| Ankle 2 views (73600) |
$191.58 |
$191.58 |
2.1× |
| Bone age studies (77072) |
$142.14 |
$142.14 |
1.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$543.84 |
$543.84 |
3.0× |
| Clavicle complete (73000) |
$311.06 |
$311.06 |
3.4× |
| CT - st neck w&wo contr (70492) |
$2,981.85 |
$2,981.85 |
16.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,271.15 |
$2,271.15 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,271.15 |
$2,271.15 |
9.1× |
| CT abdomen w wo contrast (74170) |
$3,249.65 |
$3,249.65 |
17.7× |
| CT abdomen w/contrast (74160) |
$2,801.60 |
$2,801.60 |
15.3× |
| CT abdomen w/o contrast (74150) |
$2,801.60 |
$2,801.60 |
25.7× |
| CT angio abdom w/o & w/dye (74175) |
$2,953.01 |
$2,953.01 |
16.1× |
| CT angio abdominal arteries (75635) |
$1,022 |
$1,022 |
5.6× |
| CT angiograph pelv w/o&w/dye (72191) |
$2,500.84 |
$2,500.84 |
13.7× |
| CT cervical spine w/o contrast (72125) |
$2,575 |
$2,575 |
23.6× |
| CT chest w/contrast (71260) |
$2,840.74 |
$2,840.74 |
15.5× |
| CT head/brain without and with contrast (70470) |
$2,924.17 |
$2,924.17 |
16.0× |
| CT lower extremity w contrast (73701) |
$2,275.27 |
$2,275.27 |
12.4× |
| CT lower extremity w/o contrast unilateral (73700) |
$2,195.96 |
$2,195.96 |
20.1× |
| CT lumbar spine w/o contrast (72131) |
$2,493.63 |
$2,493.63 |
22.8× |
| CT maxillofacial area w/o contrast (70486) |
$2,439.04 |
$2,439.04 |
22.3× |
| CT maxillofacial w/contrast (70487) |
$2,538.95 |
$2,538.95 |
13.9× |
| CT maxillofacial w/o then w/ con (70488) |
$2,931.38 |
$2,931.38 |
16.0× |
| CT orbit sella ear w/o con (70480) |
$1,909.62 |
$1,909.62 |
17.5× |
| CT pelvis w & w/o contrast (72194) |
$2,453.46 |
$2,453.46 |
13.4× |
| CT pelvis w/o contrast (72192) |
$1,804.56 |
$1,804.56 |
16.5× |
| CT soft tissue neck w/contrast (70491) |
$2,625.47 |
$2,625.47 |
14.3× |
| CT soft tissue neck w/o contrast (70490) |
$2,390.63 |
$2,390.63 |
21.9× |
| CT thoracic spine w/contrast (72129) |
$1,645 |
$1,645 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$1,970.39 |
$1,970.39 |
18.0× |
| CT thorax lung cancer scr c- (71271) |
$1,300 |
$1,300 |
11.9× |
| CT thorax w/o contrast (71250) |
$2,679.03 |
$2,679.03 |
24.5× |
| CT thorax w/o then w/ contrast (71270) |
$3,367.07 |
$3,367.07 |
18.4× |
| CT upper extremity w/dye (73201) |
$2,275.27 |
$2,275.27 |
6.2× |
| CT upper extremity w/o contrast rt (73200) |
$2,195.96 |
$2,195.96 |
20.1× |
| CTA chest w/wo contrast (71275) |
$3,249.65 |
$3,249.65 |
17.7× |
| CTA head w contrast (70496) |
$2,460.67 |
$2,460.67 |
13.4× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$2,448.31 |
$2,448.31 |
13.4× |
| Cta Neck (70498) |
$2,381.36 |
$2,381.36 |
13.0× |
| Esophogram (74220) |
$532.51 |
$532.51 |
2.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$511.91 |
$511.91 |
2.1× |
| Gastric emptying study (78264) |
$1,368.87 |
$1,368.87 |
3.3× |
| Hepatobil syst image w/drug (78227) |
$1,472.90 |
$1,472.90 |
2.6× |
| Hepatobiliary system imaging (78226) |
$1,172.90 |
$1,172.90 |
2.8× |
| Humerus min 2 views (73060) |
$170.98 |
$170.98 |
1.9× |
| Lung ventilat&perfus imaging (78582) |
$927 |
$927 |
1.6× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$3,388.70 |
$3,388.70 |
9.3× |
| MRA head w/o contrast (70544) |
$2,568.82 |
$2,568.82 |
10.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,491.70 |
$3,491.70 |
9.6× |
| MRI abdomen w/o contrast (74181) |
$2,646.07 |
$2,646.07 |
10.6× |
| MRI cervical spine w/o contrast (72141) |
$3,574.10 |
$3,574.10 |
14.3× |
| MRI joint upr extrem w/o dye (73221) |
$2,761.43 |
$2,761.43 |
11.1× |
| Mri Lower Extremity W/O Dye (73718) |
$2,630.11 |
$2,630.11 |
10.6× |
| MRI lumbar w/wo contrast (72158) |
$4,004.64 |
$4,004.64 |
11.0× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$3,491.70 |
$3,491.70 |
9.6× |
| MRI pelvis w/o contrast (72195) |
$3,151.80 |
$3,151.80 |
12.6× |
| MRI pelvis w/wo contrast (72197) |
$3,491.70 |
$3,491.70 |
9.6× |
| MRI spine cervical wo/w contrast (72156) |
$4,004.64 |
$4,004.64 |
11.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,390.76 |
$3,390.76 |
13.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,761.43 |
$2,761.43 |
11.1× |
| Nm bone 3 phase (78315) |
$1,251.45 |
$1,251.45 |
3.0× |
| Nm bone imaging whole body (78306) |
$1,474.96 |
$1,474.96 |
3.5× |
| Nm heart perfusion spect stress rest (78452) |
$1,730.40 |
$1,730.40 |
1.3× |
| Ob us < 14 wks single fetus (76801) |
$340.93 |
$340.93 |
3.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$175.10 |
$175.10 |
1.9× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$174.07 |
$174.07 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$174.07 |
$174.07 |
1.6× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$357.41 |
$357.41 |
3.3× |
| Radex spine cervical 2 or 3 views (72040) |
$366.17 |
$366.17 |
4.0× |
| Radex spine cervical 4 or 5 views (72050) |
$524.27 |
$524.27 |
4.8× |
| Radex spine cervical 6 or more views (72052) |
$591.22 |
$591.22 |
5.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$611.82 |
$611.82 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$368.74 |
$368.74 |
4.1× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$626.24 |
$626.24 |
5.7× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$60 |
$60 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$643.75 |
$643.75 |
5.9× |
| Us breast uni real time with image complete (76641) |
$375 |
$375 |
3.4× |
| Us chest (76604) |
$314.15 |
$314.15 |
2.9× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$405.82 |
$405.82 |
3.7× |
| Us ob limited 1 or more fetuses (76815) |
$432.60 |
$432.60 |
4.0× |
| Us obstetric transvaginal (76817) |
$143.17 |
$143.17 |
1.3× |
| Us pelvic limited or f/u non-ob (76857) |
$491.31 |
$491.31 |
4.5× |
| Us pelvis complete (76856) |
$542.81 |
$542.81 |
5.0× |
| Us retroperitoneal complete (76770) |
$587.10 |
$587.10 |
5.4× |
| Us retroperitoneal limited (76775) |
$509.85 |
$509.85 |
4.7× |
| Us scrotum (76870) |
$664.35 |
$664.35 |
6.1× |
| Us soft tissue head/neck (76536) |
$209.09 |
$209.09 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$351.23 |
$351.23 |
3.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$340.93 |
$340.93 |
3.8× |
| X-ray exam of finger(s) (73140) |
$109.18 |
$109.18 |
1.2× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$217.33 |
$217.33 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$353.29 |
$353.29 |
3.9× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$294.58 |
$294.58 |
2.7× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$342.99 |
$342.99 |
3.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$294.58 |
$294.58 |
3.2× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$395.52 |
$395.52 |
4.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$418.18 |
$418.18 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$135 |
$135 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$392.43 |
$392.43 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$569.59 |
$569.59 |
5.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$488.22 |
$488.22 |
4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$355.35 |
$355.35 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$349.17 |
$349.17 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$370.80 |
$370.80 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$390.37 |
$390.37 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$624.18 |
$624.18 |
5.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$109.18 |
$109.18 |
1.2× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$265.74 |
$265.74 |
2.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$314.15 |
$314.15 |
3.5× |
| Xr abdomen 1 view (74018) |
$340.93 |
$340.93 |
3.8× |
| Xr abdomen 2 views (74019) |
$438.78 |
$438.78 |
4.0× |
| Xr bone density axial (77080) |
$318.27 |
$318.27 |
2.9× |
| Xr chest 1 view (71045) |
$263.68 |
$263.68 |
2.9× |
| Xr chest 2 views (71046) |
$360.50 |
$360.50 |
4.0× |
| Xr facial bones 3 views (70150) |
$449.08 |
$449.08 |
4.1× |
| Xr sternum 2 views (71120) |
$290.46 |
$290.46 |
3.2× |
| Xray elbow 2 views (73070) |
$312.09 |
$312.09 |
3.4× |
| Xray forearm 2 views (73090) |
$325.48 |
$325.48 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$314.15 |
$314.15 |
3.5× |
| Xray neck soft tissue (70360) |
$292.52 |
$292.52 |
3.2× |
| Xray orbits complete min 4 views (70200) |
$452.17 |
$452.17 |
4.1× |
| Xray pelvis 1 or 2 views (72170) |
$279.13 |
$279.13 |
2.6× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$395.52 |
$395.52 |
3.6× |
| Xray scapula complete (73010) |
$260.59 |
$260.59 |
2.4× |
| Xray shoulder 1 view (73020) |
$103 |
$103 |
1.1× |
| Xray sinuses paranasal <3 views (70210) |
$103 |
$103 |
1.1× |
| Xray spine thoracic 2 views (72070) |
$350.20 |
$350.20 |
3.2× |
| Xray spine thoracic 3 views (72072) |
$413.03 |
$413.03 |
3.8× |
| Xray tibia-fibula 2 views bil (73590) |
$321.36 |
$321.36 |
3.5× |