| Abdomen 2 views (74019) |
$212.03 |
$316 |
2.2× |
| Ankle 2 views (73600) |
$148.29 |
$221 |
1.8× |
| Arthrogram shoulder (73040) |
$554.91 |
$827 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$545.52 |
$813 |
1.5× |
| Bone &/joint imaging whole body (78306) |
$667.64 |
$995 |
1.8× |
| Bone age studies (77072) |
$231.49 |
$345 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$688.44 |
$1,026 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$122.12 |
$182 |
1.5× |
| Chest 1 view (71045) |
$122.12 |
$182 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$269.74 |
$402 |
1.7× |
| Clavicle complete (73000) |
$128.16 |
$191 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,048.77 |
$1,563 |
10.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,970.72 |
$2,937 |
6.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,390.98 |
$2,073 |
6.3× |
| CT abdomen w contrast (74160) |
$1,099.09 |
$1,638 |
6.7× |
| CT abdomen w wo contrast (74170) |
$1,264.83 |
$1,885 |
7.7× |
| CT abdomen w/o contrast (74150) |
$1,076.95 |
$1,605 |
11.1× |
| CT c-spine w/o contrast (72125) |
$987.71 |
$1,472 |
10.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,744.60 |
$2,600 |
10.7× |
| CT cervical spine with contrast (72126) |
$1,511.09 |
$2,252 |
4.7× |
| CT chest w/wo contrast (71270) |
$1,175.59 |
$1,752 |
7.2× |
| CT chest with contrast (71260) |
$1,252.08 |
$1,866 |
7.7× |
| CT head/brain with contrast (70460) |
$1,011.19 |
$1,507 |
6.2× |
| CT head/brain without and with contrast (70470) |
$1,299.05 |
$1,936 |
8.0× |
| CT iac w contrast (70481) |
$693.81 |
$1,034 |
4.2× |
| CT lower ext w/o (73700) |
$743.46 |
$1,108 |
7.6× |
| CT lower extremity w wo contrast (73702) |
$831.36 |
$1,239 |
5.1× |
| CT lower extremity with contrast (73701) |
$683.41 |
$1,018.50 |
4.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,174.25 |
$1,750 |
7.2× |
| CT lumbar spine w/o contrast (72131) |
$1,182.97 |
$1,763 |
12.2× |
| CT lumbar spine with contrast (72132) |
$1,174.92 |
$1,751 |
3.6× |
| CT maxillofacial w contrast (70487) |
$874.98 |
$1,304 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$966.24 |
$1,440 |
9.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,017.23 |
$1,516 |
6.2× |
| CT neck soft tissue w contrast (70491) |
$1,028.64 |
$1,533 |
6.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$957.51 |
$1,427 |
5.9× |
| CT orbits w/o contrast (70480) |
$860.22 |
$1,282 |
8.8× |
| CT pelvis w & w/o contrast (72194) |
$1,280.93 |
$1,909 |
7.8× |
| CT pelvis w/o contrast (72192) |
$904.50 |
$1,348 |
9.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$939.40 |
$1,400 |
5.8× |
| CT soft tissue neck w/o contrast (70490) |
$911.21 |
$1,358 |
9.4× |
| CT thoracic spine w/contrast (72129) |
$718.64 |
$1,071 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$947.45 |
$1,412 |
9.7× |
| CT thoracic spine w/wo contrast (72130) |
$772.32 |
$1,151 |
4.7× |
| CT thorax w/o contrast (71250) |
$1,048.77 |
$1,563 |
10.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$818.62 |
$1,220 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$945.43 |
$1,409 |
9.7× |
| CT upper extremity with contrast (73201) |
$693.81 |
$1,034 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$854.18 |
$1,273 |
5.2× |
| Cta Abdomen (74175) |
$999.11 |
$1,489 |
6.1× |
| CTA abdomen pelvis (74174) |
$1,684.21 |
$2,510 |
5.2× |
| CTA chest (71275) |
$1,299.05 |
$1,936 |
8.0× |
| Cta Head (70496) |
$1,257.45 |
$1,874 |
7.7× |
| CTA lwr ext w&w/o contrast (73706) |
$980.33 |
$1,461 |
6.0× |
| Cta Neck (70498) |
$1,046.76 |
$1,560 |
6.4× |
| Cta Pelvis (72191) |
$854.18 |
$1,273 |
5.2× |
| Cystography minimum 3 views rs&i (74430) |
$355.63 |
$530 |
1.1× |
| Diskogram cervical (72285) |
$2,885.30 |
$4,300 |
1.6× |
| Diskography lumbar (72295) |
$2,885.30 |
$4,300 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$208.68 |
$311 |
2.1× |
| Esophagus (74220) |
$269.21 |
$401.22 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$366.36 |
$546 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$384.60 |
$573.18 |
1.7× |
| Foot 2 views (73620) |
$128.16 |
$191 |
1.6× |
| Forearm 2 views (73090) |
$127.49 |
$190 |
1.6× |
| Hand 2 views (73120) |
$163.72 |
$244 |
1.7× |
| Hand 3 views (73130) |
$163.05 |
$243 |
2.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,212.49 |
$1,807 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$909.54 |
$1,355.50 |
2.4× |
| Ht muscle image spect sing (78451) |
$1,677.50 |
$2,500 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$164.39 |
$245 |
2.0× |
| Hysterosalpingogram (74740) |
$573.70 |
$855 |
2.6× |
| Kidney imaging morphology (78700) |
$622.01 |
$927 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$834.05 |
$1,243 |
1.6× |
| Knee 3 views (73562) |
$185.86 |
$277 |
2.3× |
| Liver & spleen imaging static only (78215) |
$607.92 |
$906 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$607.92 |
$906 |
1.6× |
| Lymphoscintigraphy (78195) |
$539.48 |
$804 |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,282.95 |
$1,912 |
3.9× |
| MRA head w/o contrast (70544) |
$1,209.81 |
$1,803 |
5.4× |
| MRA head with contrast (70545) |
$879.01 |
$1,310 |
2.7× |
| MRA neck w contrast (70548) |
$795.13 |
$1,185 |
2.4× |
| MRA neck w/o contrast (70547) |
$930 |
$1,386 |
4.2× |
| MRI abdomen w contrast (74182) |
$997.10 |
$1,486 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,282.95 |
$1,912 |
3.9× |
| MRI abdomen w/o contrast (74181) |
$805.20 |
$1,200 |
3.6× |
| MRI any jnt lwr ext with con lt (73722) |
$894.44 |
$1,333 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$970.60 |
$1,446.50 |
1.3× |
| MRI c-spine with contrast (72142) |
$1,231.28 |
$1,835 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$1,360.78 |
$2,028 |
6.1× |
| MRI chest w/o & w/contrast material (71552) |
$972.95 |
$1,450 |
3.0× |
| MRI chest w/o contrast (71550) |
$838.75 |
$1,250 |
3.8× |
| MRI chest with contrast (71551) |
$939.40 |
$1,400 |
1.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$868.94 |
$1,295 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$958.85 |
$1,429 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,376.89 |
$2,052 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$868.94 |
$1,295 |
3.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,501.02 |
$2,237 |
4.6× |
| MRI pelvis w contrast (72196) |
$1,038.70 |
$1,548 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,244.70 |
$1,855 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$1,516.46 |
$2,260 |
6.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,256.78 |
$1,873 |
3.9× |
| MRI scan of leg joint before and after contrast (73723) |
$1,256.78 |
$1,873 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,411.57 |
$3,594 |
7.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,231.28 |
$1,835 |
3.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,873.43 |
$2,792 |
5.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,194.38 |
$1,780 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,855.31 |
$2,765 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,360.78 |
$2,028 |
6.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,197.06 |
$1,784 |
5.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,028.64 |
$1,533 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,216.52 |
$1,813 |
5.5× |
| Myelogram Lumbar (72265) |
$469.70 |
$700 |
0.6× |
| Myelogram thoracic (72255) |
$469.70 |
$700 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,551.81 |
$3,803 |
2.1× |
| Neck soft tissue (70360) |
$136.88 |
$204 |
1.7× |
| Nm gastric emptying study (78264) |
$609.26 |
$908 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$452.92 |
$675 |
2.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$204.65 |
$305 |
2.1× |
| Osseous survey infant (77076) |
$163.72 |
$244 |
1.7× |
| Parathyroid imaging (78070) |
$449.57 |
$670 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$163.72 |
$244 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,127.61 |
$1,680.50 |
3.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$583.09 |
$869 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,163.51 |
$1,734 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$122.12 |
$182 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$163.72 |
$244 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$180.49 |
$269 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$226.79 |
$338 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$128.83 |
$192 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$122.12 |
$182 |
1.5× |
| Radiologic exam colon single contrast study (74270) |
$328.11 |
$489 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$611.28 |
$911 |
3.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$373.74 |
$557 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$122.12 |
$182 |
1.5× |
| Radiological examination surgical specimen (76098) |
$727.36 |
$1,084 |
1.4× |
| Ribs bilateral 3 views (71110) |
$187.88 |
$280 |
1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,180.96 |
$1,760 |
3.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,180.96 |
$1,760 |
2.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,968.04 |
$2,933 |
3.9× |
| Scanogram (77073) |
$218.07 |
$325 |
2.2× |
| Scapula complete (73010) |
$163.72 |
$244 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$33.55 |
$50 |
1.4× |
| Small bowel series (74250) |
$244.91 |
$365 |
1.5× |
| Spine thoracic 3 views (72072) |
$163.72 |
$244 |
1.7× |
| Thoracolumbar 2 views (72080) |
$122.12 |
$182 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$363.68 |
$542 |
1.0× |
| Thyroid uptake measurement (78012) |
$305.30 |
$455 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$683.74 |
$1,019 |
1.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,771.44 |
$2,640 |
3.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$535.79 |
$798.50 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$319.39 |
$476 |
3.3× |
| Upper Extremity Infant (73092) |
$163.72 |
$244 |
1.7× |
| Urethrocystography voiding (74455) |
$355.63 |
$530 |
1.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$540.82 |
$806 |
3.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$355.63 |
$530 |
2.2× |
| Us abdl aorta screen aaa (76706) |
$231.82 |
$345.50 |
2.4× |
| Us breast unilateral complete (76641) |
$110.71 |
$165 |
1.1× |
| Us breast unilateral limited (76642) |
$189.22 |
$282 |
2.3× |
| Us chest (76604) |
$165.73 |
$247 |
1.7× |
| Us ob transvaginal (76817) |
$153.65 |
$229 |
1.6× |
| Us pelvic non ob complete (76856) |
$442.86 |
$660 |
4.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$110.71 |
$165 |
1.1× |
| Us pregnancy ltd (76815) |
$199.95 |
$298 |
2.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$319.39 |
$476 |
3.3× |
| Us retroperitoneal complete (76770) |
$319.39 |
$476 |
3.3× |
| Us scrotum and contents (76870) |
$319.39 |
$476 |
3.3× |
| Us soft tissue head/neck (76536) |
$381.79 |
$569 |
3.9× |
| Us transrectal (76872) |
$271.75 |
$405 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$171.54 |
$255.65 |
1.8× |
| Wrist 2 views (73100) |
$128.16 |
$191 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$250.95 |
$374 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$215.39 |
$321 |
2.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$162.38 |
$242 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$299.93 |
$447 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$155.67 |
$232 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$154.33 |
$230 |
1.9× |
| X-ray exam hip uni 1 view (73501) |
$180.49 |
$269 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$180.49 |
$269 |
2.2× |
| X-ray exam hip uni 4/> views (73503) |
$180.49 |
$269 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$180.49 |
$269 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$163.72 |
$244 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$135.54 |
$202 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$163.05 |
$243 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$121.45 |
$181 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$163.72 |
$244 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$122.12 |
$182 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$122.12 |
$182 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$163.72 |
$244 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$163.72 |
$244 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$122.12 |
$182 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$163.05 |
$243 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$209.35 |
$312 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$163.72 |
$244 |
1.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$462.31 |
$689 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$139.56 |
$208 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$226.79 |
$338 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$290.54 |
$433 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$163.72 |
$244 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$185.86 |
$277 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$173.78 |
$259 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$212.03 |
$316 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$128.16 |
$191 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$211.36 |
$315 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$163.72 |
$244 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$83.87 |
$125 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$156.34 |
$233 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$163.72 |
$244 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$163.72 |
$244 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$122.12 |
$182 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$163.05 |
$243 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$163.72 |
$244 |
1.7× |
| Xr finger(s) 2+ views (73140) |
$128.16 |
$191 |
1.6× |
| Xr shoulder 1 view (73020) |
$173.78 |
$259 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$163.72 |
$244 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$169.76 |
$253 |
2.1× |
| Xr tmj bilateral (70330) |
$144.93 |
$216 |
1.8× |
| Xray knee 1 or 2 views rt (73560) |
$122.12 |
$182 |
1.5× |