| Abdomen 2 views (74019) |
$227 |
$324 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$844 |
$1,206 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$846 |
$1,209 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,033 |
$1,476 |
2.6× |
| Bone survey complete (77075) |
$250 |
$357 |
2.4× |
| Brain image w/flow 4 + views (78606) |
$1,105 |
$1,578 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$187 |
$267 |
2.1× |
| Chest 1 view (71045) |
$187 |
$267 |
2.1× |
| Chest 3 views (71047) |
$233 |
$333 |
2.7× |
| Clavicle complete (73000) |
$187 |
$267 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$252 |
$360 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,770 |
$3,957 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,524 |
$3,606 |
10.5× |
| CT abdomen w contrast (74160) |
$1,686 |
$2,409 |
9.6× |
| CT abdomen w wo contrast (74170) |
$1,951 |
$2,787 |
11.1× |
| CT abdomen w/o contrast (74150) |
$1,363 |
$1,947 |
13.0× |
| CT c-spine w/o contrast (72125) |
$1,357 |
$1,938 |
12.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,510 |
$2,157 |
8.6× |
| CT cervical spine with contrast (72126) |
$1,472 |
$2,103 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,900 |
$2,715 |
10.8× |
| CT chest with contrast (71260) |
$1,686 |
$2,409 |
9.6× |
| CT head/brain with contrast (70460) |
$1,363 |
$1,947 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,900 |
$2,715 |
10.8× |
| CT lower ext w/o (73700) |
$815 |
$1,164 |
7.8× |
| CT lower extremity w wo contrast (73702) |
$1,161 |
$1,659 |
6.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,900 |
$2,715 |
10.8× |
| CT lumbar spine w/o contrast (72131) |
$1,363 |
$1,947 |
13.0× |
| CT lumbar spine with contrast (72132) |
$1,472 |
$2,103 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$1,472 |
$2,103 |
14.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,900 |
$2,715 |
10.8× |
| CT neck soft tissue w contrast (70491) |
$1,634 |
$2,334 |
9.3× |
| CT orbits w/o contrast (70480) |
$1,472 |
$2,103 |
14.0× |
| CT pelvis w & w/o contrast (72194) |
$1,951 |
$2,787 |
11.1× |
| CT pelvis w/o contrast (72192) |
$1,472 |
$2,103 |
14.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,758 |
$2,511 |
10.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,363 |
$1,947 |
13.0× |
| CT thoracic spine w/contrast (72129) |
$1,340 |
$1,914 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$1,023 |
$1,461 |
9.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,428 |
$2,040 |
8.1× |
| CT thorax w/o contrast (71250) |
$1,363 |
$1,947 |
13.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$886 |
$1,266 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$815 |
$1,164 |
7.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,045 |
$2,922 |
11.6× |
| CTA chest (71275) |
$1,686 |
$2,409 |
9.6× |
| Cystography minimum 3 views rs&i (74430) |
$785 |
$1,122 |
2.2× |
| Diskography lumbar (72295) |
$3,942 |
$5,631 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$208 |
$297 |
2.0× |
| Esophagus (74220) |
$380 |
$543 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$500 |
$714 |
2.1× |
| Forearm 2 views (73090) |
$187 |
$267 |
2.1× |
| Hand 3 views (73130) |
$187 |
$267 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,105 |
$1,578 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$187 |
$267 |
2.1× |
| Kidney imaging morphology (78700) |
$844 |
$1,206 |
2.1× |
| Knee 3 views (73562) |
$223 |
$318 |
2.6× |
| MRA head w/o contrast (70544) |
$1,659 |
$2,370 |
6.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,638 |
$2,340 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,382 |
$1,974 |
5.8× |
| MRI abdomen w contrast (74182) |
$1,659 |
$2,370 |
4.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,897.50 |
$2,710.50 |
5.4× |
| MRI abdomen w/o contrast (74181) |
$1,382 |
$1,974 |
5.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,157 |
$3,081 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,157 |
$3,081 |
2.7× |
| MRI c-spine with contrast (72142) |
$2,157 |
$3,081 |
6.2× |
| MRI cervical spine w/o contrast (72141) |
$1,867 |
$2,667 |
7.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,766 |
$3,951 |
7.9× |
| MRI chest w/o contrast (71550) |
$1,382 |
$1,974 |
5.8× |
| MRI chest with contrast (71551) |
$2,157 |
$3,081 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,789 |
$2,556 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,243 |
$1,776 |
5.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,382 |
$1,974 |
5.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,766 |
$3,951 |
7.9× |
| MRI orbit/face/neck w/contrast (70542) |
$2,157 |
$3,081 |
6.2× |
| MRI pelvis w contrast (72196) |
$2,157 |
$3,081 |
6.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,766 |
$3,951 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$1,867 |
$2,667 |
7.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,766 |
$3,951 |
7.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,766 |
$3,951 |
7.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,766 |
$3,951 |
7.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,157 |
$3,081 |
6.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,766 |
$3,951 |
7.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,157 |
$3,081 |
6.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,766 |
$3,951 |
7.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,865 |
$2,664 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,867 |
$2,667 |
7.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,523 |
$2,175 |
6.4× |
| Neck soft tissue (70360) |
$187 |
$267 |
2.1× |
| Parathyroid imaging (78070) |
$844 |
$1,206 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$227 |
$324 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,789 |
$2,556 |
5.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$844 |
$1,206 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,142 |
$1,632 |
2.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$200 |
$285 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$258 |
$369 |
2.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$239 |
$342 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$227 |
$324 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$216 |
$309 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$187 |
$267 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$233 |
$333 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$214 |
$306 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$209 |
$298.50 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$199.50 |
$285 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$187 |
$267 |
2.1× |
| Ribs bilateral 3 views (71110) |
$216 |
$309 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$227 |
$324 |
2.2× |
| Scapula complete (73010) |
$227 |
$324 |
2.2× |
| Small bowel series (74250) |
$132 |
$189 |
0.7× |
| Spine thoracic 3 views (72072) |
$229 |
$327 |
2.2× |
| Testicular Imaging With Vascular Flow (78761) |
$844 |
$1,206 |
2.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$924 |
$1,320 |
2.3× |
| Thyroid uptake measurement (78012) |
$594 |
$849 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$393 |
$561 |
3.7× |
| Unlisted magnetic resonance procedure (76498) |
$2,766 |
$3,951 |
31.6× |
| Unlisted Ultrasound Procedure (76999) |
$316.50 |
$451.50 |
3.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$416 |
$594 |
2.4× |
| Us breast unilateral complete (76641) |
$246 |
$351 |
2.3× |
| Us chest (76604) |
$342 |
$489 |
3.3× |
| Us ob transvaginal (76817) |
$227 |
$324 |
2.2× |
| Us pelvic non ob complete (76856) |
$506 |
$723 |
4.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$349 |
$498 |
3.3× |
| Us retroperitoneal complete (76770) |
$407.50 |
$582 |
3.9× |
| Us scrotum and contents (76870) |
$386 |
$552 |
3.7× |
| Us soft tissue head/neck (76536) |
$378 |
$540 |
3.6× |
| Wrist 2 views (73100) |
$69 |
$99 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$260 |
$372 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$187 |
$267 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$187 |
$267 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$187 |
$267 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$176 |
$252 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$214 |
$306 |
2.4× |
| X-ray exam hip uni 4/> views (73503) |
$227 |
$324 |
2.2× |
| X-ray eye for foreign body (70030) |
$187 |
$267 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$225 |
$321 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$61 |
$87 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$223 |
$318 |
2.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$187 |
$267 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$229 |
$327 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$187 |
$267 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$250 |
$357 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$187 |
$267 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$227 |
$324 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$227 |
$324 |
2.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,428 |
$2,040 |
4.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$187 |
$267 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$210 |
$300 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$227 |
$324 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$187 |
$267 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$258 |
$369 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$254 |
$363 |
2.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$187 |
$267 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$309 |
$441 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$227 |
$324 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$187 |
$267 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$187 |
$267 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$227 |
$324 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$187 |
$267 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$187 |
$267 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$300 |
$429 |
2.9× |
| Xr chest 4+ views (71048) |
$227 |
$324 |
2.2× |
| Xr Cholecystography Oral Contrast (74290) |
$376 |
$537 |
2.1× |
| Xr finger(s) 2+ views (73140) |
$187 |
$267 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$277 |
$396 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$187 |
$267 |
2.1× |
| Xr tmj bilateral (70330) |
$189 |
$270 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$187 |
$267 |
2.1× |