| Ankle 2 views (73600) |
$270.08 |
$277 |
2.9× |
| Clavicle complete (73000) |
$298.84 |
$306.50 |
3.3× |
| Complex dynamic pharyngeal and speech evaluation by cine or video recording Age Under 21 (70371) |
$702.98 |
$721 |
2.8× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$3,545.10 |
$3,636 |
9.6× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$3,717.68 |
$3,813 |
20.1× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$3,545.10 |
$3,636 |
19.2× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$3,653.33 |
$3,747 |
19.7× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$2,988.38 |
$3,065 |
16.2× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,474.55 |
$2,538 |
13.4× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,320.50 |
$2,380 |
12.5× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$2,507.70 |
$2,572 |
22.7× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$2,320.50 |
$2,380 |
12.5× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$2,320.50 |
$2,380 |
12.5× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$2,533.05 |
$2,598 |
13.7× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$2,221.05 |
$2,278 |
20.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$2,151.83 |
$2,207 |
19.5× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,265.90 |
$2,324 |
12.2× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$3,180.45 |
$3,262 |
17.2× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$2,320.50 |
$2,380 |
12.5× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$3,296.48 |
$3,381 |
17.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,828.55 |
$5,978 |
15.8× |
| CT abdomen and pelvis without contrast (74176) |
$3,117.08 |
$3,197 |
12.4× |
| CT abdomen w & w/o contrast (74170) |
$3,030.30 |
$3,108 |
16.4× |
| CT abdomen w/contrast (74160) |
$2,676.38 |
$2,745 |
14.5× |
| CT abdomen w/o contrast (74150) |
$2,249.33 |
$2,307 |
20.4× |
| CT cervical spine w/contrast (72126) |
$2,235.68 |
$2,293 |
6.1× |
| CT cervical spine w/o contrast (72125) |
$2,807.03 |
$2,879 |
25.5× |
| CT chest w/contrast (71260) |
$2,913.30 |
$2,988 |
15.7× |
| CT extremity upper w & w/o contrast (73202) |
$2,320.50 |
$2,380 |
12.5× |
| CT extremity upper w/o contrast (73200) |
$2,151.83 |
$2,207 |
19.5× |
| CT head/brain with contrast (70460) |
$2,904.53 |
$2,979 |
15.7× |
| CT head/brain without and with contrast (70470) |
$2,320.50 |
$2,380 |
12.5× |
| CT l-spine w/contrast (72132) |
$2,235.68 |
$2,293 |
6.1× |
| CT lower extremity w/dye (73701) |
$2,235.68 |
$2,293 |
12.1× |
| CT lumbar spine w/o contrast (72131) |
$2,730 |
$2,800 |
24.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,320.50 |
$2,380 |
12.5× |
| CT neck w/contrast (70491) |
$2,732.93 |
$2,803 |
14.8× |
| CT neck w/o contrast (70490) |
$2,319.53 |
$2,379 |
21.0× |
| CT pelvis w & w/o contrast (72194) |
$2,979.60 |
$3,056 |
16.1× |
| CT pelvis w/o contrast (72192) |
$2,561.33 |
$2,627 |
23.2× |
| CT thoracic spine w/contrast (72129) |
$2,235.68 |
$2,293 |
12.1× |
| CT thoracic spine w/o contrast (72128) |
$2,700.75 |
$2,770 |
24.5× |
| CT thorax lung cancer scr c- (71271) |
$322.73 |
$331 |
2.9× |
| CT thorax w/o contrast (71250) |
$2,655.90 |
$2,724 |
24.1× |
| CT upper extremity w/dye (73201) |
$2,170.35 |
$2,226 |
5.9× |
| CTA head w contrast (70496) |
$3,448.58 |
$3,537 |
18.6× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$593.78 |
$609 |
5.4× |
| Dxa bone density/peripheral (77081) |
$269.10 |
$276 |
2.9× |
| Fetal biophys profile w/o nst (76819) |
$630.83 |
$647 |
5.7× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$3,978.98 |
$4,081 |
10.8× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$3,064.43 |
$3,143 |
12.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$3,889.28 |
$3,989 |
10.6× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,855.78 |
$2,929 |
11.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,068.68 |
$4,173 |
11.1× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$3,179.48 |
$3,261 |
8.6× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$2,918.18 |
$2,993 |
7.9× |
| Mandible min 4v (70110) |
$405.60 |
$416 |
3.7× |
| MRA head w/o contrast (70544) |
$3,130.73 |
$3,211 |
12.4× |
| MRA neck w/ contrast (70548) |
$3,441.75 |
$3,530 |
9.4× |
| MRA neck w/o contrast (70547) |
$3,074.18 |
$3,153 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$3,142.43 |
$3,223 |
12.5× |
| MRI abdomen w/wo contrast (74183) |
$3,889.28 |
$3,989 |
10.6× |
| MRI c-spine w&w/o cont (72156) |
$3,824.93 |
$3,923 |
10.4× |
| MRI chest w/o contrast (71550) |
$2,952.30 |
$3,028 |
11.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$3,636.75 |
$3,730 |
9.9× |
| MRI joint upr extrem w/o dye (73221) |
$3,267.23 |
$3,351 |
13.0× |
| MRI lumbar spine w/wo contrast (72158) |
$4,322.18 |
$4,433 |
11.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,971.80 |
$3,048 |
8.1× |
| MRI pelvis w & w/o contrast (72197) |
$3,667.95 |
$3,762 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,910.38 |
$2,985 |
11.6× |
| MRI spine cervical w/o contrast (72141) |
$3,306.23 |
$3,391 |
13.1× |
| MRI t-spine w&w/o cont (72157) |
$4,114.50 |
$4,220 |
11.2× |
| MRI thoracic spine w/o contrst (72146) |
$3,432.98 |
$3,521 |
13.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,156.08 |
$3,237 |
12.5× |
| Ob us limited fetus(s) (76815) |
$638.63 |
$655 |
5.8× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$388.05 |
$398 |
4.2× |
| Radex hip unilateral with pelvis 1 view (73501) |
$315.90 |
$324 |
3.4× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$439.24 |
$450.50 |
4.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$507.49 |
$520.50 |
4.6× |
| Radex spine cervical 2 or 3 views (72040) |
$396.83 |
$407 |
4.3× |
| Radex spine cervical 4 or 5 views (72050) |
$632.29 |
$648.50 |
5.7× |
| Radiologic exam swallow function contrast study (74230) |
$878.48 |
$901 |
4.7× |
| Radiologic examination femur 1 view (73551) |
$274.95 |
$282 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$386.10 |
$396 |
4.2× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$265.20 |
$272 |
2.9× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$348.56 |
$357.50 |
3.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$513.83 |
$527 |
4.7× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$314.92 |
$323 |
3.4× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$341.26 |
$350 |
3.7× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$322.72 |
$331 |
3.5× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$343.20 |
$352 |
3.7× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$323.70 |
$332 |
3.5× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$447.52 |
$459 |
4.1× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$294.94 |
$302.50 |
3.2× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$551.36 |
$565.50 |
5.0× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$310.54 |
$318.50 |
2.8× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$360.26 |
$369.50 |
3.3× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$323.70 |
$332 |
3.5× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$264.23 |
$271 |
2.9× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$386.10 |
$396 |
3.5× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$477.76 |
$490 |
4.3× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$420.72 |
$431.50 |
3.8× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$747.34 |
$766.50 |
6.8× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$317.86 |
$326 |
3.5× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$434.36 |
$445.50 |
4.7× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$332.48 |
$341 |
3.6× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$319.80 |
$328 |
3.5× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$428.52 |
$439.50 |
3.9× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Age Under 21 (70370) |
$278.36 |
$285.50 |
3.0× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$326.62 |
$335 |
3.6× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$286.16 |
$293.50 |
3.1× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$332.48 |
$341 |
3.0× |
| Scapula complete (73010) |
$312.49 |
$320.50 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$770.25 |
$790 |
7.0× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$718.58 |
$737 |
6.5× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$863.85 |
$886 |
7.8× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$666.90 |
$684 |
6.0× |
| Us abdominal aorta real time screen study aaa (76706) |
$463.62 |
$475.50 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$799.50 |
$820 |
7.2× |
| Us exam, pelvic, limited (76857) |
$728.33 |
$747 |
6.6× |
| US OB Follow-Up/Repeat (76816) |
$723.45 |
$742 |
6.6× |
| Us ob transvaginal (76817) |
$755.63 |
$775 |
6.9× |
| Us retroperitoneal complete (76770) |
$838.50 |
$860 |
7.6× |
| Us retroperitoneal ltd (76775) |
$715.65 |
$734 |
6.5× |
| Us scrotum (76870) |
$842.40 |
$864 |
7.6× |
| Us soft tissue head/neck (76536) |
$799.50 |
$820 |
7.2× |
| X-ray exam of finger(s) (73140) |
$273 |
$280 |
3.0× |
| X-ray exam of knee 1 or 2 (73560) |
$350.52 |
$359.50 |
3.8× |
| X-ray exam ribs bil 3 views (71110) |
$314.93 |
$323 |
2.9× |
| X-ray exam ribs uni 2 views (71100) |
$257.40 |
$264 |
2.8× |
| X-ray heel (73650) |
$284.22 |
$291.50 |
3.1× |
| Xr abdomen 1 view (74018) |
$293.96 |
$301.50 |
3.2× |
| Xr abdomen 2 views (74019) |
$391.95 |
$402 |
3.6× |
| Xr bone age studies (77072) |
$323.70 |
$332 |
2.9× |
| Xr bone survey infant (77076) |
$455.32 |
$467 |
4.1× |
| Xr chest 1 view (71045) |
$288.12 |
$295.50 |
3.1× |
| Xr chest 2 views (71046) |
$370.99 |
$380.50 |
4.0× |
| Xr facial bones 3+ views (70150) |
$402.68 |
$413 |
3.7× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$257.40 |
$264 |
2.8× |
| Xr forearm 2 views (73090) |
$301.76 |
$309.50 |
3.3× |
| Xr hand 2v (73120) |
$266.18 |
$273 |
2.4× |
| Xr neck soft tissue (70360) |
$313.96 |
$322 |
3.4× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$399.75 |
$410 |
4.4× |
| Xr osseous survey complete (77075) |
$959.89 |
$984.50 |
8.7× |
| Xr pelvis 1-2 views (72170) |
$354.42 |
$363.50 |
3.2× |
| Xr sacrum/coccyx 2+ views (72220) |
$422.66 |
$433.50 |
4.6× |
| Xr shoulder 1 view (73020) |
$239.36 |
$245.50 |
2.6× |
| Xr sinuses 3+ views (70220) |
$402.68 |
$413 |
4.4× |
| Xr skull min 4 view (70260) |
$499.69 |
$512.50 |
4.5× |
| Xr spine thoracic 3v (72072) |
$548.44 |
$562.50 |
5.0× |
| Xr sternum 2+ views (71120) |
$337.36 |
$346 |
3.7× |
| Xr t-spine 2 views (72070) |
$435.34 |
$446.50 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$344.18 |
$353 |
3.7× |
| Xr wrist 2 views (73100) |
$276.90 |
$284 |
3.0× |