| Abdomen 2 views (74019) |
$183.30 |
$611 |
1.8× |
| Ankle 2 views (73600) |
$259.20 |
$864 |
3.1× |
| Arthrogram shoulder (73040) |
$414.90 |
$1,383 |
1.2× |
| Arthrography knee lt (73580) |
$379.80 |
$1,266 |
1.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$424.50 |
$1,415 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$711 |
$2,370 |
1.8× |
| Bone age studies (77072) |
$123.90 |
$413 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$989.70 |
$3,299 |
2.6× |
| Bone survey complete (77075) |
$585 |
$1,950 |
5.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$399.90 |
$1,333 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$277.20 |
$924 |
3.3× |
| Chest 1 view (71045) |
$127.20 |
$424 |
1.5× |
| Chest 3 views (71047) |
$223.50 |
$745 |
2.7× |
| Clavicle complete (73000) |
$248.70 |
$829 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$112.20 |
$374 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,996.50 |
$6,655 |
6.0× |
| CT abdomen and pelvis without contrast (74176) |
$918 |
$3,060 |
4.0× |
| CT abdomen w contrast (74160) |
$1,006.50 |
$3,355 |
6.0× |
| CT abdomen w wo contrast (74170) |
$1,329.90 |
$4,433 |
7.9× |
| CT abdomen w/o contrast (74150) |
$915 |
$3,050 |
9.1× |
| CT angio hrt w/3d image (75574) |
$1,423.80 |
$4,746 |
4.2× |
| CT angiography upper extremity lt (73206) |
$1,229.10 |
$4,097 |
7.3× |
| CT c-spine w/o contrast (72125) |
$1,010.10 |
$3,367 |
10.0× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$161.40 |
$538 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$540.30 |
$1,801 |
3.2× |
| CT cervical spine with contrast (72126) |
$1,111.50 |
$3,705 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,251.30 |
$4,171 |
7.4× |
| CT chest with contrast (71260) |
$1,112.40 |
$3,708 |
6.6× |
| CT head/brain with contrast (70460) |
$888.60 |
$2,962 |
5.3× |
| CT head/brain without and with contrast (70470) |
$944.10 |
$3,147 |
5.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$193.80 |
$646 |
0.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$86.10 |
$287 |
1.0× |
| CT hrt w/3d image congen (75573) |
$189.60 |
$632 |
0.6× |
| CT iac w contrast (70481) |
$715.20 |
$2,384 |
4.2× |
| CT lower ext w/o (73700) |
$953.70 |
$3,179 |
9.5× |
| CT lower extremity w wo contrast (73702) |
$360.30 |
$1,201 |
2.1× |
| CT lower extremity with contrast (73701) |
$1,311.38 |
$4,371.25 |
7.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,203 |
$4,010 |
7.1× |
| CT lumbar spine w/o contrast (72131) |
$994.20 |
$3,314 |
9.9× |
| CT lumbar spine with contrast (72132) |
$1,093.50 |
$3,645 |
3.3× |
| CT maxillofacial w contrast (70487) |
$704.40 |
$2,348 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$646.20 |
$2,154 |
6.4× |
| CT maxillofacial w/wo contrast (70488) |
$934.80 |
$3,116 |
5.5× |
| CT neck soft tissue w contrast (70491) |
$788.70 |
$2,629 |
4.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$787.20 |
$2,624 |
4.7× |
| CT orbits w/o contrast (70480) |
$650.10 |
$2,167 |
6.5× |
| CT pelvis w & w/o contrast (72194) |
$1,123.20 |
$3,744 |
6.7× |
| CT pelvis w/o contrast (72192) |
$928.80 |
$3,096 |
9.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$898.20 |
$2,994 |
5.3× |
| CT soft tissue neck w/o contrast (70490) |
$660 |
$2,200 |
6.6× |
| CT thoracic spine w/contrast (72129) |
$540.30 |
$1,801 |
3.2× |
| CT thoracic spine w/o contrast (72128) |
$958.80 |
$3,196 |
9.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,203 |
$4,010 |
7.1× |
| CT thorax w/o contrast (71250) |
$961.80 |
$3,206 |
9.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,163.70 |
$3,879 |
6.9× |
| CT upper extremity w/o contrast rt (73200) |
$961.50 |
$3,205 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,057.50 |
$3,525 |
3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,524.30 |
$5,081 |
9.0× |
| Cta Abdomen (74175) |
$1,416.90 |
$4,723 |
8.4× |
| CTA abdomen pelvis (74174) |
$2,029.80 |
$6,766 |
6.0× |
| CTA chest (71275) |
$1,395 |
$4,650 |
8.3× |
| Cta Head (70496) |
$901.80 |
$3,006 |
5.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,670.70 |
$5,569 |
5.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,442.25 |
$4,807.50 |
8.5× |
| Cta Neck (70498) |
$1,016.40 |
$3,388 |
6.0× |
| Cta Pelvis (72191) |
$1,397.70 |
$4,659 |
8.3× |
| Cystography minimum 3 views rs&i (74430) |
$438.30 |
$1,461 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$292.50 |
$975 |
2.9× |
| Echoencephalography real time imaging (76506) |
$123.90 |
$413 |
1.2× |
| Esophagus (74220) |
$257.40 |
$858 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$436.50 |
$1,455 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$123.90 |
$413 |
1.2× |
| Foot 2 views (73620) |
$326.62 |
$1,088.75 |
3.9× |
| Forearm 2 views (73090) |
$334.12 |
$1,113.75 |
4.0× |
| Gated Heart Planar Single (78472) |
$393.30 |
$1,311 |
1.0× |
| Hand 2 views (73120) |
$316.12 |
$1,053.75 |
3.1× |
| Hand 3 views (73130) |
$379.12 |
$1,263.75 |
4.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$864.60 |
$2,882 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$883.20 |
$2,944 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$273 |
$910 |
3.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$489 |
$1,630 |
0.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,247.70 |
$4,159 |
2.4× |
| Knee 3 views (73562) |
$360.75 |
$1,202.50 |
4.3× |
| Meckels Diverticulum (78290) |
$534.30 |
$1,781 |
1.4× |
| MRA head w/o contrast (70544) |
$760.80 |
$2,536 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,016.70 |
$3,389 |
3.0× |
| MRI abdomen w contrast (74182) |
$1,524.60 |
$5,082 |
4.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,677 |
$5,590 |
5.0× |
| MRI abdomen w/o contrast (74181) |
$1,385.70 |
$4,619 |
6.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,635 |
$5,450 |
2.2× |
| MRI cervical spine w/o contrast (72141) |
$1,383.30 |
$4,611 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,371.90 |
$4,573 |
6.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,488.90 |
$4,963 |
4.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,854.30 |
$6,181 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$988.20 |
$3,294 |
4.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,798.50 |
$5,995 |
5.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,791.90 |
$5,973 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,629.60 |
$5,432 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,749.90 |
$5,833 |
5.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,550.70 |
$5,169 |
4.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,686 |
$5,620 |
5.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,311.60 |
$4,372 |
5.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,848 |
$6,160 |
8.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,396.80 |
$4,656 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,207.50 |
$4,025 |
5.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,612.50 |
$5,375 |
1.3× |
| Neck soft tissue (70360) |
$155.40 |
$518 |
1.9× |
| Nm gastric emptying study (78264) |
$622.50 |
$2,075 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$338.10 |
$1,127 |
3.4× |
| Osseous survey infant (77076) |
$123.90 |
$413 |
1.2× |
| Osseous survey limited (77074) |
$112.50 |
$375 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$280.20 |
$934 |
2.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,573.20 |
$5,244 |
4.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$257.10 |
$857 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$282.60 |
$942 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$224.40 |
$748 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$404.70 |
$1,349 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$279 |
$930 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$150.90 |
$503 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$201.90 |
$673 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$203.40 |
$678 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$320.10 |
$1,067 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$360 |
$1,200 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$350.25 |
$1,167.50 |
4.2× |
| Ribs bilateral 3 views (71110) |
$467.40 |
$1,558 |
4.6× |
| Sacroiliac Joints < 3 Views (72200) |
$131.70 |
$439 |
1.3× |
| Scapula complete (73010) |
$266.70 |
$889 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$54.60 |
$182 |
2.3× |
| Small bowel series (74250) |
$351.30 |
$1,171 |
2.1× |
| Spine thoracic 3 views (72072) |
$389.10 |
$1,297 |
3.9× |
| Thoracolumbar 2 views (72080) |
$67.50 |
$225 |
0.8× |
| Tmj unilateral (70328) |
$92.40 |
$308 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$404.40 |
$1,348 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$193.20 |
$644 |
1.9× |
| Upper Extremity Infant (73092) |
$130.80 |
$436 |
1.3× |
| Urethrocystography voiding (74455) |
$425.10 |
$1,417 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$123.90 |
$413 |
1.2× |
| Us breast unilateral complete (76641) |
$429.30 |
$1,431 |
4.3× |
| Us breast unilateral limited (76642) |
$433.12 |
$1,443.75 |
5.2× |
| Us chest (76604) |
$305.40 |
$1,018 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$290.40 |
$968 |
2.9× |
| Us kidney transplant (76776) |
$118.20 |
$394 |
1.2× |
| Us ob detailed single fetus (76811) |
$123.90 |
$413 |
0.5× |
| Us ob transvaginal (76817) |
$320.10 |
$1,067 |
3.2× |
| Us pelvic non ob complete (76856) |
$444.30 |
$1,481 |
4.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$244.50 |
$815 |
2.4× |
| Us pregnancy ltd (76815) |
$341.40 |
$1,138 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$384.30 |
$1,281 |
3.8× |
| Us retroperitoneal complete (76770) |
$481.80 |
$1,606 |
4.8× |
| Us retroperitoneal limited (76775) |
$323.70 |
$1,079 |
3.2× |
| Us scrotum and contents (76870) |
$414.90 |
$1,383 |
4.1× |
| Us soft tissue head/neck (76536) |
$351.30 |
$1,171 |
3.5× |
| Us xtr non-vasc lmtd (76882) |
$329.25 |
$1,097.50 |
3.3× |
| Wrist 2 views (73100) |
$300.75 |
$1,002.50 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$261.30 |
$871 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$165 |
$550 |
2.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$383.25 |
$1,277.50 |
4.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$540.30 |
$1,801 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$319.50 |
$1,065 |
3.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$367.88 |
$1,226.25 |
4.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$310.80 |
$1,036 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$98.70 |
$329 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$203.70 |
$679 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$312.60 |
$1,042 |
3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$343.80 |
$1,146 |
3.4× |
| X-ray exam of femur 1 (73551) |
$146.40 |
$488 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$555.90 |
$1,853 |
5.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$155.70 |
$519 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$388.88 |
$1,296.25 |
4.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$399 |
$1,330 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$67.50 |
$225 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$663.75 |
$2,212.50 |
6.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$189 |
$630 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$84.60 |
$282 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$290.40 |
$968 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$588.30 |
$1,961 |
5.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$201 |
$670 |
2.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$273.30 |
$911 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$194.70 |
$649 |
2.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$220.50 |
$735 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$308.70 |
$1,029 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$264.90 |
$883 |
3.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$389.10 |
$1,297 |
3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$514.50 |
$1,715 |
5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$184.20 |
$614 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$241.80 |
$806 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$335.62 |
$1,118.75 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$350.40 |
$1,168 |
4.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$251.10 |
$837 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$435.90 |
$1,453 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$230.40 |
$768 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$67.80 |
$226 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$167.10 |
$557 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$267 |
$890 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$221.40 |
$738 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$373.88 |
$1,246.25 |
4.5× |
| Xr c-spine 6 or more views (72052) |
$412.50 |
$1,375 |
4.1× |
| Xr chest 4+ views (71048) |
$253.80 |
$846 |
2.5× |
| Xr finger(s) 2+ views (73140) |
$224.40 |
$748 |
2.7× |
| Xr shoulder 1 view (73020) |
$241.80 |
$806 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$375.30 |
$1,251 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$339 |
$1,130 |
4.1× |
| Xr tmj bilateral (70330) |
$67.50 |
$225 |
0.8× |
| Xray knee 1 or 2 views rt (73560) |
$362.25 |
$1,207.50 |
4.3× |