| Abdomen 2 views (74019) |
$250.22 |
$250.22 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$986.64 |
$986.64 |
2.5× |
| Ankle 2 views (73600) |
$220.78 |
$220.78 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$568.55 |
$568.55 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$854.77 |
$854.77 |
2.1× |
| Bone age studies (77072) |
$297.94 |
$297.94 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,161.59 |
$1,161.59 |
2.9× |
| Cervical spine 2 or 3 views (72040) |
$317.92 |
$317.92 |
3.6× |
| Chest 1 view (71045) |
$231.45 |
$231.45 |
2.6× |
| Chest 3 views (71047) |
$308.05 |
$308.05 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$522.34 |
$522.34 |
3.0× |
| Clavicle complete (73000) |
$220.78 |
$220.78 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,523.19 |
$1,523.19 |
14.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,813.58 |
$2,813.58 |
8.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,963.56 |
$1,963.56 |
8.2× |
| CT abdomen w contrast (74160) |
$1,648.48 |
$1,648.48 |
9.4× |
| CT abdomen w wo contrast (74170) |
$2,225.45 |
$2,225.45 |
12.6× |
| CT abdomen w/o contrast (74150) |
$1,325.73 |
$1,325.73 |
12.6× |
| CT c-spine w/o contrast (72125) |
$1,715.46 |
$1,715.46 |
16.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,814.57 |
$1,814.57 |
10.3× |
| CT cervical spine with contrast (72126) |
$1,540.23 |
$1,540.23 |
4.4× |
| CT chest w/wo contrast (71270) |
$2,082.67 |
$2,082.67 |
11.8× |
| CT chest with contrast (71260) |
$1,804.20 |
$1,804.20 |
10.2× |
| CT head/brain with contrast (70460) |
$1,446.55 |
$1,446.55 |
8.2× |
| CT head/brain without and with contrast (70470) |
$2,000.37 |
$2,000.37 |
11.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$203.61 |
$203.61 |
2.3× |
| CT iac w contrast (70481) |
$1,390.91 |
$1,390.91 |
7.9× |
| CT lower ext w/o (73700) |
$1,351.16 |
$1,351.16 |
12.9× |
| CT lower extremity w wo contrast (73702) |
$1,803.02 |
$1,803.02 |
10.2× |
| CT lower extremity with contrast (73701) |
$1,435.06 |
$1,435.06 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,119.47 |
$2,119.47 |
12.0× |
| CT lumbar spine w/o contrast (72131) |
$1,526.02 |
$1,526.02 |
14.5× |
| CT maxillofacial w contrast (70487) |
$1,390.91 |
$1,390.91 |
7.9× |
| CT maxillofacial w/o contrast (70486) |
$1,309.27 |
$1,309.27 |
12.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,551.39 |
$1,551.39 |
8.8× |
| CT neck soft tissue w contrast (70491) |
$1,526.02 |
$1,526.02 |
8.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,780.95 |
$1,780.95 |
10.1× |
| CT orbits w/o contrast (70480) |
$1,242.66 |
$1,242.66 |
11.8× |
| CT pelvis w & w/o contrast (72194) |
$1,841.59 |
$1,841.59 |
10.5× |
| CT pelvis w/o contrast (72192) |
$1,549.87 |
$1,549.87 |
14.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,147.44 |
$2,147.44 |
12.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,199.57 |
$1,199.57 |
11.4× |
| CT thoracic spine w/o contrast (72128) |
$1,695.59 |
$1,695.59 |
16.1× |
| CT thorax w/o contrast (71250) |
$1,831.63 |
$1,831.63 |
17.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,673.50 |
$1,673.50 |
9.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,251.08 |
$1,251.08 |
11.9× |
| CT upper extremity with contrast (73201) |
$1,435.06 |
$1,435.06 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,639.61 |
$2,639.61 |
15.0× |
| Cta Abdomen (74175) |
$1,839.82 |
$1,839.82 |
10.4× |
| CTA chest (71275) |
$2,386.27 |
$2,386.27 |
13.5× |
| Cta Head (70496) |
$1,839.82 |
$1,839.82 |
10.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,764.60 |
$2,764.60 |
15.7× |
| Cta Neck (70498) |
$1,839.82 |
$1,839.82 |
10.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$547.71 |
$547.71 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$624.84 |
$624.84 |
5.9× |
| Fluoroscopy up to 1 hr (76000) |
$446.10 |
$446.10 |
1.9× |
| Foot 2 views (73620) |
$222.54 |
$222.54 |
2.5× |
| Forearm 2 views (73090) |
$279.49 |
$279.49 |
3.2× |
| Hand 2 views (73120) |
$317.08 |
$317.08 |
3.0× |
| Hand 3 views (73130) |
$286.14 |
$286.14 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,043.84 |
$1,043.84 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$923.74 |
$923.74 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$264.93 |
$264.93 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$974.02 |
$974.02 |
1.8× |
| Knee 3 views (73562) |
$292.79 |
$292.79 |
3.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$580.17 |
$580.17 |
1.4× |
| Liver imaging w/vascular flow (78202) |
$1,788.81 |
$1,788.81 |
3.3× |
| Meckels Diverticulum (78290) |
$523.13 |
$523.13 |
1.3× |
| MRA head w & w/o contrast (70546) |
$2,645.49 |
$2,645.49 |
7.5× |
| MRA head w/o contrast (70544) |
$2,164.50 |
$2,164.50 |
9.0× |
| MRA head with contrast (70545) |
$2,453.10 |
$2,453.10 |
7.0× |
| MRA neck w contrast (70548) |
$2,276.87 |
$2,276.87 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,455.44 |
$2,455.44 |
7.0× |
| MRA neck w/o contrast (70547) |
$2,164.50 |
$2,164.50 |
9.0× |
| MRI abdomen w contrast (74182) |
$2,790.28 |
$2,790.28 |
8.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,190.79 |
$3,190.79 |
9.1× |
| MRI abdomen w/o contrast (74181) |
$2,640.78 |
$2,640.78 |
11.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,232.22 |
$2,232.22 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,232.22 |
$2,232.22 |
2.8× |
| MRI c-spine with contrast (72142) |
$2,232.22 |
$2,232.22 |
6.4× |
| MRI cervical spine w/o contrast (72141) |
$2,384.40 |
$2,384.40 |
9.9× |
| MRI chest w/o & w/contrast material (71552) |
$2,455.44 |
$2,455.44 |
7.0× |
| MRI chest w/o contrast (71550) |
$2,009 |
$2,009 |
8.4× |
| MRI chest with contrast (71551) |
$2,095 |
$2,095 |
2.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,095 |
$2,095 |
6.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,095 |
$2,095 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,384.40 |
$2,384.40 |
9.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,285.97 |
$2,285.97 |
9.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,724.13 |
$3,724.13 |
10.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,289.84 |
$2,289.84 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,405 |
$2,405 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,698.41 |
$2,698.41 |
7.7× |
| MRI pelvis w/o contrast (72195) |
$2,207.79 |
$2,207.79 |
9.2× |
| MRI scan of arm joint before and after contrast (73223) |
$2,698.41 |
$2,698.41 |
7.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,698.41 |
$2,698.41 |
7.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,698.41 |
$2,698.41 |
7.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,136.90 |
$2,136.90 |
6.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,914.28 |
$2,914.28 |
8.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,095 |
$2,095 |
6.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,698.41 |
$2,698.41 |
7.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,384.40 |
$2,384.40 |
9.9× |
| MRI tmj (70336) |
$1,885.50 |
$1,885.50 |
7.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,384.40 |
$2,384.40 |
9.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,698.41 |
$2,698.41 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,384.40 |
$2,384.40 |
9.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,145.26 |
$2,145.26 |
1.6× |
| Neck soft tissue (70360) |
$206.05 |
$206.05 |
2.4× |
| Nm gastric emptying study (78264) |
$916.20 |
$916.20 |
2.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$523.13 |
$523.13 |
1.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$331.53 |
$331.53 |
3.2× |
| Osseous survey limited (77074) |
$461.76 |
$461.76 |
4.4× |
| Parathyroid imaging (78070) |
$557.40 |
$557.40 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$317.92 |
$317.92 |
3.0× |
| Pr heart first pass single,planar (78481) |
$674.59 |
$674.59 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,504.55 |
$2,504.55 |
7.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$577.18 |
$577.18 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,040.93 |
$1,040.93 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$199.74 |
$199.74 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$397.83 |
$397.83 |
3.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$330 |
$330 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$331.53 |
$331.53 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$254.34 |
$254.34 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$398.97 |
$398.97 |
3.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$314.10 |
$314.10 |
3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$548.71 |
$548.71 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$690.47 |
$690.47 |
3.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$264.93 |
$264.93 |
3.0× |
| Ribs bilateral 3 views (71110) |
$382.68 |
$382.68 |
3.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,130.66 |
$2,130.66 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$250.22 |
$250.22 |
2.4× |
| Scapula complete (73010) |
$232.24 |
$232.24 |
2.2× |
| Small bowel series (74250) |
$508.95 |
$508.95 |
2.9× |
| Testicular Imaging With Vascular Flow (78761) |
$523.13 |
$523.13 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$712.49 |
$712.49 |
1.8× |
| Tmj unilateral (70328) |
$201.12 |
$201.12 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$500.73 |
$500.73 |
4.8× |
| Umbilical-artery Doppler (OB) (76820) |
$490.23 |
$490.23 |
4.7× |
| Unlisted fluoroscopic procedure (76496) |
$232.18 |
$232.18 |
2.7× |
| Unlisted Ultrasound Procedure (76999) |
$335.79 |
$335.79 |
3.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$669.67 |
$669.67 |
3.8× |
| Us breast unilateral complete (76641) |
$703.16 |
$703.16 |
6.7× |
| Us breast unilateral limited (76642) |
$502.26 |
$502.26 |
5.7× |
| Us compl joint r-t w/image documentation (76881) |
$449.14 |
$449.14 |
4.3× |
| Us ob transvaginal (76817) |
$609.44 |
$609.44 |
5.8× |
| Us pelvic non ob complete (76856) |
$596.10 |
$596.10 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$395.27 |
$395.27 |
3.8× |
| Us pregnancy ltd (76815) |
$474.67 |
$474.67 |
4.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$592.61 |
$592.61 |
5.6× |
| Us retroperitoneal complete (76770) |
$667.63 |
$667.63 |
6.4× |
| Us retroperitoneal limited (76775) |
$430.32 |
$430.32 |
4.1× |
| Us soft tissue head/neck (76536) |
$484.75 |
$484.75 |
4.6× |
| Us xtr non-vasc lmtd (76882) |
$432.89 |
$432.89 |
4.1× |
| Wrist 2 views (73100) |
$220.78 |
$220.78 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$256.43 |
$256.43 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$286.14 |
$286.14 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$584.48 |
$584.48 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$264.93 |
$264.93 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$270.23 |
$270.23 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$220.78 |
$220.78 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$317.92 |
$317.92 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$371.40 |
$371.40 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$359.16 |
$359.16 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$256.52 |
$256.52 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$220.78 |
$220.78 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$276.28 |
$276.28 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$293.59 |
$293.59 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$235.50 |
$235.50 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$379.06 |
$379.06 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$276.28 |
$276.28 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$221.20 |
$221.20 |
2.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$352.12 |
$352.12 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$317.92 |
$317.92 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$250.22 |
$250.22 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$262.74 |
$262.74 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$338.51 |
$338.51 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$414.41 |
$414.41 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$344.09 |
$344.09 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$192.31 |
$192.31 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$251.40 |
$251.40 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$276.28 |
$276.28 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$317.08 |
$317.08 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$228.57 |
$228.57 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$254.34 |
$254.34 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$590.16 |
$590.16 |
5.6× |
| Xr chest 4+ views (71048) |
$391.16 |
$391.16 |
3.7× |
| Xr finger(s) 2+ views (73140) |
$228.57 |
$228.57 |
2.6× |
| Xr shoulder 1 view (73020) |
$206.05 |
$206.05 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$492.79 |
$492.79 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$405.35 |
$405.35 |
4.6× |
| Xr tmj bilateral (70330) |
$326.82 |
$326.82 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$255.11 |
$255.11 |
2.9× |