| Acute gastrointestinal blood loss imaging (78278) |
$509.99 |
$849.98 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,896.90 |
$6,494.83 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,896.90 |
$6,494.83 |
1.4× |
| Angiography internal mammary rs&i (75756) |
$3,896.90 |
$6,494.83 |
1.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,126.82 |
$1,878.03 |
0.4× |
| Ankle 2 views (73600) |
$345.68 |
$576.12 |
4.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,182.98 |
$6,971.64 |
1.5× |
| Aortography abdominal serialography rs&i (75625) |
$3,896.90 |
$6,494.83 |
1.4× |
| Arthrogram elbow (73085) |
$2,205.73 |
$3,676.22 |
6.9× |
| Arthrogram hip (73525) |
$2,205.73 |
$3,676.22 |
6.9× |
| Arthrogram shoulder (73040) |
$2,205.73 |
$3,676.22 |
6.9× |
| Arthrogram wrist (73115) |
$2,205.73 |
$3,676.22 |
6.9× |
| Arthrography knee lt (73580) |
$2,205.73 |
$3,676.22 |
6.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,412.76 |
$2,354.60 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$1,412.76 |
$2,354.60 |
3.9× |
| Bone age studies (77072) |
$231.19 |
$385.31 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,412.76 |
$2,354.60 |
3.9× |
| Cervical spine 2 or 3 views (72040) |
$231.19 |
$385.31 |
2.9× |
| Chest 1 view (71045) |
$231.19 |
$385.31 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$145.85 |
$243.09 |
0.9× |
| Clavicle complete (73000) |
$345.68 |
$576.12 |
4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$135.07 |
$225.11 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,380.65 |
$5,634.41 |
10.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,093.05 |
$3,488.42 |
9.6× |
| CT abdomen w contrast (74160) |
$1,420.74 |
$2,367.90 |
8.9× |
| CT abdomen w wo contrast (74170) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT abdomen w/o contrast (74150) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT angiography upper extremity lt (73206) |
$2,364.11 |
$3,940.18 |
14.8× |
| CT c-spine w/o contrast (72125) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT cervical spine with contrast (72126) |
$1,420.74 |
$2,367.90 |
4.5× |
| CT chest w/wo contrast (71270) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT chest with contrast (71260) |
$1,420.74 |
$2,367.90 |
8.9× |
| CT head/brain with contrast (70460) |
$1,420.74 |
$2,367.90 |
8.9× |
| CT head/brain without and with contrast (70470) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$80.47 |
$134.11 |
1.0× |
| CT lower ext w/o (73700) |
$1,587.16 |
$2,645.28 |
16.7× |
| CT lower extremity w wo contrast (73702) |
$2,536.04 |
$4,226.72 |
15.9× |
| CT lower extremity with contrast (73701) |
$2,131.47 |
$3,552.45 |
13.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT lumbar spine w/o contrast (72131) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT lumbar spine with contrast (72132) |
$1,420.74 |
$2,367.90 |
4.5× |
| CT maxillofacial w contrast (70487) |
$1,469.02 |
$2,448.36 |
9.2× |
| CT maxillofacial w/o contrast (70486) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT neck soft tissue w contrast (70491) |
$1,420.74 |
$2,367.90 |
8.9× |
| CT orbits w/o contrast (70480) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT pelvis w & w/o contrast (72194) |
$1,690.69 |
$2,817.81 |
10.6× |
| CT pelvis w/o contrast (72192) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$93.17 |
$155.28 |
1.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,673.87 |
$2,789.78 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT thoracic spine w/contrast (72129) |
$1,420.74 |
$2,367.90 |
8.9× |
| CT thoracic spine w/o contrast (72128) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT thorax w/o contrast (71250) |
$1,046.89 |
$1,744.82 |
11.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,311.84 |
$3,853.08 |
14.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,569.97 |
$2,616.62 |
16.5× |
| CT upper extremity with contrast (73201) |
$1,914.92 |
$3,191.53 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,037.47 |
$3,395.78 |
12.8× |
| Cta Abdomen (74175) |
$1,420.74 |
$2,367.90 |
8.9× |
| CTA chest (71275) |
$1,420.74 |
$2,367.90 |
8.9× |
| Cta Head (70496) |
$1,685.57 |
$2,809.28 |
10.6× |
| CTA lwr ext w&w/o contrast (73706) |
$3,307.48 |
$5,512.47 |
20.7× |
| Cta Neck (70498) |
$1,685.57 |
$2,809.28 |
10.6× |
| Cystography minimum 3 views rs&i (74430) |
$806.93 |
$1,344.89 |
2.5× |
| Esophagus (74220) |
$463.82 |
$773.03 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$501.14 |
$835.23 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$337.65 |
$562.75 |
1.6× |
| Foot 2 views (73620) |
$345.68 |
$576.12 |
4.4× |
| Forearm 2 views (73090) |
$345.68 |
$576.12 |
4.4× |
| Gated Heart Planar Single (78472) |
$651.61 |
$1,086.01 |
1.8× |
| Hand 2 views (73120) |
$345.68 |
$576.12 |
3.6× |
| Hand 3 views (73130) |
$345.68 |
$576.12 |
4.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,527.40 |
$2,545.66 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,527.40 |
$2,545.66 |
4.2× |
| Ht muscle image spect sing (78451) |
$1,541.21 |
$2,568.68 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$345.68 |
$576.12 |
4.4× |
| Hysterosalpingogram (74740) |
$437.57 |
$729.29 |
2.0× |
| Knee 3 views (73562) |
$344.20 |
$573.68 |
4.3× |
| Liver & spleen imaging static only (78215) |
$1,527.40 |
$2,545.66 |
4.2× |
| Lymphoscintigraphy (78195) |
$2,180.18 |
$3,633.63 |
4.4× |
| Meckels Diverticulum (78290) |
$1,387.57 |
$2,312.62 |
3.8× |
| MRA head w & w/o contrast (70546) |
$2,021.02 |
$3,368.36 |
6.4× |
| MRA head w/o contrast (70544) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRA neck w contrast (70548) |
$1,943.09 |
$3,238.48 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,943.09 |
$3,238.48 |
6.1× |
| MRA neck w/o contrast (70547) |
$2,004.53 |
$3,340.89 |
9.2× |
| MRI abdomen w/o contrast (74181) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRI cervical spine w/o contrast (72141) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,816.60 |
$4,694.34 |
8.9× |
| MRI pelvis w contrast (72196) |
$2,064.53 |
$3,440.89 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,003.15 |
$5,005.25 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$1,833.36 |
$3,055.60 |
8.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,816.60 |
$4,694.34 |
8.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,908.05 |
$4,846.75 |
9.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,816.60 |
$4,694.34 |
8.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,379.60 |
$3,966 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,816.60 |
$4,694.34 |
8.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,908.05 |
$4,846.75 |
9.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRI tmj (70336) |
$1,687.76 |
$2,812.93 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,943.09 |
$3,238.48 |
8.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,270.26 |
$7,117.10 |
13.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,914.26 |
$4,857.11 |
13.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,840.21 |
$3,067.01 |
1.6× |
| Neck soft tissue (70360) |
$231.19 |
$385.31 |
2.9× |
| Nm gastric emptying study (78264) |
$1,334.74 |
$2,224.57 |
3.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,840.21 |
$3,067.01 |
1.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,294.10 |
$2,156.83 |
3.6× |
| Osseous survey infant (77076) |
$392.13 |
$653.55 |
4.1× |
| Osseous survey limited (77074) |
$392.13 |
$653.55 |
4.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,359.93 |
$2,266.55 |
2.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,359.93 |
$2,266.55 |
3.7× |
| Parathyroid imaging (78070) |
$985.21 |
$1,642.01 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$231.19 |
$385.31 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,816.60 |
$4,694.34 |
8.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,173.79 |
$1,956.31 |
3.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,892.36 |
$3,153.94 |
3.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$369.93 |
$616.55 |
4.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$369.93 |
$616.55 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$436.19 |
$726.98 |
4.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$739.87 |
$1,233.11 |
7.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$227.82 |
$379.70 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$231.19 |
$385.31 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$231.19 |
$385.31 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$231.19 |
$385.31 |
2.9× |
| Radiologic exam colon single contrast study (74270) |
$463.82 |
$773.03 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$341.80 |
$569.66 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$345.68 |
$576.12 |
4.4× |
| Radiological examination surgical specimen (76098) |
$215.09 |
$358.48 |
0.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,125.10 |
$3,541.83 |
4.3× |
| Scapula complete (73010) |
$345.68 |
$576.12 |
3.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$131.17 |
$218.61 |
1.4× |
| Small bowel series (74250) |
$463.82 |
$773.03 |
2.9× |
| Spine thoracic 3 views (72072) |
$231.19 |
$385.31 |
2.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$2,205.73 |
$3,676.22 |
10.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$873.02 |
$1,455.04 |
2.4× |
| Thyroid uptake measurement (78012) |
$873.02 |
$1,455.04 |
2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$873.02 |
$1,455.04 |
2.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,125.10 |
$3,541.83 |
5.8× |
| Ultrasound, abdomen limited (76705) |
$501.14 |
$835.23 |
5.3× |
| Upper Extremity Infant (73092) |
$231.19 |
$385.31 |
2.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$806.93 |
$1,344.89 |
5.1× |
| Us breast unilateral complete (76641) |
$186.35 |
$310.58 |
2.0× |
| Us breast unilateral limited (76642) |
$186.35 |
$310.58 |
2.4× |
| Us chest (76604) |
$501.14 |
$835.23 |
5.3× |
| Us compl joint r-t w/image documentation (76881) |
$501.14 |
$835.23 |
5.3× |
| Us ob transvaginal (76817) |
$501.14 |
$835.23 |
5.3× |
| Us pelvic non ob complete (76856) |
$501.14 |
$835.23 |
5.3× |
| Us pregnancy ltd (76815) |
$313.85 |
$523.08 |
3.3× |
| Us retroperitoneal complete (76770) |
$501.14 |
$835.23 |
5.3× |
| Us retroperitoneal limited (76775) |
$501.14 |
$835.23 |
5.3× |
| Us scrotum and contents (76870) |
$501.14 |
$835.23 |
5.3× |
| Us soft tissue head/neck (76536) |
$501.14 |
$835.23 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$250.94 |
$418.23 |
2.6× |
| Venography caval inferior serialography rs&i (75825) |
$3,896.90 |
$6,494.83 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$1,126.82 |
$1,878.03 |
0.8× |
| Wrist 2 views (73100) |
$345.68 |
$576.12 |
4.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$392.13 |
$653.55 |
4.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$345.68 |
$576.12 |
4.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$725.74 |
$1,209.56 |
4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$345.68 |
$576.12 |
4.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$345.68 |
$576.12 |
4.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$739.87 |
$1,233.11 |
7.8× |
| X-ray exam hip uni 1 view (73501) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$218.09 |
$363.49 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$327.14 |
$545.24 |
3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$436.19 |
$726.98 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$872.38 |
$1,453.97 |
9.2× |
| X-ray eye for foreign body (70030) |
$460.16 |
$766.94 |
5.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$220.20 |
$367 |
2.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$220.20 |
$367 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$345.68 |
$576.12 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$286.78 |
$477.96 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$345.68 |
$576.12 |
3.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$460.16 |
$766.94 |
5.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$231.19 |
$385.31 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$220.20 |
$367 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$256.87 |
$428.12 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$231.19 |
$385.31 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$220.20 |
$367 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$784.26 |
$1,307.10 |
8.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$231.19 |
$385.31 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$345.68 |
$576.12 |
4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$392.13 |
$653.55 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$231.19 |
$385.31 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$231.19 |
$385.31 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$231.19 |
$385.31 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$345.68 |
$576.12 |
4.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$345.68 |
$576.12 |
4.4× |
| Xr arthrogram ankle (73615) |
$2,205.73 |
$3,676.22 |
6.9× |
| Xr c-spine 6 or more views (72052) |
$392.13 |
$653.55 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$345.68 |
$576.12 |
4.4× |
| Xr internal auditory meati complete (70134) |
$784.26 |
$1,307.10 |
1.6× |
| Xr shoulder 1 view (73020) |
$345.68 |
$576.12 |
4.4× |
| Xr spine cervical 4 or 5 views (72050) |
$392.13 |
$653.55 |
4.1× |
| Xr tibia/fibula 2 views (73590) |
$345.68 |
$576.12 |
4.4× |
| Xray knee 1 or 2 views rt (73560) |
$345.68 |
$576.12 |
4.4× |