$3,413.25 |
$4,551 |
13.7× |
| MRI, joint upper extrem combo (73223) |
$4,836 |
$6,448 |
13.3× |
| MRI, lumbar spine combo (72158) |
$5,160 |
$6,880 |
14.2× |
| Myelogram cervical (72240) |
$2,940.75 |
$3,921 |
3.6× |
| Myelogram Lumbar (72265) |
$2,895.75 |
$3,861 |
3.5× |
| Myelography thoracic (72255) |
$2,501.25 |
$3,335 |
3.1× |
| Myelograpy 2/more regions rs&i (72270) |
$3,454.50 |
$4,606 |
4.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$2,583.75 |
$3,445 |
6.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,825 |
$9,100 |
5.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,758.25 |
$5,011 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$5,838 |
$7,784 |
4.3× |
| N-invas est c ffr sw aly CTA (75580) |
$4,977 |
$6,636 |
5.5× |
| Neck soft tissue (70360) |
$459.75 |
$613 |
5.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$962.25 |
$1,283 |
2.3× |
| Nonvascular Shunt X-Ray (75809) |
$813.75 |
$1,085 |
7.5× |
| Nuclear Rx Intra-Arterial (79445) |
$1,542 |
$2,056 |
6.3× |
| Nuclear Rx Oral Admin (79005) |
$2,160 |
$2,880 |
8.9× |
| Ob us nuchal meas 1 gest (76813) |
$689.25 |
$919 |
6.3× |
| Panoramic X-ray of jaws (70355) |
$420.75 |
$561 |
4.6× |
| Parathyroid Planar Imaging (78070) |
$1,992 |
$2,656 |
4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,362.50 |
$3,150 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$482.25 |
$643 |
4.4× |
| Perineogram (74775) |
$1,458 |
$1,944 |
5.9× |
| Peritoneogram Rs&I (74190) |
$1,506 |
$2,008 |
2.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,397.25 |
$9,863 |
2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,906.50 |
$2,542 |
4.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$750 |
$1,000 |
6.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,319.25 |
$1,759 |
2.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$530.25 |
$707 |
5.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$420 |
$560 |
4.6× |
| Radex elbow complete minimum 3 views (73080) |
$534.75 |
$713 |
5.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$657.75 |
$877 |
6.0× |
| Radex fingr minimum 2 views (73140) |
$407.25 |
$543 |
4.5× |
| Radex foot complete minimum 3 views (73630) |
$522.75 |
$697 |
5.8× |
| Radex Hand Minimum 3 Views (73130) |
$526.50 |
$702 |
5.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$525.75 |
$701 |
5.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$480.75 |
$641 |
5.3× |
| Radex shoulder complete minimum 2 views (73030) |
$537 |
$716 |
5.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$396.75 |
$529 |
4.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$2,080.50 |
$2,774 |
11.4× |
| Radex Spine 1 View Specify Level (72020) |
$457.50 |
$610 |
5.0× |
| Radex Sternum Minimum 2 Views (71120) |
$486.75 |
$649 |
5.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$573.75 |
$765 |
6.3× |
| Radex Toe Minimum 2 Views (73660) |
$405.75 |
$541 |
4.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$527.25 |
$703 |
5.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$990 |
$1,320 |
9.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$642.75 |
$857 |
5.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$639.75 |
$853 |
5.9× |
| Radiologic exam colon double contrast study (74280) |
$1,527.75 |
$2,037 |
8.3× |
| Radiologic exam colon single contrast study (74270) |
$1,191 |
$1,588 |
6.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$813 |
$1,084 |
4.4× |
| Radiologic exam knee complete 4/more views (73564) |
$649.50 |
$866 |
5.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$583.50 |
$778 |
5.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,120.50 |
$1,494 |
6.1× |
| Radiologic exam swallow function contrast study (74230) |
$918.75 |
$1,225 |
5.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,147.50 |
$1,530 |
6.3× |
| Radiologic examination femur 1 view (73551) |
$417 |
$556 |
4.6× |
| Radiologic examination femur minimum 2 views (73552) |
$480.75 |
$641 |
5.3× |
| Radiologic examination knee 1/2 views (73560) |
$454.50 |
$606 |
5.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$780.75 |
$1,041 |
7.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$502.50 |
$670 |
5.5× |
| Ribs bilateral 3 views (71110) |
$678 |
$904 |
6.2× |
| 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× |
| Scapula (73010) |
$507 |
$676 |
4.6× |
| Shoulder 1 view (73020) |
$421.50 |
$562 |
4.6× |
| Shoulder Arthrography (73040) |
$1,488 |
$1,984 |
4.1× |
| Skull less than 4 views (70250) |
$561.75 |
$749 |
5.1× |
| Sternoclavicular joints (71130) |
$430.50 |
$574 |
4.7× |
| Testicular Imaging W/Flow (78761) |
$4,456.50 |
$5,942 |
10.7× |
| Thoracic spine 2 views (72070) |
$532.50 |
$710 |
4.9× |
| Thoracic spine 3 views (72072) |
$633 |
$844 |
5.8× |
| Thoracolumbar 2 views (72080) |
$532.50 |
$710 |
5.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,310.25 |
$1,747 |
3.1× |
| Thyroid Met Imaging Body (78018) |
$2,805.75 |
$3,741 |
4.9× |
| Thyroid Uptake 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 elastography first target lesion (76982) |
$463.50 |
$618 |
4.2× |
| Ultrasound Elastography Parenchyma (76981) |
$624 |
$832 |
5.7× |
| Ultrasound Exam Aaa Screen (76706) |
$634.50 |
$846 |
5.8× |
| Ultrasound, abdomen limited (76705) |
$1,031.25 |
$1,375 |
9.4× |
| Umbilical-artery Doppler (OB) (76820) |
$551.25 |
$735 |
5.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$685.50 |
$914 |
7.5× |
| Unlisted magnetic resonance procedure (76498) |
$2,879.25 |
$3,839 |
31.7× |
| Upper gi w/o kub (74240) |
$1,078.50 |
$1,438 |
5.9× |
| Urethrocystogram voiding (74455) |
$1,227 |
$1,636 |
4.9× |
| Urethrocystography retrograde (74450) |
$1,122.75 |
$1,497 |
4.5× |
| Us breast unilateral complete (76641) |
$772.50 |
$1,030 |
7.1× |
| Us chest (76604) |
$768.75 |
$1,025 |
7.0× |
| Us complete joint (76881) |
$938.25 |
$1,251 |
8.6× |
| Us exam, pelvic, limited (76857) |
$741.75 |
$989 |
6.8× |
| Us head (76506) |
$831 |
$1,108 |
7.6× |
| Us kidney transplant (76776) |
$1,124.25 |
$1,499 |
10.3× |
| Us lmtd joint/oth 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 limited 1 or more fetuses (76815) |
$786.75 |
$1,049 |
7.2× |
| Us ob transvaginal (76817) |
$939.75 |
$1,253 |
8.6× |
| Us pelvic non ob complete (76856) |
$1,146 |
$1,528 |
10.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,026.75 |
$1,369 |
9.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$695.25 |
$927 |
6.4× |
| Us retroperitoneal complete (76770) |
$1,104 |
$1,472 |
10.1× |
| Us retroperitoneal limited (76775) |
$875.25 |
$1,167 |
8.0× |
| Us scrotum and contents (76870) |
$1,050 |
$1,400 |
9.6× |
| Us spinal canal and contents (76800) |
$1,066.50 |
$1,422 |
9.8× |
| Us thyroid (76536) |
$945.75 |
$1,261 |
8.7× |
| Vein X-Ray Chest (75827) |
$4,377.75 |
$5,837 |
2.7× |
| Venogram Sinus/Jugular (75860) |
$5,206.50 |
$6,942 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$6,554.25 |
$8,739 |
2.0× |
| Venography extremity bilateral rs&i (75822) |
$4,220.25 |
$5,627 |
2.6× |
| Venography extremity unilateral rs&i (75820) |
$3,358.50 |
$4,478 |
2.0× |
| Venography Renal Bilateral (75833) |
$7,755.75 |
$10,341 |
2.4× |
| Venography Renal Unilateral (75831) |
$6,327.75 |
$8,437 |
1.9× |
| Venous sampling by catheter (75893) |
$9,741 |
$12,988 |
1.7× |
| Wrist 2 views (73100) |
$443.25 |
$591 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$495.75 |
$661 |
5.5× |
| X-ray antegrade pyelogram tube (74425) |
$1,281.75 |
$1,709 |
3.5× |
| X-Ray Aorta Leg Arteries (75630) |
$8,562.75 |
$11,417 |
2.6× |
| X-Ray Bend Only L-S Spine (72120) |
$594 |
$792 |
5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$447.75 |
$597 |
4.9× |
| X-Ray Exam Breast Specimen (76098) |
$1,142.25 |
$1,523 |
2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$436.50 |
$582 |
4.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$645.75 |
$861 |
5.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$813 |
$1,084 |
7.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$418.50 |
$558 |
4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$507.75 |
$677 |
5.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$684 |
$912 |
6.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$636.75 |
$849 |
5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$718.50 |
$958 |
6.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$909 |
$1,212 |
8.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$948 |
$1,264 |
8.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$559.50 |
$746 |
6.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$912 |
$1,216 |
8.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$630.75 |
$841 |
5.8× |
| X-ray eye for foreign body (70030) |
$359.25 |
$479 |
4.0× |
| X-ray humerus (73060) |
$482.25 |
$643 |
5.3× |
| X-ray IV pyelogram (ivp) (74400) |
$1,383 |
$1,844 |
7.6× |
| X-ray IV pyelogram+tomography (74415) |
$1,301.25 |
$1,735 |
7.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$450.75 |
$601 |
5.0× |
| 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 nose-rectum child f.b. (76010) |
$371.25 |
$495 |
4.1× |
| 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 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 thoracic spine 4 vw (72074) |
$699 |
$932 |
6.4× |
| X-Ray Tmj Unilat (70328) |
$379.50 |
$506 |
4.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,545 |
$2,060 |
4.2× |
| X-Rays Bone Length Studies (77073) |
$572.25 |
$763 |
5.2× |
| X-Rays Bone Survey Complete (77075) |
$1,188.75 |
$1,585 |
10.9× |
| Xr c-spine 4 or 5 views (72050) |
$783.75 |
$1,045 |
7.2× |
| Xr facial bones less than 3 views (70140) |
$468.75 |
$625 |
5.2× |
| Xr orbits complete 4 views (70200) |
$636 |
$848 |
5.8× |
| Xr Tomogram Single Plane (76100) |
$1,041 |
$1,388 |
9.5× |