| Abdomen 2 views (74019) |
$237.21 |
$237.21 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$832.32 |
$832.32 |
2.3× |
| Ankle 2 views (73600) |
$161.26 |
$161.26 |
2.0× |
| Arthrogram hip (73525) |
$910.35 |
$910.35 |
2.8× |
| Arthrogram shoulder (73040) |
$499.39 |
$499.39 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$541.01 |
$541.01 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$738.68 |
$738.68 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$766.77 |
$766.77 |
2.1× |
| Bone age studies (77072) |
$176.87 |
$176.87 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$807.35 |
$807.35 |
2.2× |
| Bone survey complete (77075) |
$645.05 |
$645.05 |
6.7× |
| Brain image w/flow 4 + views (78606) |
$577.42 |
$577.42 |
1.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$577.42 |
$577.42 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$197.68 |
$197.68 |
2.5× |
| Chest 1 view (71045) |
$171.67 |
$171.67 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$602.39 |
$602.39 |
3.7× |
| Clavicle complete (73000) |
$175.83 |
$175.83 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$676.26 |
$676.26 |
7.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$910.35 |
$910.35 |
2.8× |
| CT abdomen and pelvis without contrast (74176) |
$733.48 |
$733.48 |
3.3× |
| CT abdomen w contrast (74160) |
$634.64 |
$634.64 |
3.9× |
| CT abdomen w wo contrast (74170) |
$663.78 |
$663.78 |
4.1× |
| CT abdomen w/o contrast (74150) |
$585.75 |
$585.75 |
6.1× |
| CT angiography upper extremity lt (73206) |
$1,004 |
$1,004 |
6.2× |
| CT c-spine w/o contrast (72125) |
$605.51 |
$605.51 |
6.3× |
| CT cervical spine w&w/o contrast (72127) |
$678.34 |
$678.34 |
4.2× |
| CT cervical spine with contrast (72126) |
$626.32 |
$626.32 |
2.0× |
| CT chest w/wo contrast (71270) |
$736.60 |
$736.60 |
4.6× |
| CT chest with contrast (71260) |
$715.80 |
$715.80 |
4.4× |
| CT head/brain with contrast (70460) |
$702.27 |
$702.27 |
4.4× |
| CT head/brain without and with contrast (70470) |
$585.75 |
$585.75 |
3.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$688.50 |
$688.50 |
8.6× |
| CT lower ext w/o (73700) |
$630 |
$630 |
6.6× |
| CT lower extremity w wo contrast (73702) |
$630 |
$630 |
3.9× |
| CT lower extremity with contrast (73701) |
$630 |
$630 |
3.9× |
| CT lumbar spine w & w/o contrast (72133) |
$764.69 |
$764.69 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$679.38 |
$679.38 |
7.1× |
| CT lumbar spine with contrast (72132) |
$733.48 |
$733.48 |
2.3× |
| CT maxillofacial w contrast (70487) |
$703.31 |
$703.31 |
4.4× |
| CT maxillofacial w/o contrast (70486) |
$661.69 |
$661.69 |
6.9× |
| CT maxillofacial w/wo contrast (70488) |
$713.71 |
$713.71 |
4.4× |
| CT neck soft tissue w contrast (70491) |
$676.26 |
$676.26 |
4.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$688.50 |
$688.50 |
4.3× |
| CT orbits w/o contrast (70480) |
$706.43 |
$706.43 |
7.3× |
| CT pelvis w & w/o contrast (72194) |
$663.78 |
$663.78 |
4.1× |
| CT pelvis w/o contrast (72192) |
$706.43 |
$706.43 |
7.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$717.88 |
$717.88 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$642.97 |
$642.97 |
6.7× |
| CT thoracic spine w/contrast (72129) |
$691.40 |
$691.40 |
4.3× |
| CT thoracic spine w/o contrast (72128) |
$605.51 |
$605.51 |
6.3× |
| CT thoracic spine w/wo contrast (72130) |
$726.20 |
$726.20 |
4.5× |
| CT thorax w/o contrast (71250) |
$634.64 |
$634.64 |
6.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$630 |
$630 |
3.9× |
| CT upper extremity w/o contrast rt (73200) |
$630 |
$630 |
6.6× |
| CT upper extremity with contrast (73201) |
$625 |
$625 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,850 |
$1,850 |
11.5× |
| Cta Abdomen (74175) |
$1,833.18 |
$1,833.18 |
11.4× |
| CTA abdomen pelvis (74174) |
$2,424.13 |
$2,424.13 |
7.6× |
| CTA chest (71275) |
$1,766.60 |
$1,766.60 |
11.0× |
| Cta Head (70496) |
$1,791.57 |
$1,791.57 |
11.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,820 |
$1,820 |
5.7× |
| Cta Neck (70498) |
$1,791.57 |
$1,791.57 |
11.1× |
| Cystography minimum 3 views rs&i (74430) |
$447.37 |
$447.37 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$312.12 |
$312.12 |
3.2× |
| Esophagus (74220) |
$417.20 |
$417.20 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$348.53 |
$348.53 |
1.6× |
| Foot 2 views (73620) |
$152 |
$152 |
1.9× |
| Forearm 2 views (73090) |
$174 |
$174 |
2.2× |
| Gated Heart Planar Single (78472) |
$653.37 |
$653.37 |
1.8× |
| Hand 2 views (73120) |
$155 |
$155 |
1.6× |
| Hand 3 views (73130) |
$200 |
$200 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$790.70 |
$790.70 |
1.6× |
| Ht muscle image spect sing (78451) |
$1,508.58 |
$1,508.58 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$200 |
$200 |
2.5× |
| Hysterosalpingogram (74740) |
$1,247.44 |
$1,247.44 |
5.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$953.01 |
$953.01 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,377 |
$1,377 |
2.8× |
| Knee 3 views (73562) |
$220 |
$220 |
2.7× |
| Liver & spleen imaging static only (78215) |
$577.42 |
$577.42 |
1.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$91.56 |
$91.56 |
1.1× |
| Meckels Diverticulum (78290) |
$468.18 |
$468.18 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,106.99 |
$1,106.99 |
3.5× |
| MRA head w/o contrast (70544) |
$1,047.68 |
$1,047.68 |
4.8× |
| MRA head with contrast (70545) |
$1,068.49 |
$1,068.49 |
3.3× |
| MRA neck w contrast (70548) |
$1,030 |
$1,030 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,070.57 |
$1,070.57 |
3.3× |
| MRA neck w/o contrast (70547) |
$1,011.27 |
$1,011.27 |
4.6× |
| MRI abdomen w contrast (74182) |
$842.72 |
$842.72 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$904.11 |
$904.11 |
2.8× |
| MRI abdomen w/o contrast (74181) |
$842.72 |
$842.72 |
3.8× |
| MRI any jnt lwr ext with con lt (73722) |
$903 |
$903 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$828 |
$828 |
1.1× |
| MRI c-spine with contrast (72142) |
$864.57 |
$864.57 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$835.44 |
$835.44 |
3.8× |
| MRI chest w/o & w/contrast material (71552) |
$756.37 |
$756.37 |
2.4× |
| MRI chest w/o contrast (71550) |
$737.64 |
$737.64 |
3.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$903 |
$903 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$903 |
$903 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$961 |
$961 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$728.28 |
$728.28 |
3.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$739.72 |
$739.72 |
2.3× |
| MRI pelvis w contrast (72196) |
$862.49 |
$862.49 |
2.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$877.06 |
$877.06 |
2.7× |
| MRI pelvis w/o contrast (72195) |
$836.48 |
$836.48 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$868 |
$868 |
2.7× |
| MRI scan of leg joint before and after contrast (73723) |
$833 |
$833 |
2.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$981.10 |
$981.10 |
3.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$887.46 |
$887.46 |
2.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$929.08 |
$929.08 |
2.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$856.25 |
$856.25 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$933.24 |
$933.24 |
2.9× |
| MRI thoracic spine w/o contrast (72146) |
$835.44 |
$835.44 |
3.8× |
| MRI tmj (70336) |
$811.51 |
$811.51 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$803 |
$803 |
3.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$933 |
$933 |
2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$911.04 |
$911.04 |
4.2× |
| Myelogram Cervical (72240) |
$3,771.45 |
$3,771.45 |
5.2× |
| Myelogram Lumbar (72265) |
$3,771.45 |
$3,771.45 |
5.2× |
| Myelogram thoracic (72255) |
$3,771.45 |
$3,771.45 |
5.2× |
| Myelography 2 or more regions (72270) |
$4,259.40 |
$4,259.40 |
5.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,184.84 |
$2,184.84 |
1.8× |
| Neck soft tissue (70360) |
$198.72 |
$198.72 |
2.5× |
| Nm gastric emptying study (78264) |
$739.72 |
$739.72 |
2.0× |
| Osseous survey limited (77074) |
$462.98 |
$462.98 |
4.8× |
| Parathyroid imaging (78070) |
$488.99 |
$488.99 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$181.03 |
$181.03 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$891 |
$891 |
2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$475.46 |
$475.46 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$888.50 |
$888.50 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$206 |
$206 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$293.39 |
$293.39 |
3.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$251.78 |
$251.78 |
2.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$245 |
$245 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$501.47 |
$501.47 |
5.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$325.65 |
$325.65 |
3.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$171.67 |
$171.67 |
2.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$199.76 |
$199.76 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$530.60 |
$530.60 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$483.79 |
$483.79 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$236.17 |
$236.17 |
3.0× |
| Radiological examination surgical specimen (76098) |
$55.14 |
$55.14 |
0.1× |
| Ribs bilateral 3 views (71110) |
$254.90 |
$254.90 |
2.7× |
| Scanogram (77073) |
$315.24 |
$315.24 |
3.3× |
| Scapula complete (73010) |
$183 |
$183 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$119.65 |
$119.65 |
5.1× |
| Small bowel series (74250) |
$560.78 |
$560.78 |
3.5× |
| Spine thoracic 3 views (72072) |
$311.08 |
$311.08 |
3.2× |
| Thoracolumbar 2 views (72080) |
$297.55 |
$297.55 |
3.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$715 |
$715 |
1.9× |
| Thyroid uptake measurement (78012) |
$707.47 |
$707.47 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$364.14 |
$364.14 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$199.76 |
$199.76 |
2.1× |
| Upper Extremity Infant (73092) |
$192 |
$192 |
2.0× |
| Urethrocystography voiding (74455) |
$728.28 |
$728.28 |
3.3× |
| Us abdl aorta screen aaa (76706) |
$192.47 |
$192.47 |
2.0× |
| Us breast unilateral complete (76641) |
$127.97 |
$127.97 |
1.3× |
| Us breast unilateral limited (76642) |
$127.97 |
$127.97 |
1.6× |
| Us chest (76604) |
$148.78 |
$148.78 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$224.73 |
$224.73 |
2.3× |
| Us ob detailed single fetus (76811) |
$436.97 |
$436.97 |
2.0× |
| Us ob transvaginal (76817) |
$311.08 |
$311.08 |
3.2× |
| Us pelvic non ob complete (76856) |
$239.29 |
$239.29 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$166.46 |
$166.46 |
1.7× |
| Us pregnancy ltd (76815) |
$123.81 |
$123.81 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$252.82 |
$252.82 |
2.6× |
| Us retroperitoneal complete (76770) |
$294.43 |
$294.43 |
3.1× |
| Us retroperitoneal limited (76775) |
$176.87 |
$176.87 |
1.8× |
| Us scrotum and contents (76870) |
$229.93 |
$229.93 |
2.4× |
| Us soft tissue head/neck (76536) |
$702.27 |
$702.27 |
7.3× |
| Us xtr non-vasc lmtd (76882) |
$181.03 |
$181.03 |
1.9× |
| Wrist 2 views (73100) |
$137.72 |
$137.72 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$407.84 |
$407.84 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$226.81 |
$226.81 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$208.08 |
$208.08 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,584.53 |
$1,584.53 |
9.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$181.03 |
$181.03 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$228.89 |
$228.89 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$156.06 |
$156.06 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$239.29 |
$239.29 |
3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$156.06 |
$156.06 |
1.6× |
| X-ray exam of femur 1 (73551) |
$204.96 |
$204.96 |
2.6× |
| X-ray eye for foreign body (70030) |
$138 |
$138 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$234.09 |
$234.09 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$276.75 |
$276.75 |
3.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$200 |
$200 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$176.87 |
$176.87 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$305 |
$305 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$140.45 |
$140.45 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$216.28 |
$216.28 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$269.46 |
$269.46 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$461.94 |
$461.94 |
4.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$171.67 |
$171.67 |
2.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$141.49 |
$141.49 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$228 |
$228 |
2.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$233.05 |
$233.05 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$236 |
$236 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$246 |
$246 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$405.76 |
$405.76 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$209.12 |
$209.12 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$197.68 |
$197.68 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$203 |
$203 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$300.68 |
$300.68 |
3.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$164.38 |
$164.38 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$325.65 |
$325.65 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$213.28 |
$213.28 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$264.26 |
$264.26 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$157.10 |
$157.10 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$177.91 |
$177.91 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$210.16 |
$210.16 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$130 |
$130 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$209.14 |
$209.14 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$390.15 |
$390.15 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$135.25 |
$135.25 |
1.7× |
| Xr shoulder 1 view (73020) |
$150 |
$150 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$291.31 |
$291.31 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$200 |
$200 |
2.5× |
| Xr tmj bilateral (70330) |
$211.20 |
$211.20 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$174 |
$174 |
2.2× |