| Abdomen 2 views (74019) |
$107.94 |
$539.66 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$145.93 |
$729.63 |
0.4× |
| Acute venous thrombus image (78456) |
$189.25 |
$946.22 |
0.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$670.59 |
$3,352.91 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$1,029.35 |
$5,146.74 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$900.73 |
$4,503.62 |
0.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$874.83 |
$4,374.15 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$704.47 |
$3,522.31 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$820.87 |
$4,104.32 |
0.3× |
| Angiography Spinal Selective Rs&I (75705) |
$854.99 |
$4,274.93 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$1,029.35 |
$5,146.74 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$131.41 |
$657.03 |
0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$237.89 |
$1,189.43 |
0.1× |
| Ankle 2 views (73600) |
$37.51 |
$187.55 |
0.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$128.38 |
$641.90 |
0.4× |
| Aortogram thoracic (75605) |
$873.38 |
$4,366.89 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$989.78 |
$4,948.90 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,068.92 |
$5,344.57 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$670.59 |
$3,352.91 |
0.2× |
| Arthrogram elbow (73085) |
$103.10 |
$515.46 |
0.3× |
| Arthrogram hip (73525) |
$84.22 |
$421.08 |
0.3× |
| Arthrogram shoulder (73040) |
$105.27 |
$526.35 |
0.3× |
| Arthrogram wrist (73115) |
$117.37 |
$586.85 |
0.4× |
| Arthrography knee lt (73580) |
$88.33 |
$441.65 |
0.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$160.69 |
$803.44 |
0.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$294.03 |
$1,470.15 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$325.01 |
$1,625.03 |
0.9× |
| Bone age studies (77072) |
$24.45 |
$122.21 |
0.3× |
| Bone Imaging 3 Phase (78315) |
$253.38 |
$1,266.87 |
0.7× |
| Bone Marrow Imaging Limited Area (78102) |
$134.07 |
$670.34 |
0.4× |
| Bone survey complete (77075) |
$127.30 |
$636.46 |
1.4× |
| Brain image w/flow 4 + views (78606) |
$152.71 |
$763.51 |
0.3× |
| Brain imaging < 4 static views (78600) |
$182.96 |
$914.76 |
0.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$220.47 |
$1,102.31 |
0.6× |
| Brain Imaging Minimum 4 Static Views (78605) |
$126.57 |
$632.83 |
0.3× |
| Brain Imaging Vascular Flow Only (78610) |
$209.09 |
$1,045.44 |
0.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,089 |
$5,445 |
3.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$191.43 |
$957.11 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$38.48 |
$192.39 |
0.5× |
| Chest 1 view (71045) |
$71.15 |
$355.74 |
0.9× |
| Chest 3 views (71047) |
$90.75 |
$453.75 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$107.45 |
$537.24 |
0.7× |
| Clavicle complete (73000) |
$37.51 |
$187.55 |
0.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$80.11 |
$400.51 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$969.94 |
$4,849.68 |
3.1× |
| CT abdomen and pelvis without contrast (74176) |
$669.86 |
$3,349.28 |
3.2× |
| CT abdomen w contrast (74160) |
$387.93 |
$1,939.63 |
2.5× |
| CT abdomen w wo contrast (74170) |
$484.97 |
$2,424.84 |
3.1× |
| CT abdomen w/o contrast (74150) |
$318.96 |
$1,594.78 |
3.5× |
| CT angio hrt w/3d image (75574) |
$502.88 |
$2,514.38 |
1.6× |
| CT angiography upper extremity lt (73206) |
$338.32 |
$1,691.58 |
2.2× |
| CT c-spine w/o contrast (72125) |
$513.77 |
$2,568.83 |
5.6× |
| CT cervical spine w&w/o contrast (72127) |
$457.63 |
$2,288.11 |
3.0× |
| CT cervical spine with contrast (72126) |
$325.25 |
$1,626.24 |
1.1× |
| CT chest w/wo contrast (71270) |
$533.61 |
$2,668.05 |
3.4× |
| CT chest with contrast (71260) |
$374.38 |
$1,871.87 |
2.4× |
| CT colonography screening (74263) |
$346.79 |
$1,733.93 |
1.6× |
| CT colonography w/dye (74262) |
$401.72 |
$2,008.60 |
2.6× |
| CT colonography w/o cntrst (74261) |
$266.93 |
$1,334.63 |
2.9× |
| CT head/brain with contrast (70460) |
$387.93 |
$1,939.63 |
2.5× |
| CT head/brain without and with contrast (70470) |
$471.18 |
$2,355.87 |
3.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$465.37 |
$2,326.83 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$36.06 |
$180.29 |
0.5× |
| CT hrt w/3d image congen (75573) |
$474.57 |
$2,372.81 |
1.5× |
| CT iac w contrast (70481) |
$301.54 |
$1,507.66 |
1.9× |
| CT limited/localized follow up study (76380) |
$41.39 |
$206.91 |
0.5× |
| CT lower ext w/o (73700) |
$277.34 |
$1,386.66 |
3.0× |
| CT lower extremity w wo contrast (73702) |
$373.65 |
$1,868.24 |
2.4× |
| CT lower extremity with contrast (73701) |
$346.79 |
$1,733.93 |
2.2× |
| CT lumbar spine w & w/o contrast (72133) |
$433.91 |
$2,169.53 |
2.8× |
| CT lumbar spine w/o contrast (72131) |
$332.75 |
$1,663.75 |
3.6× |
| CT lumbar spine with contrast (72132) |
$431.97 |
$2,159.85 |
1.4× |
| CT maxillofacial w contrast (70487) |
$313.88 |
$1,569.37 |
2.0× |
| CT maxillofacial w/o contrast (70486) |
$304.68 |
$1,523.39 |
3.3× |
| CT maxillofacial w/wo contrast (70488) |
$567.25 |
$2,836.24 |
3.7× |
| CT neck soft tissue w contrast (70491) |
$387.93 |
$1,939.63 |
2.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$409.71 |
$2,048.53 |
2.6× |
| CT orbits w/o contrast (70480) |
$325.25 |
$1,626.24 |
3.5× |
| CT pelvis w & w/o contrast (72194) |
$484.97 |
$2,424.84 |
3.1× |
| CT pelvis w/o contrast (72192) |
$351.15 |
$1,755.71 |
3.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$132.14 |
$660.66 |
1.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$431.97 |
$2,159.85 |
2.8× |
| CT soft tissue neck w/o contrast (70490) |
$349.69 |
$1,748.45 |
3.8× |
| CT thoracic spine w/contrast (72129) |
$411.16 |
$2,055.79 |
2.7× |
| CT thoracic spine w/o contrast (72128) |
$313.88 |
$1,569.37 |
3.4× |
| CT thoracic spine w/wo contrast (72130) |
$457.63 |
$2,288.11 |
3.0× |
| CT thorax w/o contrast (71250) |
$302.02 |
$1,510.08 |
3.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$373.65 |
$1,868.24 |
2.4× |
| CT upper extremity w/o contrast rt (73200) |
$241.28 |
$1,206.37 |
2.6× |
| CT upper extremity with contrast (73201) |
$346.79 |
$1,733.93 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$338.32 |
$1,691.58 |
2.2× |
| Cta Abdomen (74175) |
$510.87 |
$2,554.31 |
3.3× |
| CTA abdomen pelvis (74174) |
$639.61 |
$3,198.03 |
2.1× |
| CTA chest (71275) |
$434.39 |
$2,171.95 |
2.8× |
| Cta Head (70496) |
$486.66 |
$2,433.31 |
3.1× |
| CTA lwr ext w&w/o contrast (73706) |
$370.51 |
$1,852.51 |
2.4× |
| Cta Neck (70498) |
$548.98 |
$2,744.88 |
3.5× |
| Cta Pelvis (72191) |
$338.32 |
$1,691.58 |
2.2× |
| Cystography minimum 3 views rs&i (74430) |
$65.59 |
$327.91 |
0.2× |
| Diskogram cervical (72285) |
$497.56 |
$2,487.76 |
0.3× |
| Diskography lumbar (72295) |
$638.16 |
$3,190.77 |
0.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$123.91 |
$619.52 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$33.88 |
$169.40 |
0.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$38.72 |
$193.60 |
0.5× |
| Echo exam of fetal heart (76825) |
$351.63 |
$1,758.13 |
0.7× |
| Echoencephalography real time imaging (76506) |
$106.24 |
$531.19 |
1.1× |
| Esophagus (74220) |
$69.46 |
$347.27 |
0.4× |
| Fetal biophysical profile non-stress testing (76818) |
$124.63 |
$623.15 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$121.24 |
$606.21 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$102.61 |
$513.04 |
0.5× |
| Foot 2 views (73620) |
$38 |
$189.97 |
0.5× |
| Forearm 2 views (73090) |
$38 |
$189.97 |
0.5× |
| Gated Heart Planar Single (78472) |
$242.25 |
$1,211.21 |
0.7× |
| Hand 2 views (73120) |
$38 |
$189.97 |
0.4× |
| Hand 3 views (73130) |
$43.08 |
$215.38 |
0.6× |
| Heart Infarct Image (78466) |
$152.71 |
$763.51 |
0.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$683.90 |
$3,419.46 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$287.02 |
$1,435.06 |
0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$228.69 |
$1,143.45 |
0.6× |
| Ht muscle image spect sing (78451) |
$340.74 |
$1,703.68 |
0.3× |
| Humerus Min 2 Views Left (73060) |
$39.21 |
$196.02 |
0.5× |
| Hysterosalpingogram (74740) |
$138.67 |
$693.33 |
0.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$62.20 |
$310.97 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$275.40 |
$1,376.98 |
0.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$229.18 |
$1,145.87 |
0.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$552.97 |
$2,764.85 |
1.2× |
| Knee 3 views (73562) |
$41.14 |
$205.70 |
0.5× |
| Liver & spleen imaging static only (78215) |
$322.35 |
$1,611.72 |
0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$200.86 |
$1,004.30 |
0.6× |
| Liver imaging static only (78201) |
$181.75 |
$908.71 |
0.4× |
| Lung perf&ventilat diferentl (78598) |
$321.86 |
$1,609.30 |
0.7× |
| Lung perfusion differential (78597) |
$305.65 |
$1,528.23 |
0.9× |
| Lung Ventilation Imaging (78579) |
$245.39 |
$1,226.94 |
0.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$113.50 |
$567.49 |
0.0× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$101.16 |
$505.78 |
0.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$103.58 |
$517.88 |
0.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$106.24 |
$531.19 |
0.0× |
| Lymphoscintigraphy (78195) |
$196.27 |
$981.31 |
0.4× |
| Meckels Diverticulum (78290) |
$242.25 |
$1,211.21 |
0.7× |
| MRA head w & w/o contrast (70546) |
$722.50 |
$3,612.46 |
2.3× |
| MRA head w/o contrast (70544) |
$325.01 |
$1,625.03 |
1.5× |
| MRA head with contrast (70545) |
$564.35 |
$2,821.72 |
1.8× |
| MRA neck w contrast (70548) |
$375.59 |
$1,877.92 |
1.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$571.61 |
$2,858.02 |
1.9× |
| MRA neck w/o contrast (70547) |
$325.01 |
$1,625.03 |
1.5× |
| MRI abdomen w contrast (74182) |
$497.07 |
$2,485.34 |
1.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$571.61 |
$2,858.02 |
1.9× |
| MRI abdomen w/o contrast (74181) |
$373.89 |
$1,869.45 |
1.8× |
| MRI any jnt lwr ext with con lt (73722) |
$497.07 |
$2,485.34 |
0.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$497.07 |
$2,485.34 |
0.7× |
| MRI breast w/o contrast bilateral (77047) |
$245.63 |
$1,228.15 |
1.2× |
| MRI breast w/o contrast unilat (77046) |
$245.63 |
$1,228.15 |
1.2× |
| MRI c-spine with contrast (72142) |
$497.07 |
$2,485.34 |
1.6× |
| MRI cardiac w/o contrast (75557) |
$735.20 |
$3,675.98 |
3.5× |
| MRI cervical spine w/o contrast (72141) |
$373.89 |
$1,869.45 |
1.8× |
| MRI chest w/o & w/contrast material (71552) |
$571.61 |
$2,858.02 |
1.9× |
| MRI chest w/o contrast (71550) |
$373.89 |
$1,869.45 |
1.8× |
| MRI chest with contrast (71551) |
$497.07 |
$2,485.34 |
0.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$497.07 |
$2,485.34 |
1.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$497.07 |
$2,485.34 |
1.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$373.89 |
$1,869.45 |
1.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$373.89 |
$1,869.45 |
1.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$571.61 |
$2,858.02 |
1.9× |
| MRI orbit/face/neck w/contrast (70542) |
$497.07 |
$2,485.34 |
1.6× |
| MRI pelvis w contrast (72196) |
$497.07 |
$2,485.34 |
1.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$766.06 |
$3,830.26 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$568.10 |
$2,840.48 |
2.7× |
| MRI scan of arm joint before and after contrast (73223) |
$571.61 |
$2,858.02 |
1.9× |
| MRI scan of leg joint before and after contrast (73723) |
$571.61 |
$2,858.02 |
1.9× |
| MRI spectroscopy (76390) |
$495.62 |
$2,478.08 |
6.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$766.90 |
$3,834.49 |
2.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$497.07 |
$2,485.34 |
1.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$765.45 |
$3,827.23 |
2.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$497.07 |
$2,485.34 |
1.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$767.26 |
$3,836.30 |
2.5× |
| MRI thoracic spine w/o contrast (72146) |
$373.89 |
$1,869.45 |
1.8× |
| MRI tmj (70336) |
$597.99 |
$2,989.91 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$373.89 |
$1,869.45 |
1.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$571.61 |
$2,858.02 |
1.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$373.89 |
$1,869.45 |
1.8× |
| Myelogram Cervical (72240) |
$380.43 |
$1,902.12 |
0.5× |
| Myelogram Lumbar (72265) |
$380.43 |
$1,902.12 |
0.5× |
| Myelogram thoracic (72255) |
$380.43 |
$1,902.12 |
0.5× |
| Myelography 2 or more regions (72270) |
$380.43 |
$1,902.12 |
0.5× |
| Myocardial infarct spect (78469) |
$191.43 |
$957.11 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$658.24 |
$3,291.20 |
0.6× |
| Neck soft tissue (70360) |
$42.11 |
$210.54 |
0.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$145.20 |
$726 |
0.4× |
| Nm adrenal scan (78075) |
$172.07 |
$860.31 |
0.2× |
| Nm bone marrow multiple (78103) |
$248.54 |
$1,242.67 |
0.7× |
| Nm bone marrow wb (78104) |
$267.66 |
$1,338.26 |
0.8× |
| Nm cisternogram (78630) |
$420.60 |
$2,102.98 |
0.9× |
| Nm csf leak detection (78650) |
$191.43 |
$957.11 |
0.2× |
| Nm gastric emptying study (78264) |
$311.70 |
$1,558.48 |
0.9× |
| Nm gastroesophageal reflux study (78262) |
$191.43 |
$957.11 |
0.5× |
| Nm peritoneal-venous shunt patency (78291) |
$144.48 |
$722.37 |
0.4× |
| Nm red cell sequestration (78140) |
$172.07 |
$860.31 |
0.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$999.22 |
$4,996.09 |
0.8× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$344.13 |
$1,720.62 |
0.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$293.31 |
$1,466.52 |
0.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$127.05 |
$635.25 |
0.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$172.07 |
$860.31 |
0.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$181.75 |
$908.71 |
0.5× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$152.71 |
$763.51 |
0.3× |
| Nuclear Rx Oral Admin (79005) |
$242.97 |
$1,214.84 |
1.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$87.85 |
$439.23 |
1.0× |
| Orthopantogram (70355) |
$39.21 |
$196.02 |
0.5× |
| Osseous survey infant (77076) |
$75.75 |
$378.73 |
0.8× |
| Osseous survey limited (77074) |
$75.75 |
$378.73 |
0.8× |
| Parathyrd planar w/spect&CT (78072) |
$242.97 |
$1,214.84 |
0.5× |
| Parathyrd planar w/wo subtrj (78071) |
$242.97 |
$1,214.84 |
0.7× |
| Parathyroid imaging (78070) |
$162.63 |
$813.12 |
0.5× |
| Pelvis 1 or 2 views (72170) |
$42.60 |
$212.96 |
0.5× |
| Peritoneogram rs&i (74190) |
$130.93 |
$654.61 |
0.3× |
| PET image w/CT, skull-thigh (78815) |
$1,500.89 |
$7,504.42 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$1,573 |
$7,865 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$571.61 |
$2,858.02 |
1.9× |
| Pr sono bone density measure,peripheral (76977) |
$2.67 |
$13.31 |
0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$820.87 |
$4,104.32 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$804.65 |
$4,023.25 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$196.27 |
$981.31 |
0.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$396.40 |
$1,981.98 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$81.80 |
$408.98 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$68.97 |
$344.85 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$46.47 |
$232.32 |
0.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$134.07 |
$670.34 |
1.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$50.58 |
$252.89 |
0.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$141.57 |
$707.85 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$51.31 |
$256.52 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$85.43 |
$427.13 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$114.47 |
$572.33 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$78.65 |
$393.25 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$137.46 |
$687.28 |
0.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$132.86 |
$664.29 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$97.53 |
$487.63 |
0.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$71.39 |
$356.95 |
0.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$95.59 |
$477.95 |
1.2× |
| Radiological examination surgical specimen (76098) |
$39.69 |
$198.44 |
0.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$670.59 |
$3,352.91 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$897.82 |
$4,489.10 |
0.3× |
| Ribs bilateral 3 views (71110) |
$52.52 |
$262.57 |
0.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$221.19 |
$1,105.94 |
0.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$449.64 |
$2,248.18 |
0.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$191.43 |
$957.11 |
0.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$547.89 |
$2,739.44 |
0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$696.96 |
$3,484.80 |
0.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$547.89 |
$2,739.44 |
0.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$310.73 |
$1,553.64 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$233.29 |
$1,166.44 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$66.31 |
$331.54 |
0.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$189.25 |
$946.22 |
0.9× |
| Salivary gland imaging (78230) |
$143.27 |
$716.32 |
0.4× |
| Scanogram (77073) |
$32.43 |
$162.14 |
0.4× |
| Scapula complete (73010) |
$46.47 |
$232.32 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$18.15 |
$90.75 |
0.8× |
| Sella turcica (70240) |
$35.58 |
$177.87 |
0.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$201.35 |
$1,006.72 |
2.2× |
| Sialogram (70390) |
$101.64 |
$508.20 |
0.5× |
| Small bowel series (74250) |
$82.77 |
$413.82 |
0.5× |
| Spine thoracic 3 views (72072) |
$89.30 |
$446.49 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$211.27 |
$1,056.33 |
0.1× |
| Testicular Imaging With Vascular Flow (78761) |
$172.07 |
$860.31 |
0.5× |
| Therapeutic Enema (74283) |
$235.95 |
$1,179.75 |
1.5× |
| Thoracolumbar 2 views (72080) |
$47.19 |
$235.95 |
0.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$219.50 |
$1,097.47 |
0.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$181.50 |
$907.50 |
0.5× |
| Thyroid uptake measurement (78012) |
$181.50 |
$907.50 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$538.94 |
$2,694.67 |
1.5× |
| Tomogram (76100) |
$99.71 |
$498.52 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$770.77 |
$3,853.85 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$143.27 |
$716.32 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$166.74 |
$833.69 |
1.8× |
| Umbilical-artery Doppler (OB) (76820) |
$121.73 |
$608.63 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$349.69 |
$1,748.45 |
4.5× |
| Upper Extremity Infant (73092) |
$66.55 |
$332.75 |
0.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$229.18 |
$1,145.87 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$90.75 |
$453.75 |
0.4× |
| Urethrocystography voiding (74455) |
$77.93 |
$389.62 |
0.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$125.84 |
$629.20 |
0.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$152.95 |
$764.72 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$120.52 |
$602.58 |
1.3× |
| Us breast unilateral complete (76641) |
$104.06 |
$520.30 |
1.1× |
| Us breast unilateral limited (76642) |
$60.50 |
$302.50 |
0.8× |
| Us chest (76604) |
$97.77 |
$488.84 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$64.13 |
$320.65 |
0.7× |
| Us guided compression repair (76936) |
$223.37 |
$1,116.83 |
1.2× |
| Us infant hips dynamic (76885) |
$82.77 |
$413.82 |
1.1× |
| Us kidney transplant (76776) |
$133.59 |
$667.92 |
1.4× |
| Us ob detailed single fetus (76811) |
$207.40 |
$1,036.97 |
1.0× |
| Us ob transvaginal (76817) |
$119.31 |
$596.53 |
1.3× |
| Us pelvic non ob complete (76856) |
$131.17 |
$655.82 |
1.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$120.04 |
$600.16 |
1.3× |
| Us pregnancy ltd (76815) |
$113.74 |
$568.70 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$78.41 |
$392.04 |
0.8× |
| Us retroperitoneal complete (76770) |
$99.47 |
$497.31 |
1.1× |
| Us retroperitoneal limited (76775) |
$102.37 |
$511.83 |
1.1× |
| Us scrotum and contents (76870) |
$127.78 |
$638.88 |
1.4× |
| Us soft tissue head/neck (76536) |
$113.99 |
$569.91 |
1.2× |
| Us spinal canal and contents (76800) |
$78.17 |
$390.83 |
0.8× |
| Us transrectal (76872) |
$97.77 |
$488.84 |
1.1× |
| Us transrectal prostate volume (76873) |
$128.26 |
$641.30 |
1.4× |
| Us xtr non-vasc lmtd (76882) |
$64.13 |
$320.65 |
0.7× |
| Venogram extremity bilateral (75822) |
$335.18 |
$1,675.85 |
0.2× |
| Venogram orbital (75880) |
$166.50 |
$832.48 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,013.98 |
$5,069.90 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$480.62 |
$2,403.06 |
0.3× |
| Venography epidural rs&i (75872) |
$207.16 |
$1,035.76 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$94.63 |
$473.11 |
0.1× |
| Venography Renal Bilateral (75833) |
$782.39 |
$3,911.93 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$718.26 |
$3,591.28 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$219.74 |
$1,098.68 |
0.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$670.59 |
$3,352.91 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$66.55 |
$332.75 |
0.9× |
| Wrist 2 views (73100) |
$37.51 |
$187.55 |
0.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$47.19 |
$235.95 |
0.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$39.21 |
$196.02 |
0.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$41.14 |
$205.70 |
0.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$127.30 |
$636.46 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$39.21 |
$196.02 |
0.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$46.47 |
$232.32 |
0.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$117.37 |
$586.85 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$44.77 |
$223.85 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$95.59 |
$477.95 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$116.16 |
$580.80 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$155.61 |
$778.03 |
1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$177.15 |
$885.72 |
1.9× |
| X-ray exam of femur 1 (73551) |
$71.88 |
$359.37 |
0.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$81.07 |
$405.35 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$46.47 |
$232.32 |
0.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$38 |
$189.97 |
0.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$41.14 |
$205.70 |
0.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$770.77 |
$3,853.85 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$65.59 |
$327.91 |
0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$30.25 |
$151.25 |
0.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$45.26 |
$226.27 |
0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$62.20 |
$310.97 |
0.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$39.21 |
$196.02 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$41.14 |
$205.70 |
0.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$91.72 |
$458.59 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$143.03 |
$715.11 |
1.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$65.83 |
$329.12 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$52.52 |
$262.57 |
0.7× |
| X-ray of voice box or throat (70370) |
$108.90 |
$544.50 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$46.47 |
$232.32 |
0.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$37.27 |
$186.34 |
0.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$101.16 |
$505.78 |
0.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$142.54 |
$712.69 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$51.31 |
$256.52 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$55.42 |
$277.09 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$67.76 |
$338.80 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$48.16 |
$240.79 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$43.32 |
$216.59 |
0.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$45.74 |
$228.69 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$46.47 |
$232.32 |
0.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$38.48 |
$192.39 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$53.49 |
$267.41 |
0.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$42.60 |
$212.96 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$34.61 |
$173.03 |
0.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$38.24 |
$191.18 |
0.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$49.13 |
$245.63 |
0.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$42.60 |
$212.96 |
0.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$89.30 |
$446.49 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$33.88 |
$169.40 |
0.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$40.66 |
$203.28 |
0.5× |
| Xr arthrogram ankle (73615) |
$73.81 |
$369.05 |
0.2× |
| Xr c-spine 6 or more views (72052) |
$81.56 |
$407.77 |
0.9× |
| Xr chest 4+ views (71048) |
$96.80 |
$484 |
1.0× |
| Xr Cholecystography Oral Contrast (74290) |
$90.27 |
$451.33 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$33.88 |
$169.40 |
0.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$40.42 |
$202.07 |
0.4× |
| Xr optic foramina (70190) |
$35.58 |
$177.87 |
0.5× |
| Xr shoulder 1 view (73020) |
$38.48 |
$192.39 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$61.47 |
$307.34 |
0.7× |
| Xr tibia/fibula 2 views (73590) |
$39.21 |
$196.02 |
0.5× |
| Xr tmj bilateral (70330) |
$46.47 |
$232.32 |
0.6× |
| Xray knee 1 or 2 views rt (73560) |
$36.06 |
$180.29 |
0.5× |