| Abdomen 1 View (74018) |
$180.34 |
$355 |
2.1× |
| Abdomen 2 views (74019) |
$235.20 |
$463 |
2.3× |
| Ankle 2 views (73600) |
$182.37 |
$359 |
2.2× |
| Arthrogram hip (73525) |
$499.36 |
$983 |
1.5× |
| Bone age studies (77072) |
$152.91 |
$301 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,453.90 |
$2,862 |
3.7× |
| Bone Imaging Limited Area (78300) |
$879.86 |
$1,732 |
2.3× |
| Bone Imaging Whole Body (78306) |
$1,426.46 |
$2,808 |
3.7× |
| Bone survey infant (77076) |
$853.95 |
$1,681 |
8.4× |
| Chest 1 view (71045) |
$169.16 |
$333 |
2.0× |
| Chest 2 views (71046) |
$177.80 |
$350 |
2.1× |
| Chest 3 views (71047) |
$183.90 |
$362 |
2.2× |
| Clavicle complete (73000) |
$173.74 |
$342 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$142.75 |
$281 |
1.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$796.04 |
$1,567 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,473.45 |
$4,869 |
7.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,033.02 |
$4,002 |
8.8× |
| CT abdomen w contrast (74160) |
$1,590.04 |
$3,130 |
9.3× |
| CT abdomen w wo contrast (74170) |
$1,590.04 |
$3,130 |
9.3× |
| CT abdomen w/o contrast (74150) |
$977.90 |
$1,925 |
9.6× |
| CT Angio Abdomen and Pelvis (74174) |
$2,049.78 |
$4,035 |
6.0× |
| CT Angio Chest (71275) |
$1,590.04 |
$3,130 |
9.3× |
| CT Angio Head (70496) |
$1,320.80 |
$2,600 |
7.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,590.04 |
$3,130 |
9.3× |
| CT Angio Neck (70498) |
$1,590.04 |
$3,130 |
9.3× |
| CT cervical spine w/o contrast (72125) |
$977.90 |
$1,925 |
9.6× |
| CT chest w contrast (71260) |
$1,486.41 |
$2,926 |
8.7× |
| CT chest w/wo contrast (71270) |
$1,590.04 |
$3,130 |
9.3× |
| CT head/brain with contrast (70460) |
$1,486.41 |
$2,926 |
8.7× |
| CT head/brain without and with contrast (70470) |
$1,590.04 |
$3,130 |
9.3× |
| CT iac w contrast (70481) |
$707.14 |
$1,392 |
4.2× |
| CT lower ext w/o (73700) |
$977.90 |
$1,925 |
9.6× |
| CT lower extremity w/contrast material (73701) |
$1,596.14 |
$3,142 |
9.4× |
| CT lumbar spine w contrast (72132) |
$672.08 |
$1,323 |
2.0× |
| CT lumbar spine w/o contrast (72131) |
$977.90 |
$1,925 |
9.6× |
| CT maxillofacial w contrast (70487) |
$1,590.04 |
$3,130 |
9.3× |
| CT maxillofacial wo contrast (70486) |
$977.90 |
$1,925 |
9.6× |
| CT neck tissue combo (70492) |
$1,555.50 |
$3,062 |
9.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$912.37 |
$1,796 |
5.4× |
| CT orbits w/o contrast (70480) |
$852.93 |
$1,679 |
8.4× |
| CT pelvis w/o contrast (72192) |
$977.90 |
$1,925 |
9.6× |
| CT scan of leg combo (73702) |
$123.95 |
$244 |
0.7× |
| CT scans face/jaw combo (70488) |
$499.36 |
$983 |
2.9× |
| CT soft tissue neck w contrast (70491) |
$1,590.04 |
$3,130 |
9.3× |
| CT soft tissue neck w/o contrast (70490) |
$977.90 |
$1,925 |
9.6× |
| CT thoracic spine w contrast (72129) |
$676.15 |
$1,331 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$977.90 |
$1,925 |
9.6× |
| CT thorax w/o contrast (71250) |
$977.90 |
$1,925 |
9.6× |
| CT upper ext wo (73200) |
$977.90 |
$1,925 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,732.28 |
$3,410 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,590.04 |
$3,130 |
9.3× |
| Cta Abdomen (74175) |
$1,590.04 |
$3,130 |
9.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,910.08 |
$3,760 |
5.6× |
| Dxa Bone Density Axial (77080) |
$429.77 |
$846 |
4.2× |
| Dxa bone density study (77085) |
$188.98 |
$372 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$384.56 |
$757 |
4.5× |
| Esophagram (74220) |
$273.81 |
$539 |
1.6× |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
$354.58–$379.48 |
$698–$747 |
varies |
| Foot 2 views (73620) |
$183.39 |
$361 |
2.2× |
| Forearm 2 views (73090) |
$183.90 |
$362 |
2.2× |
| Gastric emptying imaging study (78264) |
$546.61 |
$1,076 |
1.4× |
| Hand 2 views (73120) |
$172.72 |
$340 |
1.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,247.14 |
$2,455 |
2.4× |
| Ht Muscle Image Spect Sing (78451) |
$2,255.01 |
$4,439 |
1.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,510.28 |
$2,973 |
2.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,510.28 |
$2,973 |
2.9× |
| Knee 3 Views (73562) |
$266.70 |
$525 |
3.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,334.01 |
$2,626 |
2.5× |
| Magnetic Image Jaw Joint (70336) |
$1,535.68 |
$3,023 |
6.6× |
| Meckels Divert Exam (78290) |
$283.46 |
$558 |
0.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,323.59 |
$4,574 |
6.9× |
| MRA head w/o contrast (70544) |
$1,344.68 |
$2,647 |
5.8× |
| MRA head with contrast (70545) |
$2,116.84 |
$4,167 |
6.2× |
| MRA neck w contrast (70548) |
$2,116.84 |
$4,167 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,323.59 |
$4,574 |
6.9× |
| MRA neck w/o contrast (70547) |
$1,365 |
$2,687 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,928.37 |
$3,796 |
8.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,024.89 |
$3,986 |
2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,182.37 |
$4,296 |
6.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,280.92 |
$4,490 |
3.0× |
| MRI cervical spine w/o cont (72141) |
$2,116.84 |
$4,167 |
9.1× |
| MRI chest w/o contrast (71550) |
$1,869.95 |
$3,681 |
8.1× |
| MRI chest wo w contrast (71552) |
$2,539.49 |
$4,999 |
7.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,182.37 |
$4,296 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,087.88 |
$4,110 |
9.0× |
| MRI lumbar spine w contrast (72149) |
$1,293.37 |
$2,546 |
3.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,274.82 |
$4,478 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$155.96 |
$307 |
0.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,087.37 |
$4,109 |
6.2× |
| MRI pelvis w/o & w contrast (72197) |
$2,184.40 |
$4,300 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$1,922.78 |
$3,785 |
8.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,116.84 |
$4,167 |
9.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,088.39 |
$4,111 |
9.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,870.46 |
$3,682 |
5.5× |
| MRI, abdomen, combo (74183) |
$2,549.65 |
$5,019 |
7.5× |
| MRI, dorsal spine combo (72157) |
$2,233.17 |
$4,396 |
6.6× |
| MRI, joint upper extrem (73221) |
$1,894.33 |
$3,729 |
8.2× |
| MRI, joint upper extrem combo (73223) |
$2,323.59 |
$4,574 |
6.9× |
| MRI, lumbar spine combo (72158) |
$1,922.78 |
$3,785 |
5.7× |
| Myelogram Lumbar (72265) |
$792.99 |
$1,561 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,939.80 |
$5,787 |
2.3× |
| Neck soft tissue (70360) |
$203.20 |
$400 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$183.39 |
$361 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,166.37 |
$2,296 |
3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$240.79 |
$474 |
2.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$220.47 |
$434 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$162.05 |
$319 |
1.9× |
| Radex elbow complete minimum 3 views (73080) |
$193.55 |
$381 |
2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$293.12 |
$577 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$149.86 |
$295 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$207.77 |
$409 |
2.5× |
| Radex Hand Minimum 3 Views (73130) |
$194.06 |
$382 |
2.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$89.92 |
$177 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$203.20 |
$400 |
2.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$218.44 |
$430 |
2.6× |
| Radex shoulder complete minimum 2 views (73030) |
$201.68 |
$397 |
2.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$197.10 |
$388 |
2.3× |
| Radex Spine 1 View Specify Level (72020) |
$145.80 |
$287 |
1.7× |
| Radex Sternum Minimum 2 Views (71120) |
$212.34 |
$418 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$174.24 |
$343 |
2.1× |
| Radex Toe Minimum 2 Views (73660) |
$149.86 |
$295 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$73.15 |
$144 |
0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$212.34 |
$418 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$298.70 |
$588 |
2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$154.43 |
$304 |
1.5× |
| Radiologic exam colon double contrast study (74280) |
$527.30 |
$1,038 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$389.64 |
$767 |
2.3× |
| Radiologic exam knee complete 4/more views (73564) |
$312.42 |
$615 |
3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$324.61 |
$639 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$281.94 |
$555 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$371.86 |
$732 |
2.2× |
| Radiologic examination femur 1 view (73551) |
$83.31 |
$164 |
1.0× |
| Radiologic examination femur minimum 2 views (73552) |
$141.22 |
$278 |
1.7× |
| Radiologic examination knee 1/2 views (73560) |
$224.54 |
$442 |
2.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$201.17 |
$396 |
2.4× |
| Ribs bilateral 3 views (71110) |
$302.26 |
$595 |
3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,602.23 |
$3,154 |
3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$928.12 |
$1,827 |
0.7× |
| Scapula (73010) |
$186.94 |
$368 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$22.86 |
$45 |
1.0× |
| Shoulder 1 view (73020) |
$134.11 |
$264 |
1.6× |
| Shoulder Arthrography (73040) |
$717.30 |
$1,412 |
2.1× |
| Skull less than 4 views (70250) |
$225.04 |
$443 |
2.2× |
| Sternoclavicular joints (71130) |
$210.82 |
$415 |
2.5× |
| Thoracic spine 2 views (72070) |
$225.55 |
$444 |
2.2× |
| Thoracic spine 3 views (72072) |
$232.16 |
$457 |
2.3× |
| Thoracolumbar 2 views (72080) |
$207.77 |
$409 |
2.5× |
| Thyroid Uptake Measurement (78012) |
$276.35 |
$544 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$276.35 |
$544 |
0.7× |
| Ultrasound Breast Limited (76642) |
$444.50 |
$875 |
5.3× |
| Ultrasound Elastography Parenchyma (76981) |
$547.62 |
$1,078 |
5.4× |
| Ultrasound Exam Aaa Screen (76706) |
$359.66 |
$708 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$547.62 |
$1,078 |
5.4× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$516.13 |
$1,016 |
1.3× |
| Upper gi w/o kub (74240) |
$302.26 |
$595 |
1.8× |
| Urethrocystogram voiding (74455) |
$376.43 |
$741 |
1.6× |
| Urethrocystography retrograde (74450) |
$242.82 |
$478 |
1.0× |
| Us breast unilateral complete (76641) |
$444.50 |
$875 |
4.4× |
| Us chest (76604) |
$458.22 |
$902 |
4.5× |
| Us complete joint (76881) |
$252.98 |
$498 |
2.5× |
| Us exam, pelvic, limited (76857) |
$386.08 |
$760 |
3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$444.50 |
$875 |
4.4× |
| Us ob limited 1 or more fetuses (76815) |
$350.52 |
$690 |
3.5× |
| Us ob transvaginal (76817) |
$392.68 |
$773 |
3.9× |
| Us pelvic non ob complete (76856) |
$561.85 |
$1,106 |
5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$460.25 |
$906 |
4.5× |
| Us retroperitoneal complete (76770) |
$695.96 |
$1,370 |
6.9× |
| Us retroperitoneal limited (76775) |
$277.37 |
$546 |
2.7× |
| Us scrotum and contents (76870) |
$589.28 |
$1,160 |
5.8× |
| Us spinal canal and contents (76800) |
$173.74 |
$342 |
1.7× |
| Us thyroid (76536) |
$537.97 |
$1,059 |
5.3× |
| Us transrectal (76872) |
$321.56 |
$633 |
3.2× |
| Vertebral fracture assessment via dxa (77086) |
$140.72 |
$277 |
1.7× |
| Wrist 2 views (73100) |
$185.42 |
$365 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$274.83 |
$541 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$171.20 |
$337 |
2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$84.84 |
$167 |
1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$138.18 |
$272 |
1.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$84.84 |
$167 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$141.22 |
$278 |
1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$189.48 |
$373 |
1.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$138.18 |
$272 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$202.69 |
$399 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$324.10 |
$638 |
3.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$214.38 |
$422 |
2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$304.80 |
$600 |
3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$222.50 |
$438 |
2.2× |
| X-ray eye for foreign body (70030) |
$168.15 |
$331 |
2.0× |
| X-ray humerus (73060) |
$204.22 |
$402 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$146.30 |
$288 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$186.44 |
$367 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$273.30 |
$538 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$140.72 |
$277 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$261.11 |
$514 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$171.20 |
$337 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$192.02 |
$378 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$59.94 |
$118 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$343.92 |
$677 |
3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$711.20 |
$1,400 |
2.1× |
| X-Rays Bone Length Studies (77073) |
$167.64 |
$330 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$304.80 |
$600 |
3.0× |
| Xr facial bones less than 3 views (70140) |
$63.50 |
$125 |
0.8× |
| Xr orbits complete 4 views (70200) |
$271.78 |
$535 |
2.7× |