| Abdomen 2 views (74019) |
$260.82 |
$621 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,307.04 |
$3,112 |
3.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,474.62 |
$3,511 |
0.5× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,258.74 |
$2,997 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,170.96 |
$2,788 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,275.96 |
$3,038 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,261.26 |
$3,003 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,207.50 |
$2,875 |
0.4× |
| Ankle 2 views (73600) |
$179.34 |
$427 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$568.68 |
$1,354 |
1.6× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,136.52 |
$2,706 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,165.92 |
$2,776 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,139.04 |
$2,712 |
0.4× |
| Arthrogram elbow (73085) |
$509.88 |
$1,214 |
1.5× |
| Arthrogram hip (73525) |
$524.58 |
$1,249 |
1.5× |
| Arthrogram shoulder (73040) |
$582.96 |
$1,388 |
1.7× |
| Arthrogram wrist (73115) |
$716.52 |
$1,706 |
2.0× |
| Arthrography knee lt (73580) |
$907.20 |
$2,160 |
2.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$794.64 |
$1,892 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,048.74 |
$2,497 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,152.48 |
$2,744 |
2.9× |
| Bone age studies (77072) |
$125.58 |
$299 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$1,336.44 |
$3,182 |
3.3× |
| Bone survey complete (77075) |
$665.28 |
$1,584 |
6.3× |
| Brain image w/flow 4 + views (78606) |
$1,599.78 |
$3,809 |
2.9× |
| Brain imaging < 4 static views (78600) |
$863.10 |
$2,055 |
2.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,028.16 |
$2,448 |
2.6× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,333.92 |
$3,176 |
2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,692.26 |
$13,553 |
4.0× |
| Brain Imaging Vascular Flow Only (78610) |
$887.46 |
$2,113 |
1.6× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,135.68 |
$2,704 |
2.8× |
| Cardiac shunt detection (78428) |
$844.62 |
$2,011 |
2.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,314.18 |
$3,129 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$241.92 |
$576 |
2.8× |
| Chest 1 view (71045) |
$122.64 |
$292 |
1.4× |
| Chest 3 views (71047) |
$182.70 |
$435 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$629.16 |
$1,498 |
3.6× |
| Clavicle complete (73000) |
$182.28 |
$434 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$63.84 |
$152 |
0.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$587.58 |
$1,399 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$500 |
$4,143 |
1.4× |
| CT abdomen and pelvis without contrast (74176) |
$310 |
$1,644 |
1.3× |
| CT abdomen w contrast (74160) |
$1,423.38 |
$3,389 |
8.1× |
| CT abdomen w wo contrast (74170) |
$1,751.40 |
$4,170 |
9.9× |
| CT abdomen w/o contrast (74150) |
$987.42 |
$2,351 |
9.4× |
| CT angio hrt w/3d image (75574) |
$1,344.84 |
$3,202 |
3.8× |
| CT angiography upper extremity lt (73206) |
$1,772.40 |
$4,220 |
10.1× |
| CT c-spine w/o contrast (72125) |
$310 |
$2,546 |
3.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,731.66 |
$4,123 |
9.8× |
| CT cervical spine with contrast (72126) |
$1,382.22 |
$3,291 |
3.9× |
| CT chest w/wo contrast (71270) |
$1,647.66 |
$3,923 |
9.4× |
| CT chest with contrast (71260) |
$1,309.56 |
$3,118 |
7.4× |
| CT head/brain with contrast (70460) |
$1,108.38 |
$2,639 |
6.3× |
| CT head/brain without and with contrast (70470) |
$1,365 |
$3,250 |
7.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$325.08 |
$580 |
3.7× |
| CT iac w contrast (70481) |
$1,642.20 |
$3,910 |
9.3× |
| CT limited/localized follow up study (76380) |
$594.72 |
$1,416 |
6.8× |
| CT lower ext w/o (73700) |
$295 |
$2,419 |
2.8× |
| CT lower extremity w wo contrast (73702) |
$1,704.36 |
$4,058 |
9.7× |
| CT lower extremity with contrast (73701) |
$1,284.36 |
$3,058 |
7.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,645.98 |
$3,919 |
9.3× |
| CT lumbar spine w/o contrast (72131) |
$295 |
$2,419 |
2.8× |
| CT lumbar spine with contrast (72132) |
$1,311.24 |
$3,122 |
3.7× |
| CT maxillofacial w contrast (70487) |
$1,391.04 |
$3,312 |
7.9× |
| CT maxillofacial w/o contrast (70486) |
$1,069.32 |
$2,546 |
10.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,735.44 |
$4,132 |
9.8× |
| CT neck soft tissue w contrast (70491) |
$1,334.76 |
$3,178 |
7.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,842.54 |
$4,387 |
10.5× |
| CT orbits w/o contrast (70480) |
$1,069.32 |
$2,546 |
10.2× |
| CT pelvis w & w/o contrast (72194) |
$1,663.62 |
$3,961 |
9.4× |
| CT pelvis w/o contrast (72192) |
$994.56 |
$2,368 |
9.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$368.76 |
$878 |
4.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,672.02 |
$3,981 |
9.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,069.32 |
$2,546 |
10.2× |
| CT thoracic spine w/contrast (72129) |
$1,315.02 |
$3,131 |
7.5× |
| CT thoracic spine w/o contrast (72128) |
$1,015.98 |
$2,419 |
9.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,647.66 |
$3,923 |
9.4× |
| CT thorax w/o contrast (71250) |
$589.13 |
$2,261 |
5.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,695.96 |
$4,038 |
9.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,015.98 |
$2,419 |
9.7× |
| CT upper extremity with contrast (73201) |
$1,270.92 |
$3,026 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,772.40 |
$4,220 |
10.1× |
| Cta Abdomen (74175) |
$1,774.08 |
$4,224 |
10.1× |
| CTA abdomen pelvis (74174) |
$864.36 |
$2,058 |
2.5× |
| CTA chest (71275) |
$1,772.40 |
$4,220 |
10.1× |
| Cta Head (70496) |
$1,866.48 |
$4,444 |
10.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,772.40 |
$4,220 |
10.1× |
| Cta Neck (70498) |
$1,866.48 |
$4,444 |
10.6× |
| Cta Pelvis (72191) |
$1,772.40 |
$4,220 |
10.1× |
| Cystography minimum 3 views rs&i (74430) |
$437.64 |
$1,042 |
1.2× |
| Diskogram cervical (72285) |
$787.92 |
$1,876 |
0.4× |
| Diskography lumbar (72295) |
$776.16 |
$1,848 |
0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$120.12 |
$286 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$215.88 |
$514 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$634.20 |
$1,510 |
6.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$167.16 |
$398 |
1.9× |
| Dxa bone density study axial skeleton (77085) |
$687.12 |
$1,636 |
6.5× |
| Echo exam of fetal heart (76825) |
$764.40 |
$1,820 |
1.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$477.12 |
$1,136 |
2.0× |
| Echoencephalography real time imaging (76506) |
$351.12 |
$836 |
3.3× |
| Esophageal motility (78258) |
$1,046.64 |
$2,492 |
2.6× |
| Esophagus (74220) |
$309.12 |
$736 |
1.8× |
| Fetal biophysical profile non-stress testing (76818) |
$399 |
$950 |
3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$303.24 |
$722 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$499.80 |
$1,190 |
2.1× |
| Foot 2 views (73620) |
$173.46 |
$413 |
2.0× |
| Forearm 2 views (73090) |
$176.40 |
$420 |
2.0× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$268.80 |
$640 |
1.1× |
| Gated Heart Planar Single (78472) |
$1,107.96 |
$2,638 |
2.8× |
| Hand 2 views (73120) |
$173.46 |
$413 |
1.7× |
| Hand 3 views (73130) |
$209.58 |
$499 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,449.84 |
$3,452 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,449.84 |
$3,452 |
3.6× |
| Ht muscle image spect sing (78451) |
$1,503.18 |
$3,579 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$182.28 |
$434 |
2.1× |
| Hysterosalpingogram (74740) |
$583.80 |
$1,390 |
2.4× |
| Interstitial radiation source applic complex (77778) |
$1,810.62 |
$4,311 |
2.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$226.80 |
$540 |
2.2× |
| Kidney funcj study non-img radioisotopic study (78725) |
$460.32 |
$1,096 |
1.1× |
| Kidney imaging morphology (78700) |
$839.16 |
$1,998 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,043.28 |
$2,484 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,143.24 |
$2,722 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,624.14 |
$3,867 |
3.0× |
| Knee 3 views (73562) |
$236.04 |
$562 |
2.7× |
| Liver & spleen imaging static only (78215) |
$562.80 |
$1,340 |
1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$916.86 |
$2,183 |
2.3× |
| Liver imaging static only (78201) |
$896.28 |
$2,134 |
1.6× |
| Liver imaging w/vascular flow (78202) |
$976.08 |
$2,324 |
1.8× |
| Lung Ventilation Imaging (78579) |
$1,008 |
$2,400 |
2.5× |
| Lymphoscintigraphy (78195) |
$1,405.32 |
$3,346 |
2.6× |
| Mammary ductogram or galactogram multiple (77054) |
$568.26 |
$1,353 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$412.44 |
$982 |
1.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$526.26 |
$1,253 |
6.0× |
| Meckels Diverticulum (78290) |
$1,308.72 |
$3,116 |
3.3× |
| MRA head w & w/o contrast (70546) |
$2,406.18 |
$5,729 |
6.9× |
| MRA head w/o contrast (70544) |
$1,546.86 |
$3,683 |
6.5× |
| MRA head with contrast (70545) |
$1,969.80 |
$4,690 |
5.6× |
| MRA neck w contrast (70548) |
$1,969.80 |
$4,690 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,406.18 |
$5,729 |
6.9× |
| MRA neck w/o contrast (70547) |
$1,546.86 |
$3,683 |
6.5× |
| MRI abdomen w contrast (74182) |
$1,600.20 |
$3,810 |
4.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,954.68 |
$4,654 |
5.6× |
| MRI abdomen w/o contrast (74181) |
$1,255.80 |
$2,990 |
5.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,600.20 |
$3,810 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,600.20 |
$3,810 |
2.0× |
| MRI bone marrow blood supply (77084) |
$1,256.64 |
$2,992 |
5.2× |
| MRI c-spine with contrast (72142) |
$1,969.80 |
$4,690 |
5.6× |
| MRI cervical spine w/o contrast (72141) |
$419.05 |
$1,409.50 |
1.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,954.68 |
$4,654 |
5.6× |
| MRI chest w/o contrast (71550) |
$1,256.64 |
$2,992 |
5.2× |
| MRI chest with contrast (71551) |
$1,600.20 |
$3,810 |
2.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,600.20 |
$3,810 |
4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,600.20 |
$3,810 |
4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,256.64 |
$2,992 |
5.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,546.86 |
$3,683 |
6.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,406.18 |
$5,729 |
6.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,969.80 |
$4,690 |
5.6× |
| MRI pelvis w contrast (72196) |
$1,600.20 |
$3,810 |
4.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,954.68 |
$4,654 |
5.6× |
| MRI pelvis w/o contrast (72195) |
$1,256.64 |
$2,992 |
5.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,954.68 |
$4,654 |
5.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,954.68 |
$4,654 |
5.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,406.18 |
$5,729 |
6.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,600.20 |
$3,810 |
4.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,954.68 |
$4,654 |
5.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,583.82 |
$3,771 |
4.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,954.68 |
$4,654 |
5.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,255.80 |
$2,990 |
5.2× |
| MRI tmj (70336) |
$1,255.80 |
$2,990 |
5.2× |
| MRI upper ext joint w/o contrast (73221) |
$360 |
$2,992 |
1.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,954.68 |
$4,654 |
5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,256.64 |
$2,992 |
5.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,048.84 |
$14,402 |
4.7× |
| Myocardial infarct spect (78469) |
$1,148.70 |
$2,735 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,184.84 |
$5,202 |
1.7× |
| Neck soft tissue (70360) |
$186.48 |
$444 |
2.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$672.42 |
$1,601 |
1.7× |
| Nm adrenal scan (78075) |
$2,131.08 |
$5,074 |
1.6× |
| Nm bone marrow multiple (78103) |
$1,000.44 |
$2,382 |
2.5× |
| Nm bone marrow wb (78104) |
$1,148.70 |
$2,735 |
2.9× |
| Nm cisternogram (78630) |
$1,653.96 |
$3,938 |
3.0× |
| Nm csf leak detection (78650) |
$1,635.06 |
$3,893 |
1.3× |
| Nm gastric emptying study (78264) |
$1,307.04 |
$3,112 |
3.3× |
| Nm gastroesophageal reflux study (78262) |
$1,160.04 |
$2,762 |
2.9× |
| Nm peritoneal-venous shunt patency (78291) |
$1,143.24 |
$2,722 |
2.8× |
| Nm whole blood volume (78122) |
$497.28 |
$1,184 |
0.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$6,048.84 |
$14,402 |
4.2× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$3,041.64 |
$7,242 |
2.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,030.26 |
$2,453 |
2.6× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$996.66 |
$2,373 |
2.5× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,307.04 |
$3,112 |
3.3× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$675.36 |
$1,608 |
1.7× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$450.24 |
$1,072 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$213.36 |
$508 |
0.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$349.44 |
$832 |
3.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$273 |
$650 |
2.6× |
| Orthopantogram (70355) |
$98.70 |
$235 |
1.1× |
| Osseous survey infant (77076) |
$585.48 |
$1,394 |
5.6× |
| Osseous survey limited (77074) |
$417.48 |
$994 |
4.0× |
| Parathyrd planar w/spect&CT (78072) |
$685.02 |
$1,631 |
1.3× |
| Parathyroid imaging (78070) |
$517.02 |
$1,231 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$158.34 |
$377 |
1.5× |
| Perineogram (74775) |
$634.62 |
$1,511 |
2.6× |
| Peritoneogram rs&i (74190) |
$568.68 |
$1,354 |
1.0× |
| Pr csf ventriculography (78635) |
$1,588.86 |
$3,783 |
2.9× |
| Pr heart first pass single,planar (78481) |
$872.34 |
$2,077 |
1.6× |
| Pr MRI brain w/ dye (70558) |
$1,135.68 |
$2,704 |
6.4× |
| Pr MRI brain w/o & w/ dye (70559) |
$1,136.94 |
$2,707 |
6.5× |
| Pr MRI brain w/o dye (70557) |
$1,021.02 |
$2,431 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,954.68 |
$4,654 |
5.6× |
| Pr sono bone density measure,peripheral (76977) |
$43.68 |
$104 |
0.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,107.12 |
$2,636 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$963.48 |
$2,294 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$342.72 |
$816 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$89.46 |
$213 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$456.96 |
$1,088 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$241.92 |
$576 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$349.44 |
$832 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$634.62 |
$1,511 |
6.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$241.92 |
$576 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$86.94 |
$207 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$315 |
$750 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$167.16 |
$398 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$834.96 |
$1,988 |
4.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$340.20 |
$810 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$832.02 |
$1,981 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$747.18 |
$1,779 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$173.46 |
$413 |
2.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$294 |
$700 |
3.4× |
| Radiological examination surgical specimen (76098) |
$92.40 |
$220 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,107.12 |
$2,636 |
0.3× |
| Ribs bilateral 3 views (71110) |
$244.86 |
$583 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,167.60 |
$2,780 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,555.68 |
$3,704 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,886.24 |
$6,872 |
5.3× |
| Sacroiliac Joints < 3 Views (72200) |
$187.74 |
$447 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$507.36 |
$1,208 |
2.1× |
| Salivary gland imaging (78230) |
$566.16 |
$1,348 |
1.4× |
| Salivary gland imaging serial images (78231) |
$785.40 |
$1,870 |
2.0× |
| Scanogram (77073) |
$215.04 |
$512 |
2.0× |
| Scapula complete (73010) |
$187.74 |
$447 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$75 |
$276 |
3.2× |
| Sella turcica (70240) |
$179.34 |
$427 |
2.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$714.42 |
$1,701 |
6.8× |
| Sialogram (70390) |
$795.90 |
$1,895 |
3.3× |
| Small bowel series (74250) |
$802.62 |
$1,911 |
4.6× |
| Spine thoracic 3 views (72072) |
$238.56 |
$568 |
2.3× |
| Spleen imaging only (78185) |
$991.20 |
$2,360 |
2.5× |
| Superior sagittal sinus venogram (75870) |
$1,109.64 |
$2,642 |
0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$355.74 |
$847 |
3.5× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$504.84 |
$1,202 |
2.1× |
| Testicular Imaging With Vascular Flow (78761) |
$966.84 |
$2,302 |
2.4× |
| Therapeutic Enema (74283) |
$624.54 |
$1,487 |
3.5× |
| Thoracolumbar 2 views (72080) |
$221.34 |
$527 |
2.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,512.84 |
$3,602 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$725.76 |
$1,728 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$931.56 |
$2,218 |
2.3× |
| Tmj unilateral (70328) |
$194.46 |
$463 |
2.2× |
| Tomogram (76100) |
$727.44 |
$1,732 |
6.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,253.30 |
$5,365 |
4.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$844.62 |
$2,011 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$511.56 |
$1,218 |
4.9× |
| Unlisted Ultrasound Procedure (76999) |
$396.48 |
$944 |
4.5× |
| Upper Extremity Infant (73092) |
$199.92 |
$476 |
1.9× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,052.52 |
$2,506 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$634.62 |
$1,511 |
2.6× |
| Urethrocystography voiding (74455) |
$708.12 |
$1,686 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$845.04 |
$2,012 |
4.8× |
| Us abdl aorta screen aaa (76706) |
$325.92 |
$776 |
3.1× |
| Us breast unilateral complete (76641) |
$349.44 |
$832 |
3.3× |
| Us breast unilateral limited (76642) |
$349.44 |
$832 |
4.0× |
| Us chest (76604) |
$400.26 |
$953 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$484.68 |
$1,154 |
4.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$388.92 |
$926 |
3.7× |
| Us guided compression repair (76936) |
$551.04 |
$1,312 |
2.5× |
| Us infant hips dynamic (76885) |
$351.12 |
$836 |
4.0× |
| Us infant hips limited static (76886) |
$349.44 |
$832 |
4.0× |
| Us kidney transplant (76776) |
$642.60 |
$1,530 |
6.1× |
| Us ob detailed single fetus (76811) |
$562.80 |
$1,340 |
2.3× |
| Us ob transvaginal (76817) |
$349.44 |
$832 |
3.3× |
| Us pelvic non ob complete (76856) |
$510.72 |
$1,216 |
4.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$407.61 |
$970.50 |
3.9× |
| Us pregnancy ltd (76815) |
$393.96 |
$938 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$459.48 |
$1,094 |
4.4× |
| Us retroperitoneal complete (76770) |
$539.70 |
$1,285 |
5.1× |
| Us retroperitoneal limited (76775) |
$465.36 |
$1,108 |
4.4× |
| Us scrotum and contents (76870) |
$518.28 |
$1,234 |
4.9× |
| Us soft tissue head/neck (76536) |
$595.98 |
$1,419 |
5.7× |
| Us spinal canal and contents (76800) |
$442.26 |
$1,053 |
4.2× |
| Us transrectal (76872) |
$539.70 |
$1,285 |
5.1× |
| Us transrectal prostate volume (76873) |
$539.70 |
$1,285 |
5.1× |
| Us xtr non-vasc lmtd (76882) |
$261.66 |
$623 |
2.5× |
| Us, eye b-scan (76512) |
$226.80 |
$540 |
2.2× |
| Vascular flow imaging (78445) |
$807.66 |
$1,923 |
2.0× |
| Venogram extremity bilateral (75822) |
$732.48 |
$1,744 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,082.76 |
$2,578 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$1,105.02 |
$2,631 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$654.36 |
$1,558 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,107.12 |
$2,636 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,119.72 |
$2,666 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,099.98 |
$2,619 |
0.2× |
| Wrist 2 views (73100) |
$194.46 |
$463 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$316.68 |
$754 |
3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$241.92 |
$576 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$212.52 |
$506 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,363.32 |
$3,246 |
7.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$182.28 |
$434 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$226.80 |
$540 |
2.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$546 |
$1,300 |
5.2× |
| X-ray exam hip uni 1 view (73501) |
$118.86 |
$283 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$301.98 |
$719 |
3.5× |
| X-ray exam hip uni 4/> views (73503) |
$347.34 |
$827 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$278.04 |
$662 |
2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$320.04 |
$762 |
3.0× |
| X-ray exam of femur 1 (73551) |
$140.70 |
$335 |
1.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,359.96 |
$3,238 |
7.7× |
| X-ray eye for foreign body (70030) |
$195.72 |
$466 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$227.64 |
$542 |
2.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$182.28 |
$434 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$206.22 |
$491 |
2.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$147.84 |
$352 |
1.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$874.02 |
$2,081 |
5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$212.52 |
$506 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$268.80 |
$640 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$215.04 |
$512 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$202.86 |
$483 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$256.62 |
$611 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$492.66 |
$1,173 |
4.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$352.38 |
$839 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$217.98 |
$519 |
2.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$179.76 |
$428 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$268.80 |
$640 |
2.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$271.32 |
$646 |
2.6× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$544.74 |
$1,297 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,141.14 |
$2,717 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$191.10 |
$455 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$233.10 |
$555 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$328.44 |
$782 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$223.86 |
$533 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$185.64 |
$442 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$185.64 |
$442 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$236.04 |
$562 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$197.40 |
$470 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$271.32 |
$646 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$221.34 |
$527 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$143.22 |
$341 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$236.04 |
$562 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$197.40 |
$470 |
2.3× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$77.70 |
$185 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$202.86 |
$483 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$298.62 |
$711 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$178.08 |
$424 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$244.86 |
$583 |
2.8× |
| Xr arthrogram ankle (73615) |
$671.58 |
$1,599 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$432.60 |
$1,030 |
4.1× |
| Xr chest 4+ views (71048) |
$256.20 |
$610 |
2.4× |
| Xr Cholecystography Oral Contrast (74290) |
$509.04 |
$1,212 |
2.9× |
| Xr finger(s) 2+ views (73140) |
$173.46 |
$413 |
2.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$230.16 |
$548 |
2.2× |
| Xr optic foramina (70190) |
$223.86 |
$533 |
2.6× |
| Xr shoulder 1 view (73020) |
$143.22 |
$341 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$328.44 |
$782 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$127.47 |
$303.50 |
1.5× |
| Xr tmj bilateral (70330) |
$319.20 |
$760 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$187.74 |
$447 |
2.1× |