| Abdomen 2 views (74019) |
$274.40 |
$343 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,739.79 |
$2,174.74 |
4.2× |
| Ankle 2 views (73600) |
$201.84 |
$252.30 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,614.71 |
$2,018.39 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$1,659.20 |
$2,074 |
4.0× |
| Bone age studies (77072) |
$232.16 |
$290.20 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,831.71 |
$2,289.64 |
4.4× |
| Bone survey complete (77075) |
$942.38 |
$1,177.98 |
8.7× |
| Cervical spine 2 or 3 views (72040) |
$178.40 |
$223 |
2.0× |
| Chest 1 view (71045) |
$246.40 |
$308 |
2.7× |
| Chest 3 views (71047) |
$347.54 |
$434.42 |
3.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$548 |
$685 |
3.0× |
| Clavicle complete (73000) |
$249.22 |
$311.52 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,666.40 |
$2,083 |
15.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,985.60 |
$4,982 |
11.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,986.40 |
$3,733 |
12.1× |
| CT abdomen w contrast (74160) |
$2,001.50 |
$2,501.87 |
11.0× |
| CT abdomen w wo contrast (74170) |
$2,288.25 |
$2,860.31 |
12.6× |
| CT abdomen w/o contrast (74150) |
$1,654.59 |
$2,068.24 |
15.2× |
| CT angiography upper extremity lt (73206) |
$2,291.54 |
$2,864.43 |
12.6× |
| CT c-spine w/o contrast (72125) |
$1,838.40 |
$2,298 |
16.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,003.97 |
$2,504.96 |
11.0× |
| CT cervical spine with contrast (72126) |
$1,946.29 |
$2,432.86 |
5.4× |
| CT chest w/wo contrast (71270) |
$2,102.02 |
$2,627.53 |
11.5× |
| CT chest with contrast (71260) |
$1,976.80 |
$2,471 |
10.9× |
| CT head/brain with contrast (70460) |
$1,652.94 |
$2,066.18 |
9.1× |
| CT head/brain without and with contrast (70470) |
$1,978.42 |
$2,473.03 |
10.9× |
| CT iac w contrast (70481) |
$1,853.18 |
$2,316.47 |
10.2× |
| CT lower ext w/o (73700) |
$1,697.60 |
$2,122 |
15.6× |
| CT lower extremity w wo contrast (73702) |
$1,867.18 |
$2,333.98 |
10.3× |
| CT lower extremity with contrast (73701) |
$1,778.19 |
$2,222.74 |
9.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,532.15 |
$3,165.19 |
13.9× |
| CT lumbar spine w/o contrast (72131) |
$1,805.60 |
$2,257 |
16.6× |
| CT lumbar spine with contrast (72132) |
$2,174.40 |
$2,718 |
6.0× |
| CT maxillofacial w contrast (70487) |
$1,784.78 |
$2,230.98 |
9.8× |
| CT maxillofacial w/o contrast (70486) |
$1,426.40 |
$1,783 |
13.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,793.85 |
$2,242.31 |
9.8× |
| CT neck soft tissue w contrast (70491) |
$1,795.20 |
$2,244 |
9.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,050.11 |
$2,562.64 |
11.3× |
| CT orbits w/o contrast (70480) |
$1,657.89 |
$2,072.36 |
15.3× |
| CT pelvis w & w/o contrast (72194) |
$2,139.10 |
$2,673.88 |
11.7× |
| CT pelvis w/o contrast (72192) |
$1,704 |
$2,130 |
15.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,910.03 |
$2,387.54 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,605.15 |
$2,006.44 |
14.8× |
| CT thoracic spine w/contrast (72129) |
$1,828.46 |
$2,285.57 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$1,969.60 |
$2,462 |
18.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,431.29 |
$1,789.11 |
7.9× |
| CT thorax w/o contrast (71250) |
$1,784.80 |
$2,231 |
16.4× |
| CT unlisted procedure (76497) |
$6,477.46 |
$8,096.83 |
71.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,634.33 |
$3,292.91 |
14.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,581.60 |
$1,977 |
14.6× |
| CT upper extremity with contrast (73201) |
$1,725.46 |
$2,156.82 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,485.18 |
$3,106.48 |
13.6× |
| Cta Abdomen (74175) |
$2,560.99 |
$3,201.24 |
14.1× |
| CTA abdomen pelvis (74174) |
$4,382.03 |
$5,477.54 |
12.1× |
| CTA chest (71275) |
$2,690.40 |
$3,363 |
14.8× |
| Cta Head (70496) |
$2,449.60 |
$3,062 |
13.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,697.44 |
$2,121.80 |
9.3× |
| Cta Neck (70498) |
$2,841.60 |
$3,552 |
15.6× |
| Cta Pelvis (72191) |
$2,795.01 |
$3,493.76 |
15.3× |
| Diskography lumbar (72295) |
$1,088.80 |
$1,361 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$385.60 |
$482 |
3.6× |
| Echoencephalography real time imaging (76506) |
$518.26 |
$647.82 |
4.8× |
| Esophageal motility (78258) |
$1,085 |
$1,356.25 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$367.71 |
$459.64 |
3.4× |
| Fluoroscopy up to 1 hr (76000) |
$593.40 |
$741.75 |
2.4× |
| Foot 2 views (73620) |
$213.21 |
$266.51 |
2.4× |
| Forearm 2 views (73090) |
$235.95 |
$294.94 |
2.6× |
| Gated Heart Planar Single (78472) |
$1,719.90 |
$2,149.87 |
4.1× |
| Hand 2 views (73120) |
$214.16 |
$267.70 |
2.0× |
| Hand 3 views (73130) |
$384 |
$480 |
4.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,601.92 |
$2,002.40 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,456.46 |
$1,820.58 |
3.5× |
| Ht muscle image spect sing (78451) |
$1,296.32 |
$1,620.40 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$250.40 |
$313 |
2.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,586.28 |
$1,982.85 |
2.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,472.57 |
$1,840.71 |
2.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,486.78 |
$1,858.48 |
2.6× |
| Knee 3 views (73562) |
$464.80 |
$581 |
5.1× |
| Liver & spleen imaging static only (78215) |
$1,510.47 |
$1,888.09 |
3.6× |
| Lung perfusion differential (78597) |
$2,420.17 |
$3,025.21 |
5.8× |
| Lung Ventilation Imaging (78579) |
$1,418.56 |
$1,773.20 |
3.4× |
| Lymphoscintigraphy (78195) |
$1,556.90 |
$1,946.13 |
2.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$144.03 |
$180.04 |
1.6× |
| Meckels Diverticulum (78290) |
$1,604.29 |
$2,005.36 |
3.9× |
| MRA head w & w/o contrast (70546) |
$2,466.23 |
$3,082.79 |
6.8× |
| MRA head w/o contrast (70544) |
$2,280.01 |
$2,850.01 |
9.2× |
| MRA head with contrast (70545) |
$2,466.23 |
$3,082.79 |
6.8× |
| MRA neck w contrast (70548) |
$2,623.62 |
$3,279.52 |
7.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,623.62 |
$3,279.52 |
7.2× |
| MRA neck w/o contrast (70547) |
$1,232.70 |
$1,540.88 |
5.0× |
| MRI abdomen w contrast (74182) |
$2,715.90 |
$3,394.88 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,664.80 |
$4,581 |
10.1× |
| MRI abdomen w/o contrast (74181) |
$2,459.64 |
$3,074.55 |
9.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,121.80 |
$2,652.25 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,036.93 |
$2,546.16 |
2.5× |
| MRI c-spine with contrast (72142) |
$3,076.82 |
$3,846.02 |
8.5× |
| MRI cervical spine w/o contrast (72141) |
$3,300.80 |
$4,126 |
13.3× |
| MRI chest w/o contrast (71550) |
$2,464.58 |
$3,080.73 |
9.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,121.80 |
$2,652.25 |
5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,121.80 |
$2,652.25 |
5.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,942.17 |
$2,427.71 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,210.79 |
$2,763.49 |
8.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,804.90 |
$3,506.12 |
7.7× |
| MRI orbit/face/neck w/contrast (70542) |
$2,461.29 |
$3,076.61 |
6.8× |
| MRI pelvis w contrast (72196) |
$2,224.80 |
$2,781 |
6.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,865.87 |
$3,582.34 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$2,296.49 |
$2,870.61 |
9.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,121.80 |
$2,652.25 |
5.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,445.63 |
$3,057.04 |
6.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,630.40 |
$4,538 |
10.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,076.82 |
$3,846.02 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,123.20 |
$5,154 |
11.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,076.82 |
$3,846.02 |
8.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,715.20 |
$4,644 |
10.3× |
| MRI thoracic spine w/o contrast (72146) |
$3,300.80 |
$4,126 |
13.3× |
| MRI tmj (70336) |
$2,095.43 |
$2,619.29 |
8.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,158.40 |
$2,698 |
8.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,121.80 |
$2,652.25 |
5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,038.58 |
$2,548.22 |
8.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,515.20 |
$4,394 |
2.6× |
| Neck soft tissue (70360) |
$301.34 |
$376.67 |
3.3× |
| Nm gastric emptying study (78264) |
$1,505.74 |
$1,882.17 |
3.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$2,077.14 |
$2,596.42 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$310.61 |
$388.26 |
2.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,318.11 |
$1,647.64 |
3.2× |
| Parathyroid imaging (78070) |
$1,140.91 |
$1,426.14 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$269.60 |
$337 |
2.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,360.76 |
$2,950.95 |
6.5× |
| Pr sono bone density measure,peripheral (76977) |
$134.10 |
$167.63 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,418.56 |
$1,773.20 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,403.11 |
$3,003.89 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$311.06 |
$388.83 |
0.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$398.94 |
$498.67 |
3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$290.91 |
$363.64 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$276 |
$345 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$273.60 |
$342 |
3.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$268.80 |
$336 |
3.0× |
| Ribs bilateral 3 views (71110) |
$287.96 |
$359.95 |
2.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,426.14 |
$1,782.67 |
2.5× |
| Sacroiliac Joints < 3 Views (72200) |
$306.07 |
$382.59 |
2.8× |
| Scapula complete (73010) |
$249.22 |
$311.52 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$65.08 |
$81.35 |
2.8× |
| Spine thoracic 3 views (72072) |
$535.20 |
$669 |
4.9× |
| Testicular Imaging With Vascular Flow (78761) |
$1,085 |
$1,356.25 |
2.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,948.26 |
$2,435.33 |
3.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,526.58 |
$1,908.23 |
3.7× |
| Thyroid uptake measurement (78012) |
$929.59 |
$1,161.99 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,351.28 |
$1,689.10 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$555.20 |
$694 |
5.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,258.42 |
$1,573.02 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$544.80 |
$681 |
5.0× |
| Us breast unilateral complete (76641) |
$486.40 |
$608 |
4.5× |
| Us breast unilateral limited (76642) |
$343.20 |
$429 |
3.8× |
| Us chest (76604) |
$469.80 |
$587.25 |
4.3× |
| Us guided compression repair (76936) |
$628 |
$785 |
2.8× |
| Us kidney transplant (76776) |
$618.62 |
$773.27 |
5.7× |
| Us ob transvaginal (76817) |
$422.22 |
$527.77 |
3.9× |
| Us pelvic non ob complete (76856) |
$708 |
$885 |
6.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$476.73 |
$595.91 |
4.4× |
| Us pregnancy ltd (76815) |
$291.42 |
$364.27 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$577.09 |
$721.36 |
5.3× |
| Us retroperitoneal complete (76770) |
$721.60 |
$902 |
6.6× |
| Us retroperitoneal limited (76775) |
$249.60 |
$312 |
2.3× |
| Us scrotum and contents (76870) |
$637.60 |
$797 |
5.9× |
| Us soft tissue head/neck (76536) |
$490.40 |
$613 |
4.5× |
| Us transrectal (76872) |
$411.64 |
$514.55 |
3.8× |
| Us xtr non-vasc lmtd (76882) |
$518.26 |
$647.82 |
4.8× |
| Wrist 2 views (73100) |
$208.47 |
$260.59 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$315.55 |
$394.44 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$218.90 |
$273.62 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$368 |
$460 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$233.11 |
$291.39 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$379.20 |
$474 |
4.2× |
| X-ray exam hip uni 1 view (73501) |
$203.20 |
$254 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$372 |
$465 |
4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$569.50 |
$711.88 |
5.2× |
| X-ray eye for foreign body (70030) |
$221.26 |
$276.58 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$446.52 |
$558.15 |
4.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$229.60 |
$287 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$205.63 |
$257.04 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$302.40 |
$378 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$253.96 |
$317.45 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$355.20 |
$444 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$531.20 |
$664 |
4.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$487.06 |
$608.83 |
4.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$287.12 |
$358.90 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$452.95 |
$566.19 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$359.20 |
$449 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$272.91 |
$341.14 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$569.60 |
$712 |
5.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$443.44 |
$554.30 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$306.07 |
$382.59 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$267.22 |
$334.03 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$424.80 |
$531 |
4.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$253 |
$316.25 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$538.55 |
$673.19 |
5.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$281.44 |
$351.80 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$262.49 |
$328.11 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$306.40 |
$383 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$197.10 |
$246.38 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$376.80 |
$471 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$707.48 |
$884.35 |
6.5× |
| Xr chest 4+ views (71048) |
$307.02 |
$383.78 |
2.8× |
| Xr finger(s) 2+ views (73140) |
$235.20 |
$294 |
2.6× |
| Xr shoulder 1 view (73020) |
$211.20 |
$264 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$31.20 |
$39 |
0.3× |
| Xr tibia/fibula 2 views (73590) |
$348.72 |
$435.90 |
3.9× |
| Xr tmj bilateral (70330) |
$367.08 |
$458.85 |
4.1× |
| Xray knee 1 or 2 views rt (73560) |
$250.40 |
$313 |
2.8× |