| Abdomen 2 views (74019) |
$358 |
$527 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,398 |
$2,056 |
3.4× |
| Ankle 2 views (73600) |
$213 |
$313 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$860 |
$1,264 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,472 |
$2,165 |
3.5× |
| Bone &/joint imaging whole body (78306) |
$1,542 |
$2,268 |
3.7× |
| Bone Imaging 3 Phase (78315) |
$1,783 |
$2,622 |
4.3× |
| Cervical spine 2 or 3 views (72040) |
$290 |
$427 |
3.2× |
| Chest 1 view (71045) |
$226 |
$332 |
2.5× |
| Chest 3 views (71047) |
$405 |
$595 |
4.5× |
| Clavicle complete (73000) |
$273 |
$402 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$452 |
$665 |
4.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,777 |
$7,025 |
13.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,717 |
$5,466 |
15.0× |
| CT abdomen w contrast (74160) |
$3,262 |
$4,797 |
17.9× |
| CT abdomen w wo contrast (74170) |
$3,822 |
$5,621 |
21.0× |
| CT abdomen w/o contrast (74150) |
$2,973 |
$4,372 |
27.4× |
| CT c-spine w/o contrast (72125) |
$2,117 |
$3,113 |
19.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,973 |
$4,372 |
16.3× |
| CT cervical spine with contrast (72126) |
$2,458 |
$3,614 |
6.8× |
| CT chest w/wo contrast (71270) |
$2,586 |
$3,803 |
14.2× |
| CT chest with contrast (71260) |
$2,247 |
$3,305 |
12.3× |
| CT head/brain with contrast (70460) |
$2,043 |
$3,004 |
11.2× |
| CT head/brain without and with contrast (70470) |
$2,481 |
$3,648 |
13.6× |
| CT iac w contrast (70481) |
$2,031 |
$2,987 |
11.2× |
| CT lower ext w/o (73700) |
$1,984 |
$2,917 |
18.3× |
| CT lower extremity w wo contrast (73702) |
$3,758 |
$5,526 |
20.6× |
| CT lower extremity with contrast (73701) |
$2,327 |
$3,422 |
12.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,375 |
$3,492 |
13.0× |
| CT lumbar spine w/o contrast (72131) |
$2,033 |
$2,990 |
18.7× |
| CT lumbar spine with contrast (72132) |
$2,436 |
$3,582 |
6.7× |
| CT maxillofacial w contrast (70487) |
$2,241 |
$3,296 |
12.3× |
| CT maxillofacial w/o contrast (70486) |
$1,899 |
$2,792 |
17.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,609 |
$3,837 |
14.3× |
| CT neck soft tissue w contrast (70491) |
$2,299 |
$3,381 |
12.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,231 |
$3,281 |
12.2× |
| CT orbits w/o contrast (70480) |
$1,709 |
$2,513 |
15.7× |
| CT pelvis w & w/o contrast (72194) |
$2,536 |
$3,729 |
13.9× |
| CT pelvis w/o contrast (72192) |
$1,994 |
$2,933 |
18.4× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$269 |
$395 |
3.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,638 |
$3,880 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,958 |
$2,879 |
18.0× |
| CT thoracic spine w/contrast (72129) |
$2,337 |
$3,437 |
12.8× |
| CT thoracic spine w/o contrast (72128) |
$1,994 |
$2,933 |
18.4× |
| CT thoracic spine w/wo contrast (72130) |
$2,730 |
$4,014 |
15.0× |
| CT thorax w/o contrast (71250) |
$2,325 |
$3,419 |
21.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,317 |
$3,408 |
12.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,702.50 |
$2,504 |
15.7× |
| CT upper extremity with contrast (73201) |
$2,053 |
$3,019 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,798 |
$5,586 |
20.9× |
| Cta Abdomen (74175) |
$2,985 |
$4,389 |
16.4× |
| CTA abdomen pelvis (74174) |
$4,780 |
$7,029 |
13.2× |
| CTA chest (71275) |
$2,921 |
$4,296 |
16.0× |
| Cta Head (70496) |
$2,601 |
$3,825 |
14.3× |
| CTA lwr ext w&w/o contrast (73706) |
$3,060 |
$4,500 |
16.8× |
| Cta Neck (70498) |
$2,587 |
$3,804 |
14.2× |
| Cta Pelvis (72191) |
$2,309 |
$3,396 |
12.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$409 |
$601 |
3.8× |
| Foot 2 views (73620) |
$218 |
$320 |
2.4× |
| Forearm 2 views (73090) |
$276 |
$406 |
3.1× |
| Gated Heart Planar Single (78472) |
$2,092 |
$3,077 |
5.0× |
| Hand 2 views (73120) |
$213 |
$313 |
2.0× |
| Hand 3 views (73130) |
$277 |
$408 |
3.1× |
| Heart Infarct Image (78466) |
$1,236 |
$1,818 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,555 |
$2,287 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,376 |
$2,023 |
3.3× |
| Ht muscle image spect sing (78451) |
$3,165 |
$4,654 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$287 |
$422 |
3.2× |
| Kidney imaging morphology (78700) |
$877 |
$1,289 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,572 |
$2,312 |
2.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,493 |
$2,195 |
2.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,703 |
$2,504 |
3.0× |
| Knee 3 views (73562) |
$355 |
$522 |
3.9× |
| Liver & spleen imaging static only (78215) |
$1,564 |
$2,300 |
3.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,151 |
$1,693 |
2.8× |
| Meckels Diverticulum (78290) |
$1,115 |
$1,640 |
2.7× |
| MRA head w & w/o contrast (70546) |
$3,244 |
$4,771 |
9.0× |
| MRA head w/o contrast (70544) |
$2,664 |
$3,918 |
10.8× |
| MRA head with contrast (70545) |
$2,975 |
$4,375 |
8.2× |
| MRA neck w contrast (70548) |
$3,074 |
$4,520 |
8.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,401 |
$5,001 |
9.4× |
| MRA neck w/o contrast (70547) |
$1,945 |
$2,861 |
7.9× |
| MRI abdomen w contrast (74182) |
$2,574 |
$3,786 |
7.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,624 |
$5,330 |
10.0× |
| MRI abdomen w/o contrast (74181) |
$2,787 |
$4,098 |
11.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,615 |
$3,845 |
3.2× |
| MRI c-spine with contrast (72142) |
$3,312 |
$4,871 |
9.1× |
| MRI cervical spine w/o contrast (72141) |
$2,969 |
$4,366 |
12.0× |
| MRI chest w/o contrast (71550) |
$3,365 |
$4,949 |
13.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,256 |
$3,317 |
9.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,732 |
$4,018 |
11.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,639 |
$5,351 |
10.0× |
| MRI orbit/face/neck w/contrast (70542) |
$3,076 |
$4,523 |
8.5× |
| MRI pelvis w contrast (72196) |
$2,934 |
$4,314 |
8.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,428 |
$5,041 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,591 |
$3,810 |
10.5× |
| MRI scan of arm joint before and after contrast (73223) |
$3,411 |
$5,016 |
9.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,002 |
$4,414 |
8.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,894 |
$5,726 |
10.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,284 |
$4,829 |
9.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,860 |
$5,677 |
10.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,388 |
$4,982 |
9.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,988 |
$5,865 |
11.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,044 |
$4,477 |
12.3× |
| MRI tmj (70336) |
$1,748 |
$2,570 |
7.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,294 |
$3,374 |
9.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,153 |
$4,637 |
8.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,407 |
$3,539 |
9.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,680 |
$5,412 |
2.7× |
| Neck soft tissue (70360) |
$258 |
$380 |
2.9× |
| Nm gastric emptying study (78264) |
$1,498 |
$2,203 |
3.6× |
| Parathyroid imaging (78070) |
$1,197 |
$1,760 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$260 |
$382 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,154 |
$4,638 |
8.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,810 |
$2,662 |
4.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,016 |
$2,964 |
3.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$241 |
$354 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$488 |
$717 |
4.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$396 |
$582 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$250 |
$368 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$303 |
$446 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$275 |
$405 |
3.0× |
| Ribs bilateral 3 views (71110) |
$422 |
$620 |
3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,164 |
$1,712 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$316 |
$465 |
2.9× |
| Scapula complete (73010) |
$279 |
$410 |
2.6× |
| Spine thoracic 3 views (72072) |
$216 |
$318 |
2.0× |
| Thoracolumbar 2 views (72080) |
$313 |
$461 |
3.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,197 |
$1,760 |
2.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,131 |
$1,663 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$585 |
$860 |
5.4× |
| Us abdl aorta screen aaa (76706) |
$435 |
$639 |
4.0× |
| Us breast unilateral limited (76642) |
$386 |
$568 |
4.3× |
| Us chest (76604) |
$493 |
$725 |
4.5× |
| Us ob transvaginal (76817) |
$433 |
$637 |
4.0× |
| Us pelvic non ob complete (76856) |
$668 |
$983 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$551 |
$810 |
5.1× |
| Us pregnancy ltd (76815) |
$392 |
$576 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$623 |
$916 |
5.7× |
| Us retroperitoneal complete (76770) |
$634 |
$933 |
5.8× |
| Us retroperitoneal limited (76775) |
$634 |
$933 |
5.8× |
| Us scrotum and contents (76870) |
$583 |
$857 |
5.4× |
| Us soft tissue head/neck (76536) |
$490 |
$721 |
4.5× |
| Us xtr non-vasc lmtd (76882) |
$395.50 |
$582 |
3.6× |
| Wrist 2 views (73100) |
$243 |
$358 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$447 |
$658 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$298 |
$438 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$294 |
$433 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$222 |
$327 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$305 |
$448 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$287 |
$422 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$293 |
$431 |
3.2× |
| X-ray exam of femur 1 (73551) |
$241 |
$355 |
2.7× |
| X-ray eye for foreign body (70030) |
$215 |
$316 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$407 |
$599 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$271 |
$398 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$317 |
$466 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$213 |
$313 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$353 |
$519 |
3.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$380 |
$559 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$262 |
$385 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$395 |
$581 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$568 |
$836 |
5.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$481 |
$708 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$310 |
$456 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$386 |
$567 |
3.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$268 |
$394 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$347 |
$510 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$494 |
$727 |
4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$313 |
$461 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$334 |
$491 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$248 |
$365 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$248 |
$364 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$303 |
$446 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$234 |
$344 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$301 |
$442 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$292 |
$429 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$296 |
$436 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$404 |
$594 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$207 |
$305 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$300 |
$441 |
3.3× |
| Xr c-spine 6 or more views (72052) |
$590 |
$868 |
5.4× |
| Xr finger(s) 2+ views (73140) |
$203 |
$298 |
2.2× |
| Xr shoulder 1 view (73020) |
$248 |
$365 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$439 |
$645 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$209 |
$307.50 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$306 |
$450 |
3.4× |