| Abdomen 1 View (74018) |
$307 |
$307 |
2.9× |
| Abdomen 2 views (74019) |
$340 |
$340 |
2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,134 |
$1,134 |
2.4× |
| Ankle 2 views (73600) |
$143 |
$143 |
1.4× |
| Arthrogram hip (73525) |
$924 |
$924 |
2.2× |
| Arthrogram Wrist (73115) |
$924 |
$924 |
2.2× |
| Bone age studies (77072) |
$191 |
$191 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$996 |
$996 |
2.1× |
| Bone Imaging Limited Area (78300) |
$893 |
$893 |
1.9× |
| Bone Imaging Multiple Areas (78305) |
$815 |
$815 |
1.7× |
| Bone Imaging Whole Body (78306) |
$967 |
$967 |
2.0× |
| Brain Flow Imaging Only (78610) |
$1,434 |
$1,434 |
2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,554 |
$1,554 |
2.4× |
| Cat Scan Follow-Up Study (76380) |
$731 |
$731 |
7.0× |
| Chest 1 view (71045) |
$256 |
$256 |
2.5× |
| Chest 2 views (71046) |
$256 |
$256 |
2.5× |
| Chest 3 views (71047) |
$185 |
$185 |
1.8× |
| Chest 4 or more views (71048) |
$344 |
$344 |
2.7× |
| Cholecystography Oral Contrast (74290) |
$456 |
$456 |
2.2× |
| Clavicle complete (73000) |
$319 |
$319 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,378 |
$1,378 |
11.0× |
| Contrast X-Ray Bladder (74430) |
$715 |
$715 |
1.7× |
| Contrast X-Ray Of Elbow (73085) |
$924 |
$924 |
2.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$924 |
$924 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,265 |
$4,265 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,517 |
$2,517 |
8.8× |
| CT abdomen w contrast (74160) |
$1,497 |
$1,497 |
7.1× |
| CT abdomen w wo contrast (74170) |
$2,179 |
$2,179 |
10.4× |
| CT abdomen w/o contrast (74150) |
$1,251 |
$1,251 |
10.0× |
| CT Angio Abdomen and Pelvis (74174) |
$2,868 |
$2,868 |
6.9× |
| CT Angio Chest (71275) |
$1,079 |
$1,079 |
5.1× |
| CT Angio Head (70496) |
$1,444 |
$1,444 |
6.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,978 |
$1,978 |
9.4× |
| CT Angio Neck (70498) |
$1,343 |
$1,343 |
6.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,231 |
$1,231 |
5.9× |
| CT cervical spine w/ contrast (72126) |
$2,357 |
$2,357 |
5.6× |
| CT cervical spine w/o contrast (72125) |
$2,050 |
$2,050 |
16.4× |
| CT cervical spine w/wo cont (72127) |
$2,357 |
$2,357 |
11.2× |
| CT chest w contrast (71260) |
$1,909 |
$1,909 |
9.1× |
| CT chest w/wo contrast (71270) |
$2,080 |
$2,080 |
9.9× |
| CT head/brain with contrast (70460) |
$1,607 |
$1,607 |
7.6× |
| CT head/brain without and with contrast (70470) |
$1,700 |
$1,700 |
8.1× |
CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$33–$66 |
$33–$66 |
varies |
| CT iac w contrast (70481) |
$1,370 |
$1,370 |
6.5× |
| CT l-spine w&w/o contrast (72133) |
$2,357 |
$2,357 |
11.2× |
| CT lower ext w/o (73700) |
$1,455 |
$1,455 |
11.6× |
| CT lower extremity w/contrast material (73701) |
$1,974 |
$1,974 |
9.4× |
| CT lumbar spine w contrast (72132) |
$2,050 |
$2,050 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$2,050 |
$2,050 |
16.4× |
| CT maxillofacial w contrast (70487) |
$1,370 |
$1,370 |
6.5× |
| CT maxillofacial wo contrast (70486) |
$911 |
$911 |
7.3× |
| CT neck tissue combo (70492) |
$1,856 |
$1,856 |
8.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,953 |
$1,953 |
9.3× |
| CT orbits w/o contrast (70480) |
$911 |
$911 |
7.3× |
| CT pelvis w&w/o contrast (72194) |
$2,086 |
$2,086 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,265 |
$1,265 |
10.1× |
| CT scan of leg combo (73702) |
$1,466 |
$1,466 |
7.0× |
| CT scans face/jaw combo (70488) |
$1,953 |
$1,953 |
9.3× |
| CT soft tissue neck w contrast (70491) |
$1,409 |
$1,409 |
6.7× |
| CT soft tissue neck w/o contrast (70490) |
$980 |
$980 |
7.8× |
| CT thoracic spine w contrast (72129) |
$2,357 |
$2,357 |
11.2× |
| CT thoracic spine w/o contrast (72128) |
$2,050 |
$2,050 |
16.4× |
| CT thoracic spine w/wo cont (72130) |
$2,357 |
$2,357 |
11.2× |
| CT thorax w/o contrast (71250) |
$1,378 |
$1,378 |
11.0× |
| CT upper ext wo (73200) |
$1,455 |
$1,455 |
11.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,466 |
$1,466 |
7.0× |
| CT upper extremity with contrast (73201) |
$1,974 |
$1,974 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,650 |
$1,650 |
7.8× |
| Cta Abdomen (74175) |
$1,398 |
$1,398 |
6.7× |
| CTA pelvis (72191) |
$1,514 |
$1,514 |
7.2× |
| Dxa Bone Density Axial (77080) |
$646 |
$646 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$316 |
$316 |
3.0× |
| Echo exam uterus (76831) |
$517 |
$517 |
1.8× |
| Esophagram (74220) |
$368 |
$368 |
1.8× |
| Fetal Biophys Profile W/Nst (76818) |
$442 |
$442 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$416 |
$416 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$417 |
$417 |
1.5× |
| Foot 2 views (73620) |
$158 |
$158 |
1.5× |
| Forearm 2 views (73090) |
$319 |
$319 |
3.1× |
| Gastric emptying imaging study (78264) |
$861 |
$861 |
1.8× |
| Gastroesophageal Reflux Exam (78262) |
$887 |
$887 |
1.9× |
| Gated Heart Planar Single (78472) |
$1,151 |
$1,151 |
2.4× |
Hand 2 views (73120) range across 3 matching MRF lines |
$247–$319 |
$247–$319 |
varies |
| Hepatobil Syst Image W/Drug (78227) |
$1,616 |
$1,616 |
2.5× |
| Hepatobiliary System Imaging (78226) |
$1,616 |
$1,616 |
3.4× |
| Ht Muscle Image Spect Sing (78451) |
$2,318 |
$2,318 |
1.5× |
| Hysterosalpingogram (74740) |
$870 |
$870 |
3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$314 |
$314 |
3.0× |
| Infusion Ivp (74410) |
$715 |
$715 |
3.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,271 |
$1,271 |
2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,136 |
$1,136 |
2.4× |
| Knee 3 Views (73562) |
$319 |
$319 |
3.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,240 |
$1,240 |
2.6× |
| Lung perfusion differential (78597) |
$981 |
$981 |
2.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,513 |
$2,513 |
3.9× |
| Lymph System Imaging (78195) |
$932 |
$932 |
1.4× |
| Meckels Divert Exam (78290) |
$814 |
$814 |
1.7× |
| Myelogram Lumbar (72265) |
$1,658 |
$1,658 |
1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$1,022 |
$1,022 |
2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,343 |
$2,343 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$5,198 |
$5,198 |
3.4× |
| Neck soft tissue (70360) |
$194 |
$194 |
1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,229 |
$1,229 |
1.9× |
| Parathyroid Planar Imaging (78070) |
$767 |
$767 |
1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$767 |
$767 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$245 |
$245 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$814 |
$814 |
1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$242 |
$242 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$870 |
$870 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$319 |
$319 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$319 |
$319 |
3.1× |
| Radex elbow complete minimum 3 views (73080) |
$319 |
$319 |
3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$360 |
$360 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$319 |
$319 |
3.1× |
| Radex foot complete minimum 3 views (73630) |
$319 |
$319 |
3.1× |
Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$319–$637 |
$319–$637 |
varies |
Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$170–$255 |
$170–$255 |
varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$526 |
$526 |
4.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$319 |
$319 |
3.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$501 |
$501 |
4.8× |
| Radex shoulder complete minimum 2 views (73030) |
$319 |
$319 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$160 |
$160 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$175 |
$175 |
1.7× |
| Radex Sternum Minimum 2 Views (71120) |
$201 |
$201 |
1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$319 |
$319 |
3.1× |
| Radex Toe Minimum 2 Views (73660) |
$319 |
$319 |
3.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$245 |
$245 |
2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$319 |
$319 |
3.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$587 |
$587 |
4.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$429 |
$429 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$340 |
$340 |
2.7× |
| Radiologic exam colon double contrast study (74280) |
$555 |
$555 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$426 |
$426 |
2.0× |
| Radiologic exam knee complete 4/more views (73564) |
$433 |
$433 |
3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$226 |
$226 |
1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$657 |
$657 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$313 |
$313 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$413 |
$413 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$186 |
$186 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$267 |
$267 |
2.6× |
| Radiologic examination knee 1/2 views (73560) |
$319 |
$319 |
3.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$242 |
$242 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$319 |
$319 |
3.1× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$194 |
$194 |
0.3× |
| Ribs bilateral 3 views (71110) |
$242 |
$242 |
1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,345 |
$1,345 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,874 |
$2,874 |
1.9× |
| Scapula (73010) |
$319 |
$319 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$81 |
$81 |
3.5× |
| Shoulder 1 view (73020) |
$155 |
$155 |
1.5× |
| Shoulder Arthrography (73040) |
$1,095 |
$1,095 |
2.6× |
| Sialogram (70390) |
$870 |
$870 |
3.0× |
| Skull less than 4 views (70250) |
$378 |
$378 |
3.0× |
| Sternoclavicular joints (71130) |
$176 |
$176 |
1.7× |
| Testicular Imaging W/Flow (78761) |
$1,136 |
$1,136 |
2.4× |
| Thoracic spine 2 views (72070) |
$296 |
$296 |
2.4× |
| Thoracic spine 3 views (72072) |
$242 |
$242 |
1.9× |
| Thoracolumbar 2 views (72080) |
$668 |
$668 |
6.4× |
| Thyroid Uptake Measurement (78012) |
$852 |
$852 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$939 |
$939 |
2.0× |
| Ultrasound Breast Limited (76642) |
$843 |
$843 |
8.1× |
| Ultrasound Exam Aaa Screen (76706) |
$843 |
$843 |
6.7× |
| Ultrasound, abdomen limited (76705) |
$1,084 |
$1,084 |
8.7× |
| Umbilical-artery Doppler (OB) (76820) |
$427 |
$427 |
3.4× |
| Upper gi w/o kub (74240) |
$525 |
$525 |
2.5× |
| Urethrocystogram voiding (74455) |
$715 |
$715 |
2.5× |
| Urethrocystography retrograde (74450) |
$715 |
$715 |
2.5× |
| Us breast unilateral complete (76641) |
$843 |
$843 |
6.7× |
| Us chest (76604) |
$362 |
$362 |
2.9× |
| Us complete joint (76881) |
$394 |
$394 |
3.1× |
| Us exam, pelvic, limited (76857) |
$420 |
$420 |
3.4× |
| Us head (76506) |
$1,556 |
$1,556 |
12.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$280 |
$280 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$633 |
$633 |
5.1× |
| Us ob transvaginal (76817) |
$356 |
$356 |
2.8× |
| Us pelvic non ob complete (76856) |
$475 |
$475 |
3.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$369 |
$369 |
2.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$433 |
$433 |
3.5× |
| Us retroperitoneal complete (76770) |
$843 |
$843 |
6.7× |
| Us retroperitoneal limited (76775) |
$460 |
$460 |
3.7× |
| Us scrotum and contents (76870) |
$843 |
$843 |
6.7× |
| Us spinal canal and contents (76800) |
$394 |
$394 |
3.1× |
| Us thyroid (76536) |
$626 |
$626 |
5.0× |
| Us transrectal (76872) |
$483 |
$483 |
3.9× |
| Vascular Flow Imaging (78445) |
$911 |
$911 |
1.9× |
| Venography extremity bilateral rs&i (75822) |
$3,057 |
$3,057 |
1.6× |
| Venography extremity unilateral rs&i (75820) |
$2,301 |
$2,301 |
1.2× |
| Wrist 2 views (73100) |
$155 |
$155 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$377 |
$377 |
3.6× |
| X-ray antegrade pyelogram tube (74425) |
$715 |
$715 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$223 |
$223 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$160 |
$160 |
1.5× |
| X-Ray Exam Breast Specimen (76098) |
$886 |
$886 |
1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$186 |
$186 |
1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$307 |
$307 |
2.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$163 |
$163 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$214 |
$214 |
2.1× |
X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$269–$307 |
$269–$307 |
varies |
| X-Ray Exam Hips Bi 2 Views (73521) |
$307 |
$307 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$307 |
$307 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$587 |
$587 |
4.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$453 |
$453 |
3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$352 |
$352 |
3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$750 |
$750 |
6.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$762 |
$762 |
6.1× |
| X-ray eye for foreign body (70030) |
$429 |
$429 |
4.1× |
| X-ray humerus (73060) |
$153 |
$153 |
1.5× |
| X-ray IV pyelogram (ivp) (74400) |
$715 |
$715 |
3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$403 |
$403 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$190 |
$190 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$365 |
$365 |
2.9× |
| X-ray nose-rectum child f.b. (76010) |
$145 |
$145 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,112 |
$1,112 |
8.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$275 |
$275 |
2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$247 |
$247 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$352 |
$352 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$429 |
$429 |
4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$708 |
$708 |
5.7× |
| X-Ray Stress View (77071) |
$155 |
$155 |
1.5× |
| X-Ray Tmj Unilat (70328) |
$251 |
$251 |
2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$715 |
$715 |
1.7× |
X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$381–$633 |
$381–$633 |
varies |
| X-Rays Bone Survey Complete (77075) |
$1,006 |
$1,006 |
8.0× |
| Xr c-spine 4 or 5 views (72050) |
$668 |
$668 |
5.3× |
| Xr facial bones less than 3 views (70140) |
$333 |
$333 |
3.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$403 |
$403 |
3.2× |
| Xr orbits complete 4 views (70200) |
$212 |
$212 |
1.7× |
| Xr Tomogram Single Plane (76100) |
$548 |
$548 |
4.4× |