| Abdomen 2 views (74019) |
$398.65 |
$569.50 |
3.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,822.98 |
$2,604.25 |
4.5× |
| Ankle 2 views (73600) |
$398.65 |
$569.50 |
4.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,903.48 |
$2,719.25 |
4.7× |
| Bone &/joint imaging whole body (78306) |
$1,996.05 |
$2,851.50 |
5.0× |
| Bone age studies (77072) |
$982.63 |
$1,403.75 |
9.4× |
| Bone Imaging 3 Phase (78315) |
$2,631.65 |
$3,759.50 |
6.6× |
| Bone survey complete (77075) |
$982.63 |
$1,403.75 |
9.4× |
| Cervical spine 2 or 3 views (72040) |
$438.38 |
$626.25 |
5.0× |
| Chest 1 view (71045) |
$349.65 |
$499.50 |
4.0× |
| Clavicle complete (73000) |
$398.65 |
$569.50 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,031.58 |
$2,902.25 |
19.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,811.93 |
$8,302.75 |
16.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,929.45 |
$5,613.50 |
16.4× |
| CT abdomen w contrast (74160) |
$3,416.70 |
$4,881 |
19.4× |
| CT abdomen w wo contrast (74170) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT abdomen w/o contrast (74150) |
$2,615.55 |
$3,736.50 |
24.9× |
| CT angiography upper extremity lt (73206) |
$5,288.33 |
$7,554.75 |
30.0× |
| CT c-spine w/o contrast (72125) |
$2,631.65 |
$3,759.50 |
25.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT cervical spine with contrast (72126) |
$3,416.70 |
$4,881 |
9.7× |
| CT chest w/wo contrast (71270) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT chest with contrast (71260) |
$3,416.70 |
$4,881 |
19.4× |
| CT head/brain with contrast (70460) |
$3,424.75 |
$4,892.50 |
19.4× |
| CT head/brain without and with contrast (70470) |
$3,893.40 |
$5,562 |
22.1× |
| CT iac w contrast (70481) |
$3,416.70 |
$4,881 |
19.4× |
| CT lower ext w/o (73700) |
$2,031.58 |
$2,902.25 |
19.3× |
| CT lower extremity w wo contrast (73702) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT lower extremity with contrast (73701) |
$3,416.70 |
$4,881 |
19.4× |
| CT lumbar spine w & w/o contrast (72133) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT lumbar spine w/o contrast (72131) |
$2,631.65 |
$3,759.50 |
25.1× |
| CT lumbar spine with contrast (72132) |
$2,653.70 |
$3,791 |
7.6× |
| CT maxillofacial w contrast (70487) |
$3,416.70 |
$4,881 |
19.4× |
| CT maxillofacial w/o contrast (70486) |
$2,615.55 |
$3,736.50 |
24.9× |
| CT maxillofacial w/wo contrast (70488) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT neck soft tissue w contrast (70491) |
$3,416.70 |
$4,881 |
19.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT orbits w/o contrast (70480) |
$2,615.55 |
$3,736.50 |
24.9× |
| CT pelvis w & w/o contrast (72194) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT pelvis w/o contrast (72192) |
$2,615.55 |
$3,736.50 |
24.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,615.55 |
$3,736.50 |
24.9× |
| CT thoracic spine w/contrast (72129) |
$3,416.70 |
$4,881 |
19.4× |
| CT thoracic spine w/o contrast (72128) |
$2,631.65 |
$3,759.50 |
25.1× |
| CT thoracic spine w/wo contrast (72130) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT thorax w/o contrast (71250) |
$2,615.55 |
$3,736.50 |
24.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,874.68 |
$5,535.25 |
22.0× |
| CT upper extremity w/o contrast rt (73200) |
$2,539.43 |
$3,627.75 |
24.2× |
| CT upper extremity with contrast (73201) |
$3,416.70 |
$4,881 |
9.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,107.43 |
$5,867.75 |
23.3× |
| Cta Abdomen (74175) |
$5,288.33 |
$7,554.75 |
30.0× |
| CTA abdomen pelvis (74174) |
$4,107.43 |
$5,867.75 |
11.7× |
| CTA chest (71275) |
$4,116 |
$5,880 |
23.4× |
| Cta Head (70496) |
$4,107.43 |
$5,867.75 |
23.3× |
| CTA lwr ext w&w/o contrast (73706) |
$5,288.33 |
$7,554.75 |
30.0× |
| Cta Neck (70498) |
$4,107.43 |
$5,867.75 |
23.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$360.85 |
$515.50 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$360.85 |
$515.50 |
4.1× |
| Fetal biophysical profile non-stress testing (76818) |
$974.23 |
$1,391.75 |
9.3× |
| Fluoroscopy up to 1 hr (76000) |
$289.63 |
$413.75 |
1.2× |
| Foot 2 views (73620) |
$398.65 |
$569.50 |
4.6× |
| Forearm 2 views (73090) |
$398.65 |
$569.50 |
4.6× |
| Hand 2 views (73120) |
$398.65 |
$569.50 |
3.8× |
| Hand 3 views (73130) |
$441 |
$630 |
5.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,610.83 |
$3,729.75 |
4.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,366.05 |
$1,951.50 |
3.4× |
| Humerus Min 2 Views Left (73060) |
$398.65 |
$569.50 |
4.6× |
| Kidney imaging morphology (78700) |
$1,203.83 |
$1,719.75 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,444.63 |
$2,063.75 |
2.6× |
| Knee 3 views (73562) |
$441 |
$630 |
5.0× |
| Liver & spleen imaging static only (78215) |
$1,721.13 |
$2,458.75 |
4.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,320.33 |
$3,314.75 |
5.8× |
| Liver imaging static only (78201) |
$1,261.05 |
$1,801.50 |
2.3× |
| Liver imaging w/vascular flow (78202) |
$1,991.50 |
$2,845 |
3.7× |
| MRA head w/o contrast (70544) |
$3,938.55 |
$5,626.50 |
16.4× |
| MRA head with contrast (70545) |
$4,548.25 |
$6,497.50 |
13.0× |
| MRA neck w contrast (70548) |
$5,856.03 |
$8,365.75 |
16.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,710.38 |
$9,586.25 |
19.1× |
| MRA neck w/o contrast (70547) |
$5,070.80 |
$7,244 |
21.2× |
| MRI abdomen w contrast (74182) |
$4,918.73 |
$7,026.75 |
14.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,343.33 |
$6,204.75 |
12.4× |
| MRI abdomen w/o contrast (74181) |
$4,133.50 |
$5,905 |
17.2× |
| MRI any jnt lwr ext with con lt (73722) |
$4,918.73 |
$7,026.75 |
6.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,918.73 |
$7,026.75 |
6.2× |
| MRI c-spine with contrast (72142) |
$4,918.73 |
$7,026.75 |
14.0× |
| MRI cervical spine w/o contrast (72141) |
$4,133.50 |
$5,905 |
17.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,918.73 |
$7,026.75 |
14.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,918.73 |
$7,026.75 |
14.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,210.55 |
$4,586.50 |
13.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,181.95 |
$1,688.50 |
3.4× |
| MRI pelvis w contrast (72196) |
$4,960.55 |
$7,086.50 |
14.2× |
| MRI pelvis w/o contrast (72195) |
$3,210.55 |
$4,586.50 |
13.4× |
| MRI scan of arm joint before and after contrast (73223) |
$5,592.13 |
$7,988.75 |
16.0× |
| MRI scan of leg joint before and after contrast (73723) |
$5,592.13 |
$7,988.75 |
16.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,343.33 |
$6,204.75 |
12.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,918.73 |
$7,026.75 |
14.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,343.33 |
$6,204.75 |
12.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,820.25 |
$5,457.50 |
10.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,343.33 |
$6,204.75 |
12.4× |
| MRI thoracic spine w/o contrast (72146) |
$3,210.55 |
$4,586.50 |
13.4× |
| MRI upper ext joint w/o contrast (73221) |
$4,133.50 |
$5,905 |
17.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,592.13 |
$7,988.75 |
16.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,133.50 |
$5,905 |
17.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,207.75 |
$4,582.50 |
2.5× |
| Neck soft tissue (70360) |
$259.18 |
$370.25 |
3.0× |
| Nm gastric emptying study (78264) |
$1,473.33 |
$2,104.75 |
3.7× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$1,456.18 |
$2,080.25 |
3.6× |
| Osseous survey limited (77074) |
$772.45 |
$1,103.50 |
7.4× |
| Parathyroid imaging (78070) |
$1,705.90 |
$2,437 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$398.65 |
$569.50 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$5,592.13 |
$7,988.75 |
16.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,144.28 |
$3,063.25 |
5.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,144.28 |
$3,063.25 |
3.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$398.65 |
$569.50 |
4.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,097.60 |
$1,568 |
10.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$527.28 |
$753.25 |
5.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$441 |
$630 |
4.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$348.95 |
$498.50 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$488.60 |
$698 |
4.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$398.65 |
$569.50 |
4.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$478.28 |
$683.25 |
5.5× |
| Ribs bilateral 3 views (71110) |
$441 |
$630 |
4.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,145.85 |
$3,065.50 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$352.80 |
$504 |
3.4× |
| Scanogram (77073) |
$772.45 |
$1,103.50 |
7.4× |
| Scapula complete (73010) |
$398.65 |
$569.50 |
3.8× |
| Screening digital breast tomosynthesis (77063) |
$80.44 |
$114.92 |
3.4× |
| Spleen imaging only (78185) |
$1,326.68 |
$1,895.25 |
3.3× |
| Testicular Imaging With Vascular Flow (78761) |
$1,448.65 |
$2,069.50 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,051.58 |
$1,502.25 |
2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,366.05 |
$1,951.50 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$813.75 |
$1,162.50 |
7.7× |
| Upper Extremity Infant (73092) |
$279.13 |
$398.75 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$810.95 |
$1,158.50 |
4.6× |
| Us breast unilateral complete (76641) |
$658.70 |
$941 |
6.3× |
| Us breast unilateral limited (76642) |
$579.08 |
$827.25 |
6.6× |
| Us chest (76604) |
$974.23 |
$1,391.75 |
9.3× |
| Us compl joint r-t w/image documentation (76881) |
$558.78 |
$798.25 |
5.3× |
| Us ob transvaginal (76817) |
$974.23 |
$1,391.75 |
9.3× |
| Us pelvic non ob complete (76856) |
$1,073.63 |
$1,533.75 |
10.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$937.56 |
$1,339.38 |
8.9× |
| Us pregnancy ltd (76815) |
$900.90 |
$1,287 |
8.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$974.23 |
$1,391.75 |
9.3× |
| Us retroperitoneal complete (76770) |
$937.56 |
$1,339.38 |
8.9× |
| Us scrotum and contents (76870) |
$937.56 |
$1,339.38 |
8.9× |
| Us soft tissue head/neck (76536) |
$974.23 |
$1,391.75 |
9.3× |
| Us xtr non-vasc lmtd (76882) |
$483.88 |
$691.25 |
4.6× |
| Wrist 2 views (73100) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$497.53 |
$710.75 |
4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$441 |
$630 |
5.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$441 |
$630 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$441 |
$630 |
5.0× |
| X-ray exam hip uni 1 view (73501) |
$348.95 |
$498.50 |
4.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$421.75 |
$602.50 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$632.63 |
$903.75 |
6.0× |
| X-ray exam of femur 1 (73551) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$441 |
$630 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$352.80 |
$504 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$441 |
$630 |
5.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$463.40 |
$662 |
4.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$279.13 |
$398.75 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$398.65 |
$569.50 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$696.68 |
$995.25 |
6.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$441 |
$630 |
5.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$149.98 |
$214.25 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$436.02 |
$622.88 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$477.40 |
$682 |
4.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$424.90 |
$607 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$441 |
$630 |
4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$441 |
$630 |
5.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$624.58 |
$892.25 |
5.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$441 |
$630 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$348.95 |
$498.50 |
4.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$441 |
$630 |
5.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$398.65 |
$569.50 |
3.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$398.65 |
$569.50 |
4.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$441 |
$630 |
5.0× |
| Xr c-spine 6 or more views (72052) |
$627.38 |
$896.25 |
6.0× |
| Xr finger(s) 2+ views (73140) |
$398.65 |
$569.50 |
4.6× |
| Xr shoulder 1 view (73020) |
$348.95 |
$498.50 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$398.65 |
$569.50 |
4.6× |
| Xray knee 1 or 2 views rt (73560) |
$348.95 |
$498.50 |
4.0× |