| Abdomen 2 views (74019) |
$409 |
$409 |
3.9× |
| Ankle 2 views (73600) |
$247 |
$247 |
2.8× |
| Arthrogram elbow (73085) |
$1,450 |
$1,450 |
4.1× |
| Arthrogram hip (73525) |
$1,322 |
$1,322 |
3.8× |
| Arthrogram shoulder (73040) |
$1,527 |
$1,527 |
4.4× |
| Arthrogram wrist (73115) |
$1,524 |
$1,524 |
4.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$630 |
$630 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$1,415 |
$1,415 |
3.5× |
| Bone age studies (77072) |
$332 |
$332 |
3.2× |
| Bone Imaging 3 Phase (78315) |
$1,114 |
$1,114 |
2.8× |
| Bone survey complete (77075) |
$370 |
$370 |
3.5× |
| Brain imaging < 4 static views (78600) |
$537 |
$537 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$332 |
$332 |
3.8× |
| Chest 1 view (71045) |
$304 |
$304 |
3.5× |
| Chest 3 views (71047) |
$279.50 |
$279.50 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$487 |
$487 |
2.8× |
| Clavicle complete (73000) |
$131 |
$131 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$883 |
$883 |
8.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$186.50 |
$186.50 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,618.50 |
$1,618.50 |
4.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,187 |
$1,187 |
5.0× |
| CT abdomen w contrast (74160) |
$1,265 |
$1,265 |
7.2× |
| CT abdomen w wo contrast (74170) |
$1,475 |
$1,475 |
8.4× |
| CT abdomen w/o contrast (74150) |
$1,054 |
$1,054 |
10.0× |
| CT angiography upper extremity lt (73206) |
$1,187 |
$1,187 |
6.7× |
| CT c-spine w/o contrast (72125) |
$1,181 |
$1,181 |
11.2× |
| CT cervical spine w&w/o contrast (72127) |
$864 |
$864 |
4.9× |
| CT cervical spine with contrast (72126) |
$864 |
$864 |
2.5× |
| CT chest w/wo contrast (71270) |
$1,297 |
$1,297 |
7.4× |
| CT chest with contrast (71260) |
$1,181 |
$1,181 |
6.7× |
| CT head/brain with contrast (70460) |
$1,275 |
$1,275 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,311 |
$1,311 |
7.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$304 |
$304 |
3.5× |
| CT iac w contrast (70481) |
$1,521 |
$1,521 |
8.6× |
| CT lower ext w/o (73700) |
$1,117 |
$1,117 |
10.6× |
| CT lower extremity w wo contrast (73702) |
$1,381 |
$1,381 |
7.8× |
| CT lower extremity with contrast (73701) |
$1,235 |
$1,235 |
7.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,520 |
$1,520 |
8.6× |
| CT lumbar spine w/o contrast (72131) |
$1,184 |
$1,184 |
11.3× |
| CT lumbar spine with contrast (72132) |
$1,510 |
$1,510 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,559 |
$1,559 |
8.8× |
| CT maxillofacial w/o contrast (70486) |
$1,263 |
$1,263 |
12.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,500 |
$1,500 |
8.5× |
| CT neck soft tissue w contrast (70491) |
$1,266 |
$1,266 |
7.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,560.50 |
$1,560.50 |
8.9× |
| CT orbits w/o contrast (70480) |
$1,275.50 |
$1,275.50 |
12.1× |
| CT pelvis w & w/o contrast (72194) |
$1,476 |
$1,476 |
8.4× |
| CT pelvis w/o contrast (72192) |
$1,059.50 |
$1,059.50 |
10.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,173 |
$1,173 |
6.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,186.50 |
$1,186.50 |
11.3× |
| CT thoracic spine w/contrast (72129) |
$1,356 |
$1,356 |
7.7× |
| CT thoracic spine w/o contrast (72128) |
$1,168 |
$1,168 |
11.1× |
| CT thorax w/o contrast (71250) |
$1,078 |
$1,078 |
10.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,379 |
$1,379 |
7.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,060 |
$1,060 |
10.1× |
| CT upper extremity with contrast (73201) |
$1,238 |
$1,238 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,187 |
$1,187 |
6.7× |
| Cta Abdomen (74175) |
$1,405 |
$1,405 |
8.0× |
| CTA abdomen pelvis (74174) |
$1,737 |
$1,737 |
5.0× |
| CTA chest (71275) |
$1,245 |
$1,245 |
7.1× |
| Cta Head (70496) |
$1,310 |
$1,310 |
7.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,040 |
$3,040 |
8.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,187 |
$1,187 |
6.7× |
| Cta Neck (70498) |
$1,310 |
$1,310 |
7.4× |
| Cta Pelvis (72191) |
$1,432.50 |
$1,432.50 |
8.1× |
| Cystography minimum 3 views rs&i (74430) |
$251 |
$251 |
0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$667 |
$667 |
6.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$254 |
$254 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$293 |
$293 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$357.50 |
$357.50 |
3.4× |
| Fluoroscopy up to 1 hr (76000) |
$115 |
$115 |
0.5× |
| Foot 2 views (73620) |
$118 |
$118 |
1.3× |
| Forearm 2 views (73090) |
$131 |
$131 |
1.5× |
| Gated Heart Planar Single (78472) |
$863.50 |
$863.50 |
2.2× |
| Hand 2 views (73120) |
$132 |
$132 |
1.3× |
| Hand 3 views (73130) |
$135 |
$135 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,246.50 |
$1,246.50 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$933 |
$933 |
2.3× |
| Ht muscle image spect sing (78451) |
$2,050 |
$2,050 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$131 |
$131 |
1.5× |
| Hysterosalpingogram (74740) |
$1,527 |
$1,527 |
6.4× |
| Kidney imaging morphology (78700) |
$968.50 |
$968.50 |
2.4× |
| Knee 3 views (73562) |
$194 |
$194 |
2.2× |
| Liver & spleen imaging static only (78215) |
$955 |
$955 |
2.4× |
| Liver imaging static only (78201) |
$429 |
$429 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$543 |
$543 |
1.0× |
| Lung Ventilation Imaging (78579) |
$595 |
$595 |
1.5× |
| Lymphoscintigraphy (78195) |
$1,394 |
$1,394 |
2.6× |
| MRA head w & w/o contrast (70546) |
$1,853 |
$1,853 |
5.3× |
| MRA head w/o contrast (70544) |
$1,509 |
$1,509 |
6.3× |
| MRA head with contrast (70545) |
$1,552.50 |
$1,552.50 |
4.4× |
| MRA neck w contrast (70548) |
$1,580.50 |
$1,580.50 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,786.50 |
$1,786.50 |
5.1× |
| MRI abdomen w contrast (74182) |
$1,618.50 |
$1,618.50 |
4.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,992 |
$1,992 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,381 |
$1,381 |
5.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$575 |
$575 |
0.7× |
| MRI c-spine with contrast (72142) |
$1,535 |
$1,535 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,668.50 |
$1,668.50 |
7.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,006 |
$2,006 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,519.50 |
$1,519.50 |
6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,875 |
$1,875 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,737 |
$1,737 |
7.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,040 |
$1,040 |
4.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,600 |
$1,600 |
4.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,299.50 |
$1,299.50 |
3.7× |
| MRI pelvis w contrast (72196) |
$1,381 |
$1,381 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,726.50 |
$1,726.50 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,489 |
$1,489 |
6.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,751 |
$1,751 |
5.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,737 |
$1,737 |
5.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,902 |
$1,902 |
5.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,575 |
$1,575 |
4.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,128 |
$2,128 |
6.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,461.50 |
$1,461.50 |
4.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,855 |
$1,855 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,381 |
$1,381 |
5.8× |
| MRI tmj (70336) |
$1,122.50 |
$1,122.50 |
4.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,024 |
$1,024 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,446.50 |
$1,446.50 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,751 |
$1,751 |
7.3× |
| Myelogram Cervical (72240) |
$2,900 |
$2,900 |
3.7× |
| Myelogram Lumbar (72265) |
$2,900 |
$2,900 |
3.7× |
| Myelography 2 or more regions (72270) |
$2,900 |
$2,900 |
3.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,050 |
$2,050 |
1.6× |
| Neck soft tissue (70360) |
$127 |
$127 |
1.5× |
| Nm gastric emptying study (78264) |
$905.50 |
$905.50 |
2.3× |
| Nm peritoneal-venous shunt patency (78291) |
$571 |
$571 |
1.4× |
| Nuclear medicine of heart pumping function (78473) |
$1,298 |
$1,298 |
3.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$939 |
$939 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$319 |
$319 |
3.0× |
| Parathyroid imaging (78070) |
$867.50 |
$867.50 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$131 |
$131 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,381 |
$1,381 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$706 |
$706 |
1.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,531 |
$1,531 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$176 |
$176 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$332 |
$332 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$332 |
$332 |
3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$193 |
$193 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$249 |
$249 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$304 |
$304 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$525 |
$525 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$453 |
$453 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$301 |
$301 |
1.7× |
| Radiological examination surgical specimen (76098) |
$90 |
$90 |
0.2× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$7.50 |
$7.50 |
0.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$10 |
$10 |
0.0× |
| Ribs bilateral 3 views (71110) |
$141 |
$141 |
1.3× |
| Sacroiliac Joints < 3 Views (72200) |
$223 |
$223 |
2.1× |
| Scanogram (77073) |
$272.50 |
$272.50 |
2.6× |
| Scapula complete (73010) |
$143 |
$143 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$91 |
$91 |
3.9× |
| Sella turcica (70240) |
$141 |
$141 |
1.6× |
| Small bowel series (74250) |
$315 |
$315 |
1.8× |
| Spine thoracic 3 views (72072) |
$332 |
$332 |
3.2× |
| Spleen imaging only (78185) |
$380 |
$380 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$398 |
$398 |
1.0× |
| Thyroid uptake measurement (78012) |
$1,415 |
$1,415 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$326 |
$326 |
3.1× |
| Unlisted Ultrasound Procedure (76999) |
$245 |
$245 |
2.8× |
| Upper Extremity Infant (73092) |
$120 |
$120 |
1.1× |
| Urethrocystography voiding (74455) |
$1,100 |
$1,100 |
4.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$383 |
$383 |
2.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$466 |
$466 |
2.6× |
| Us breast unilateral complete (76641) |
$430 |
$430 |
4.1× |
| Us breast unilateral limited (76642) |
$473 |
$473 |
5.4× |
| Us chest (76604) |
$233 |
$233 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$308 |
$308 |
2.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$469 |
$469 |
4.5× |
| Us ob detailed single fetus (76811) |
$659 |
$659 |
2.7× |
| Us ob transvaginal (76817) |
$228 |
$228 |
2.2× |
| Us pelvic non ob complete (76856) |
$273 |
$273 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$216 |
$216 |
2.1× |
| Us pregnancy ltd (76815) |
$409.50 |
$409.50 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$306 |
$306 |
2.9× |
| Us retroperitoneal complete (76770) |
$336 |
$336 |
3.2× |
| Us retroperitoneal limited (76775) |
$667 |
$667 |
6.4× |
| Us scrotum and contents (76870) |
$485.50 |
$485.50 |
4.6× |
| Us soft tissue head/neck (76536) |
$308 |
$308 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$469 |
$469 |
4.5× |
| Venography caval superior serialography rs&i (75827) |
$271 |
$271 |
0.2× |
| Wrist 2 views (73100) |
$122 |
$122 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$131 |
$131 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$162 |
$162 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$406 |
$406 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$142 |
$142 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$127 |
$127 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$249 |
$249 |
2.8× |
| X-ray exam of femur 1 (73551) |
$249 |
$249 |
2.8× |
| X-ray eye for foreign body (70030) |
$223 |
$223 |
2.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$202 |
$202 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$153 |
$153 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$186 |
$186 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$162.50 |
$162.50 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$195.50 |
$195.50 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$153 |
$153 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$274.50 |
$274.50 |
2.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$251 |
$251 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$128 |
$128 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$114 |
$114 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$170 |
$170 |
1.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$281.50 |
$281.50 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$125 |
$125 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$272 |
$272 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$294.50 |
$294.50 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$170 |
$170 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$129 |
$129 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$150 |
$150 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$195 |
$195 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$194 |
$194 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$278 |
$278 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$239.50 |
$239.50 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$120 |
$120 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$143 |
$143 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$152 |
$152 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$114 |
$114 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$135 |
$135 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$260 |
$260 |
2.5× |
| Xr Cholecystography Oral Contrast (74290) |
$209.50 |
$209.50 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$116 |
$116 |
1.3× |
| Xr myelogram posterior fossa (70010) |
$2 |
$2 |
0.0× |
| Xr shoulder 1 view (73020) |
$103 |
$103 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$229 |
$229 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$135 |
$135 |
1.5× |
| Xr tmj bilateral (70330) |
$220 |
$220 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$188.50 |
$188.50 |
2.2× |