| Abdomen 2 views (74019) |
$122.82 |
$321.50 |
1.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$370.16 |
$969 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$495.84 |
$1,298 |
0.2× |
| Ankle 2 views (73600) |
$38.96 |
$102 |
0.5× |
| Arthrography knee lt (73580) |
$225.38 |
$590 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$326.61 |
$855 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$335.40 |
$878 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$359.46 |
$941 |
1.0× |
| Bone age studies (77072) |
$233.78 |
$612 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$411.03 |
$1,076 |
1.1× |
| Bone survey complete (77075) |
$313.24 |
$820 |
3.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$754.83 |
$1,976 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$36.67 |
$96 |
0.5× |
| Chest 1 view (71045) |
$29.03 |
$76 |
0.4× |
| Chest 3 views (71047) |
$53.86 |
$141 |
0.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$374.36 |
$980 |
2.4× |
| Clavicle complete (73000) |
$37.44 |
$98 |
0.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$58.45 |
$153 |
0.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$9.55 |
$25 |
0.0× |
| CT abdomen and pelvis without contrast (74176) |
$336.54 |
$881 |
1.6× |
| CT abdomen w contrast (74160) |
$569.18 |
$1,490 |
3.6× |
| CT abdomen w wo contrast (74170) |
$9.55 |
$25 |
0.1× |
| CT abdomen w/o contrast (74150) |
$422.87 |
$1,107 |
4.5× |
| CT angio hrt w/3d image (75574) |
$411.03 |
$1,076 |
1.3× |
| CT angiography upper extremity lt (73206) |
$590.19 |
$1,545 |
3.7× |
| CT c-spine w/o contrast (72125) |
$435.48 |
$1,140 |
4.6× |
| CT cervical spine w&w/o contrast (72127) |
$687.98 |
$1,801 |
4.3× |
| CT cervical spine with contrast (72126) |
$575.29 |
$1,506 |
1.8× |
| CT head/brain with contrast (70460) |
$679.58 |
$1,779 |
4.3× |
| CT head/brain without and with contrast (70470) |
$11.46 |
$30 |
0.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$106.20 |
$278 |
1.3× |
| CT iac w contrast (70481) |
$595.92 |
$1,560 |
3.7× |
| CT limited/localized follow up study (76380) |
$292.99 |
$767 |
3.7× |
| CT lower ext w/o (73700) |
$382 |
$1,000 |
4.0× |
| CT lower extremity w wo contrast (73702) |
$573.38 |
$1,501 |
3.6× |
| CT lower extremity with contrast (73701) |
$421.12 |
$1,102.40 |
2.6× |
| CT lumbar spine w & w/o contrast (72133) |
$679.58 |
$1,779 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$441.21 |
$1,155 |
4.7× |
| CT lumbar spine with contrast (72132) |
$574.53 |
$1,504 |
1.8× |
| CT maxillofacial w contrast (70487) |
$597.45 |
$1,564 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$588.28 |
$1,540 |
6.2× |
| CT neck soft tissue w contrast (70491) |
$599.55 |
$1,569.49 |
3.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$16.04 |
$42 |
0.1× |
| CT orbits w/o contrast (70480) |
$518.37 |
$1,357 |
5.5× |
| CT pelvis w & w/o contrast (72194) |
$595.92 |
$1,560 |
3.7× |
| CT pelvis w/o contrast (72192) |
$433.19 |
$1,134 |
4.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$16.81 |
$44 |
0.1× |
| CT soft tissue neck w/o contrast (70490) |
$519.52 |
$1,360 |
5.5× |
| CT thoracic spine w/contrast (72129) |
$574.15 |
$1,503 |
3.6× |
| CT thoracic spine w/o contrast (72128) |
$438.15 |
$1,147 |
4.6× |
| CT thoracic spine w/wo contrast (72130) |
$679.58 |
$1,779 |
4.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$573.38 |
$1,501 |
3.6× |
| CT upper extremity w/o contrast rt (73200) |
$385.44 |
$1,009 |
4.1× |
| CT upper extremity with contrast (73201) |
$411.03 |
$1,076 |
1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$633.74 |
$1,659 |
4.0× |
| Cta Abdomen (74175) |
$632.97 |
$1,657 |
4.0× |
| CTA abdomen pelvis (74174) |
$140.58 |
$368 |
0.4× |
| CTA chest (71275) |
$641.38 |
$1,679 |
4.0× |
| Cta Head (70496) |
$51.95 |
$136 |
0.3× |
| CTA lwr ext w&w/o contrast (73706) |
$588.28 |
$1,540 |
3.7× |
| Cta Neck (70498) |
$50.04 |
$131 |
0.3× |
| Cta Pelvis (72191) |
$638.70 |
$1,672 |
4.0× |
| Cystography minimum 3 views rs&i (74430) |
$419.82 |
$1,099 |
1.3× |
| Diskogram cervical (72285) |
$1,757.20 |
$4,600 |
1.0× |
| Diskography lumbar (72295) |
$1,748.03 |
$4,576 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$163.13 |
$427.04 |
1.7× |
| Esophagus (74220) |
$238.37 |
$624 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$15.28 |
$40 |
0.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$317.82 |
$832 |
3.4× |
| Fluoroscopy up to 1 hr (76000) |
$143.63 |
$376 |
0.7× |
| Foot 2 views (73620) |
$38.96 |
$102 |
0.5× |
| Forearm 2 views (73090) |
$38.20 |
$100 |
0.5× |
| Gated Heart Planar Single (78472) |
$411.03 |
$1,076 |
1.1× |
| Hand 2 views (73120) |
$44.69 |
$117 |
0.5× |
| Hand 3 views (73130) |
$46.22 |
$121 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$50.04 |
$131 |
0.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$764 |
$2,000 |
2.1× |
| Ht muscle image spect sing (78451) |
$339.60 |
$889 |
0.3× |
| Humerus Min 2 Views Left (73060) |
$37.05 |
$97 |
0.5× |
| Hysterosalpingogram (74740) |
$679.20 |
$1,778 |
3.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$72.20 |
$189 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$406.45 |
$1,064 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$432.04 |
$1,131 |
0.9× |
| Knee 3 views (73562) |
$50.42 |
$132 |
0.6× |
| Liver & spleen imaging static only (78215) |
$335.01 |
$877 |
0.9× |
| Liver imaging static only (78201) |
$331.58 |
$868 |
0.7× |
| Liver imaging w/vascular flow (78202) |
$341.13 |
$893 |
0.7× |
| Lung perf&ventilat diferentl (78598) |
$56.92 |
$149 |
0.1× |
| Lung perfusion differential (78597) |
$463.37 |
$1,213 |
1.3× |
| Lymphoscintigraphy (78195) |
$382 |
$1,000 |
0.8× |
| Mammary ductogram or galactogram multiple (77054) |
$222.32 |
$582 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$172.28 |
$451 |
0.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$126.06 |
$330 |
1.6× |
| Meckels Diverticulum (78290) |
$369.01 |
$966 |
1.0× |
| MRA head w/o contrast (70544) |
$127.97 |
$335 |
0.6× |
| MRA neck w contrast (70548) |
$163.11 |
$427 |
0.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$206.28 |
$540 |
0.7× |
| MRA neck w/o contrast (70547) |
$126.44 |
$331 |
0.6× |
| MRI abdomen w contrast (74182) |
$1,112.38 |
$2,912 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$191 |
$500 |
0.6× |
| MRI abdomen w/o contrast (74181) |
$123 |
$322 |
0.6× |
| MRI any jnt lwr ext with con lt (73722) |
$166.55 |
$436 |
0.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$166.55 |
$436 |
0.2× |
| MRI c-spine with contrast (72142) |
$156.62 |
$410 |
0.5× |
| MRI cervical spine w/o contrast (72141) |
$126.44 |
$331 |
0.6× |
| MRI chest w/o & w/contrast material (71552) |
$202.46 |
$530 |
0.6× |
| MRI chest w/o contrast (71550) |
$969.90 |
$2,539 |
4.5× |
| MRI chest with contrast (71551) |
$162.35 |
$425 |
0.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$166.55 |
$436 |
0.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$163.11 |
$427 |
0.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$123 |
$322 |
0.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$123 |
$322 |
0.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$191 |
$500 |
0.6× |
| MRI orbit/face/neck w/contrast (70542) |
$163.11 |
$427 |
0.5× |
| MRI pelvis w contrast (72196) |
$166.55 |
$436 |
0.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$200.55 |
$525 |
0.6× |
| MRI pelvis w/o contrast (72195) |
$126.44 |
$331 |
0.6× |
| MRI scan of arm joint before and after contrast (73223) |
$208.95 |
$547 |
0.7× |
| MRI scan of leg joint before and after contrast (73723) |
$206.28 |
$540 |
0.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$206.28 |
$540 |
0.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$163.11 |
$427 |
0.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$206.28 |
$540 |
0.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$166.55 |
$436 |
0.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$208.95 |
$547 |
0.7× |
| MRI thoracic spine w/o contrast (72146) |
$123 |
$322 |
0.6× |
| MRI upper ext joint w/o contrast (73221) |
$123.77 |
$324 |
0.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$197.88 |
$518 |
0.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$126.06 |
$330 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$156.24 |
$409 |
0.1× |
| Neck soft tissue (70360) |
$86.71 |
$227 |
1.1× |
| Nm gastric emptying study (78264) |
$343.04 |
$898 |
0.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$337.69 |
$884 |
3.6× |
| Osseous survey infant (77076) |
$67.23 |
$176 |
0.7× |
| Osseous survey limited (77074) |
$142.87 |
$374 |
1.5× |
| Parathyroid imaging (78070) |
$331.19 |
$867 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$44.31 |
$116 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$193.67 |
$507 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$323.17 |
$846 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$121.09 |
$317 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$49.66 |
$130 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$45.46 |
$119 |
0.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$92.44 |
$242 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$114.98 |
$301 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$30.56 |
$80 |
0.4× |
| Radiologic exam colon single contrast study (74270) |
$327.76 |
$858 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$238.37 |
$624 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$265.68 |
$695.50 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$37.05 |
$97 |
0.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$72.96 |
$191 |
0.9× |
| Radiological examination surgical specimen (76098) |
$335.40 |
$878 |
0.7× |
| Ribs bilateral 3 views (71110) |
$49.66 |
$130 |
0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$406.45 |
$1,064 |
1.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$112.69 |
$295 |
0.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$114.60 |
$300 |
0.2× |
| Sacroiliac Joints < 3 Views (72200) |
$43.93 |
$115 |
0.5× |
| Scanogram (77073) |
$161.97 |
$424 |
1.7× |
| Scapula complete (73010) |
$44.31 |
$116 |
0.5× |
| Small bowel series (74250) |
$238.37 |
$624 |
1.5× |
| Spine thoracic 3 views (72072) |
$58.06 |
$152 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$208.95 |
$547 |
0.6× |
| Thyroid uptake measurement (78012) |
$257.47 |
$674 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$331.19 |
$867 |
0.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$225.38 |
$590 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$234.93 |
$615 |
2.5× |
| Umbilical-artery Doppler (OB) (76820) |
$72.58 |
$190 |
0.8× |
| Upper Extremity Infant (73092) |
$43.93 |
$115 |
0.5× |
| Urethrocystography voiding (74455) |
$418.67 |
$1,096 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$490.49 |
$1,284 |
3.1× |
| Us abdl aorta screen aaa (76706) |
$70.29 |
$184 |
0.7× |
| Us breast unilateral complete (76641) |
$292.99 |
$767 |
3.1× |
| Us breast unilateral limited (76642) |
$233.78 |
$612 |
3.0× |
| Us chest (76604) |
$355.64 |
$931 |
3.7× |
| Us ob detailed single fetus (76811) |
$361.37 |
$946 |
1.7× |
| Us ob transvaginal (76817) |
$359.84 |
$942 |
3.8× |
| Us pelvic non ob complete (76856) |
$307.89 |
$806 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$235.31 |
$616 |
2.5× |
| Us pregnancy ltd (76815) |
$219.27 |
$574 |
2.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$337.31 |
$883 |
3.6× |
| Us retroperitoneal complete (76770) |
$366.72 |
$960 |
3.9× |
| Us retroperitoneal limited (76775) |
$208.95 |
$547 |
2.2× |
| Us scrotum and contents (76870) |
$238.37 |
$624 |
2.5× |
| Us soft tissue head/neck (76536) |
$234.93 |
$615 |
2.5× |
| Us spinal canal and contents (76800) |
$335.01 |
$877 |
3.5× |
| Us xtr non-vasc lmtd (76882) |
$181.83 |
$476 |
1.9× |
| Vertebral fracture assessment via dxa (77086) |
$29.03 |
$76 |
0.4× |
| Wrist 2 views (73100) |
$38.58 |
$101 |
0.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$38.96 |
$102 |
0.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$45.84 |
$120 |
0.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$418.67 |
$1,096 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$38.96 |
$102 |
0.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$45.84 |
$120 |
0.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$292.99 |
$767 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$87.48 |
$229 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$120.71 |
$316 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$50.42 |
$132 |
0.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$35.91 |
$94 |
0.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$46.22 |
$121 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$37.82 |
$99 |
0.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$35.53 |
$93 |
0.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$75.64 |
$198 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$42.02 |
$110 |
0.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$35.53 |
$93 |
0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$46.60 |
$122 |
0.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$113.45 |
$297 |
1.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$79.46 |
$208 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$35.53 |
$93 |
0.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$86.71 |
$227 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$45.08 |
$118 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$38.58 |
$101 |
0.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$49.66 |
$130 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$79.46 |
$208 |
0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$45.46 |
$119 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$45.46 |
$119 |
0.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$36.67 |
$96 |
0.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$35.24 |
$92.24 |
0.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$35.91 |
$94 |
0.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$43.93 |
$115 |
0.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$34.38 |
$90 |
0.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$49.66 |
$130 |
0.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$44.31 |
$116 |
0.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$66.09 |
$173 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$37.05 |
$97 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$45.84 |
$120 |
0.6× |
| Xr chest 4+ views (71048) |
$76.40 |
$200 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$36.29 |
$95 |
0.5× |
| Xr shoulder 1 view (73020) |
$38.96 |
$102 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$79.84 |
$209 |
0.8× |
| Xr tibia/fibula 2 views (73590) |
$38.20 |
$100 |
0.5× |
| Xr tmj bilateral (70330) |
$64.18 |
$168 |
0.8× |
| Xray knee 1 or 2 views rt (73560) |
$36.67 |
$96 |
0.5× |