| Abdomen 2 views (74019) |
$179.10 |
$199 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,605.50 |
$2,895 |
7.1× |
| Ankle 2 views (73600) |
$176.40 |
$196 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$555.30 |
$617 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,087.10 |
$2,319 |
5.7× |
| Bone &/joint imaging whole body (78306) |
$2,267.10 |
$2,519 |
6.2× |
| Bone age studies (77072) |
$180 |
$200 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$2,573.10 |
$2,859 |
7.0× |
| Bone survey complete (77075) |
$684 |
$760 |
7.1× |
| Cervical spine 2 or 3 views (72040) |
$216 |
$240 |
2.7× |
| Chest 1 view (71045) |
$166.50 |
$185 |
2.1× |
| Chest 3 views (71047) |
$206.10 |
$229 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$558 |
$620 |
3.5× |
| Clavicle complete (73000) |
$162 |
$180 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$823.50 |
$915 |
8.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,070.90 |
$2,301 |
6.5× |
| CT abdomen and pelvis without contrast (74176) |
$944.10 |
$1,049 |
4.3× |
| CT abdomen w contrast (74160) |
$1,392.30 |
$1,547 |
8.6× |
| CT abdomen w wo contrast (74170) |
$1,602 |
$1,780 |
9.9× |
| CT abdomen w/o contrast (74150) |
$748.80 |
$832 |
7.8× |
| CT angio hrt w/3d image (75574) |
$981 |
$1,090 |
3.1× |
| CT angiography upper extremity lt (73206) |
$1,984.50 |
$2,205 |
12.3× |
| CT c-spine w/o contrast (72125) |
$937.80 |
$1,042 |
9.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,723.50 |
$1,915 |
10.7× |
| CT cervical spine with contrast (72126) |
$1,389.60 |
$1,544 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,383.30 |
$1,537 |
8.6× |
| CT chest with contrast (71260) |
$1,117.80 |
$1,242 |
6.9× |
| CT head/brain with contrast (70460) |
$884.70 |
$983 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,064.70 |
$1,183 |
6.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$90 |
$100 |
1.1× |
| CT iac w contrast (70481) |
$1,719.90 |
$1,911 |
10.7× |
| CT limited/localized follow up study (76380) |
$510.30 |
$567 |
6.4× |
| CT lower ext w/o (73700) |
$937.80 |
$1,042 |
9.8× |
| CT lower extremity w wo contrast (73702) |
$1,779.30 |
$1,977 |
11.0× |
| CT lower extremity with contrast (73701) |
$1,395.90 |
$1,551 |
8.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,714.50 |
$1,905 |
10.6× |
| CT lumbar spine w/o contrast (72131) |
$937.80 |
$1,042 |
9.8× |
| CT lumbar spine with contrast (72132) |
$1,389.60 |
$1,544 |
4.3× |
| CT maxillofacial w contrast (70487) |
$926.10 |
$1,029 |
5.7× |
| CT maxillofacial w/o contrast (70486) |
$801.90 |
$891 |
8.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,170.90 |
$1,301 |
7.3× |
| CT neck soft tissue w contrast (70491) |
$1,115.10 |
$1,239 |
6.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,899 |
$2,110 |
11.8× |
| CT orbits w/o contrast (70480) |
$937.80 |
$1,042 |
9.8× |
| CT pelvis w & w/o contrast (72194) |
$1,657.80 |
$1,842 |
10.3× |
| CT pelvis w/o contrast (72192) |
$761.40 |
$846 |
7.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,363.50 |
$1,515 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$864 |
$960 |
9.0× |
| CT thoracic spine w/contrast (72129) |
$1,398.60 |
$1,554 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$937.80 |
$1,042 |
9.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,735.20 |
$1,928 |
10.8× |
| CT thorax w/o contrast (71250) |
$870.30 |
$967 |
9.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,805.40 |
$2,006 |
11.2× |
| CT upper extremity w/o contrast rt (73200) |
$937.80 |
$1,042 |
9.8× |
| CT upper extremity with contrast (73201) |
$1,368.90 |
$1,521 |
4.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,151 |
$2,390 |
13.3× |
| Cta Abdomen (74175) |
$1,804.50 |
$2,005 |
11.2× |
| CTA abdomen pelvis (74174) |
$2,295 |
$2,550 |
7.2× |
| CTA chest (71275) |
$1,739.70 |
$1,933 |
10.8× |
| Cta Head (70496) |
$1,710 |
$1,900 |
10.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,070 |
$2,300 |
12.8× |
| Cta Neck (70498) |
$1,704.60 |
$1,894 |
10.6× |
| Cta Pelvis (72191) |
$1,796.40 |
$1,996 |
11.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$265.50 |
$295 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$424.80 |
$472 |
4.4× |
| Fluoroscopy up to 1 hr (76000) |
$324 |
$360 |
1.5× |
| Foot 2 views (73620) |
$153 |
$170 |
1.9× |
| Forearm 2 views (73090) |
$144 |
$160 |
1.8× |
| Gated Heart Planar Single (78472) |
$1,574.10 |
$1,749 |
4.3× |
| Hand 2 views (73120) |
$164.70 |
$183 |
1.7× |
| Hand 3 views (73130) |
$191.70 |
$213 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,505.50 |
$3,895 |
7.0× |
| Ht muscle image spect sing (78451) |
$2,378.70 |
$2,643 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$171 |
$190 |
2.1× |
| Hysterosalpingogram (74740) |
$462.60 |
$514 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,618.20 |
$1,798 |
3.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,015.20 |
$1,128 |
2.0× |
| Knee 3 views (73562) |
$217.80 |
$242 |
2.7× |
| Meckels Diverticulum (78290) |
$2,582.10 |
$2,869 |
7.0× |
| MRA head w & w/o contrast (70546) |
$3,421.80 |
$3,802 |
10.7× |
| MRA head w/o contrast (70544) |
$1,905.30 |
$2,117 |
8.7× |
| MRA head with contrast (70545) |
$2,070.90 |
$2,301 |
6.5× |
| MRA neck w contrast (70548) |
$2,070.90 |
$2,301 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,445.20 |
$3,828 |
10.7× |
| MRA neck w/o contrast (70547) |
$1,905.30 |
$2,117 |
8.7× |
| MRI abdomen w contrast (74182) |
$2,472.30 |
$2,747 |
7.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,646 |
$2,940 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$1,746.90 |
$1,941 |
8.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,507.40 |
$2,786 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,486.70 |
$2,763 |
3.4× |
| MRI c-spine with contrast (72142) |
$1,976.40 |
$2,196 |
6.2× |
| MRI cervical spine w/o contrast (72141) |
$1,253.70 |
$1,393 |
5.7× |
| MRI chest w/o & w/contrast material (71552) |
$3,740.40 |
$4,156 |
11.7× |
| MRI chest w/o contrast (71550) |
$1,903.50 |
$2,115 |
8.7× |
| MRI chest with contrast (71551) |
$3,095.10 |
$3,439 |
4.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,687.40 |
$2,986 |
8.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,070.90 |
$2,301 |
6.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,903.50 |
$2,115 |
8.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,699.20 |
$1,888 |
7.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,477.70 |
$2,753 |
7.7× |
| MRI orbit/face/neck w/contrast (70542) |
$2,005.20 |
$2,228 |
6.2× |
| MRI pelvis w contrast (72196) |
$2,177.10 |
$2,419 |
6.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,637 |
$2,930 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$1,903.50 |
$2,115 |
8.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,029.40 |
$3,366 |
9.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,026.70 |
$3,363 |
9.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,218.50 |
$2,465 |
6.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,940.40 |
$2,156 |
6.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,209.50 |
$2,455 |
6.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,958.40 |
$2,176 |
6.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,223.90 |
$2,471 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,256.40 |
$1,396 |
5.7× |
| MRI tmj (70336) |
$1,902.60 |
$2,114 |
8.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,412.10 |
$1,569 |
6.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,275.10 |
$3,639 |
10.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,905.30 |
$2,117 |
8.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,433.50 |
$3,815 |
2.9× |
| Neck soft tissue (70360) |
$175.50 |
$195 |
2.2× |
| Nm gastric emptying study (78264) |
$2,579.40 |
$2,866 |
7.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$604.80 |
$672 |
6.3× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$360.90 |
$401 |
3.8× |
| Parathyrd planar w/wo subtrj (78071) |
$2,596.50 |
$2,885 |
7.1× |
| Parathyroid imaging (78070) |
$2,267.10 |
$2,519 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$191.70 |
$213 |
2.0× |
| PET image w/CT, skull-thigh (78815) |
$3,600 |
$4,000 |
2.7× |
| PET imaging CT for attenuation limited area (78814) |
$3,510 |
$3,900 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,780 |
$4,200 |
2.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,655 |
$2,950 |
8.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,446.20 |
$2,718 |
4.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$383.40 |
$426 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$208.80 |
$232 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$180 |
$200 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$202.50 |
$225 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$962.10 |
$1,069 |
6.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$630 |
$700 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$764.10 |
$849 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$648.90 |
$721 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$194.40 |
$216 |
2.4× |
| Ribs bilateral 3 views (71110) |
$208.80 |
$232 |
2.2× |
| Scanogram (77073) |
$324 |
$360 |
3.4× |
| Scapula complete (73010) |
$176.40 |
$196 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$103.50 |
$115 |
4.4× |
| Small bowel series (74250) |
$663.30 |
$737 |
4.1× |
| Spine thoracic 3 views (72072) |
$270 |
$300 |
2.8× |
| Testicular Imaging With Vascular Flow (78761) |
$1,521 |
$1,690 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,505.70 |
$1,673 |
4.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,881 |
$2,090 |
5.1× |
| Tmj unilateral (70328) |
$176.40 |
$196 |
2.2× |
| Ultrasound scan of cornea to determine thickness (76514) |
$55.80 |
$62 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$522 |
$580 |
5.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$67.50 |
$75 |
0.8× |
| Upper Extremity Infant (73092) |
$158.40 |
$176 |
1.6× |
| Urethrocystography voiding (74455) |
$548.10 |
$609 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$707.40 |
$786 |
4.4× |
| Us abdl aorta screen aaa (76706) |
$560.70 |
$623 |
5.8× |
| Us breast unilateral complete (76641) |
$233.10 |
$259 |
2.4× |
| Us breast unilateral limited (76642) |
$261.90 |
$291 |
3.3× |
| Us chest (76604) |
$198 |
$220 |
2.1× |
| Us infant hips dynamic (76885) |
$855 |
$950 |
10.7× |
| Us ob transvaginal (76817) |
$498.60 |
$554 |
5.2× |
| Us pelvic non ob complete (76856) |
$637.20 |
$708 |
6.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$197.10 |
$219 |
2.0× |
| Us pregnancy ltd (76815) |
$254.70 |
$283 |
2.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$619.20 |
$688 |
6.4× |
| Us retroperitoneal complete (76770) |
$642.60 |
$714 |
6.7× |
| Us retroperitoneal limited (76775) |
$211.50 |
$235 |
2.2× |
| Us scrotum and contents (76870) |
$300.60 |
$334 |
3.1× |
| Us soft tissue head/neck (76536) |
$743.40 |
$826 |
7.7× |
| Us xtr non-vasc lmtd (76882) |
$277.20 |
$308 |
2.9× |
| Wrist 2 views (73100) |
$188.10 |
$209 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$355.50 |
$395 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$208.80 |
$232 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$188.10 |
$209 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,359.90 |
$1,511 |
8.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$158.40 |
$176 |
2.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$188.10 |
$209 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$171 |
$190 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$250.20 |
$278 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$279.90 |
$311 |
2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$306 |
$340 |
3.2× |
| X-ray eye for foreign body (70030) |
$162 |
$180 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$232.20 |
$258 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$175.50 |
$195 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$173.70 |
$193 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$158.40 |
$176 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$197.10 |
$219 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$235.80 |
$262 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$224.10 |
$249 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$189 |
$210 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$234 |
$260 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$400.50 |
$445 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$315 |
$350 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$199.80 |
$222 |
2.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$148.50 |
$165 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$247.50 |
$275 |
2.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$224.10 |
$249 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$947.70 |
$1,053 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$182.70 |
$203 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$270 |
$300 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$333 |
$370 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$388.80 |
$432 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$193.50 |
$215 |
2.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$164.70 |
$183 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$206.10 |
$229 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$173.70 |
$193 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$232.20 |
$258 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$197.10 |
$219 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$229.50 |
$255 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$206.10 |
$229 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$193.50 |
$215 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$188.10 |
$209 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$179.10 |
$199 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$217.80 |
$242 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$364.50 |
$405 |
3.8× |
| Xr finger(s) 2+ views (73140) |
$208.80 |
$232 |
2.6× |
| Xr optic foramina (70190) |
$203.40 |
$226 |
2.5× |
| Xr shoulder 1 view (73020) |
$123.30 |
$137 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$310.50 |
$345 |
3.2× |
| Xr tibia/fibula 2 views (73590) |
$167.40 |
$186 |
2.1× |
| Xr tmj bilateral (70330) |
$288.90 |
$321 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$188.10 |
$209 |
2.4× |