| Abdomen 2 views (74019) |
$244 |
$305 |
2.5× |
| Ankle 2 views (73600) |
$124 |
$155 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$788.80 |
$986 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$799.20 |
$999 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$811.20 |
$1,014 |
2.2× |
| Bone age studies (77072) |
$176 |
$220 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,173.60 |
$1,467 |
3.2× |
| Bone survey complete (77075) |
$608 |
$760 |
6.3× |
| Cervical spine 2 or 3 views (72040) |
$304 |
$380 |
3.8× |
| Chest 1 view (71045) |
$148.80 |
$186 |
1.9× |
| Chest 3 views (71047) |
$203.20 |
$254 |
2.5× |
| Clavicle complete (73000) |
$138.40 |
$173 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,354.40 |
$1,693 |
14.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,360.80 |
$2,951 |
7.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,920.80 |
$2,401 |
8.8× |
| CT abdomen w contrast (74160) |
$1,392 |
$1,740 |
8.6× |
| CT abdomen w wo contrast (74170) |
$1,487.20 |
$1,859 |
9.2× |
| CT abdomen w/o contrast (74150) |
$1,354.40 |
$1,693 |
14.1× |
| CT c-spine w/o contrast (72125) |
$1,354.40 |
$1,693 |
14.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,487.20 |
$1,859 |
9.2× |
| CT cervical spine with contrast (72126) |
$1,392 |
$1,740 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,487.20 |
$1,859 |
9.2× |
| CT chest with contrast (71260) |
$1,392 |
$1,740 |
8.6× |
| CT head/brain with contrast (70460) |
$1,392 |
$1,740 |
8.6× |
| CT head/brain without and with contrast (70470) |
$1,487.20 |
$1,859 |
9.2× |
| CT iac w contrast (70481) |
$1,392 |
$1,740 |
8.6× |
| CT limited/localized follow up study (76380) |
$1,310.40 |
$1,638 |
16.4× |
| CT lower ext w/o (73700) |
$1,354.40 |
$1,693 |
14.1× |
| CT lower extremity w wo contrast (73702) |
$1,487.20 |
$1,859 |
9.2× |
| CT lower extremity with contrast (73701) |
$1,392 |
$1,740 |
8.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,487.20 |
$1,859 |
9.2× |
| CT lumbar spine w/o contrast (72131) |
$1,354.40 |
$1,693 |
14.1× |
| CT lumbar spine with contrast (72132) |
$1,392 |
$1,740 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,392 |
$1,740 |
8.6× |
| CT maxillofacial w/o contrast (70486) |
$1,354.40 |
$1,693 |
14.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,487.20 |
$1,859 |
9.2× |
| CT neck soft tissue w contrast (70491) |
$1,392 |
$1,740 |
8.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,487.20 |
$1,859 |
9.2× |
| CT orbits w/o contrast (70480) |
$1,354.40 |
$1,693 |
14.1× |
| CT pelvis w & w/o contrast (72194) |
$1,487.20 |
$1,859 |
9.2× |
| CT pelvis w/o contrast (72192) |
$1,354.40 |
$1,693 |
14.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,487.20 |
$1,859 |
9.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,354.40 |
$1,693 |
14.1× |
| CT thoracic spine w/contrast (72129) |
$1,392 |
$1,740 |
8.6× |
| CT thoracic spine w/o contrast (72128) |
$1,354.40 |
$1,693 |
14.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,487.20 |
$1,859 |
9.2× |
| CT thorax w/o contrast (71250) |
$1,354.40 |
$1,693 |
14.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,487.20 |
$1,859 |
9.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,354.40 |
$1,693 |
14.1× |
| CT upper extremity with contrast (73201) |
$1,392 |
$1,740 |
4.3× |
| Cta Abdomen (74175) |
$1,786.40 |
$2,233 |
11.1× |
| CTA abdomen pelvis (74174) |
$2,184.80 |
$2,731 |
6.8× |
| CTA chest (71275) |
$1,786.40 |
$2,233 |
11.1× |
| Cta Head (70496) |
$1,786.40 |
$2,233 |
11.1× |
| CTA lwr ext w&w/o contrast (73706) |
$1,786.40 |
$2,233 |
11.1× |
| Cta Neck (70498) |
$1,786.40 |
$2,233 |
11.1× |
| Cta Pelvis (72191) |
$1,786.40 |
$2,233 |
11.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$318.40 |
$398 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$389.60 |
$487 |
4.1× |
| Foot 2 views (73620) |
$134.40 |
$168 |
1.7× |
| Forearm 2 views (73090) |
$149.60 |
$187 |
1.9× |
| Hand 2 views (73120) |
$160 |
$200 |
1.7× |
| Hand 3 views (73130) |
$210.40 |
$263 |
2.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$820 |
$1,025 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$756.80 |
$946 |
2.1× |
| Ht muscle image spect sing (78451) |
$1,600 |
$2,000 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$165.60 |
$207 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$808 |
$1,010 |
1.6× |
| Knee 3 views (73562) |
$213.60 |
$267 |
2.7× |
| MRA head w/o contrast (70544) |
$1,796 |
$2,245 |
8.2× |
| MRA neck w contrast (70548) |
$1,796 |
$2,245 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,796 |
$2,245 |
8.2× |
| MRI abdomen w contrast (74182) |
$1,876 |
$2,345 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,052 |
$2,565 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$1,796 |
$2,245 |
8.2× |
| MRI cervical spine w/o contrast (72141) |
$1,796 |
$2,245 |
8.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,052 |
$2,565 |
6.4× |
| MRI chest w/o contrast (71550) |
$1,796 |
$2,245 |
8.2× |
| MRI chest with contrast (71551) |
$1,876 |
$2,345 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,796 |
$2,245 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,796 |
$2,245 |
8.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,052 |
$2,565 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,052 |
$2,565 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$1,796 |
$2,245 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,052 |
$2,565 |
6.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,052 |
$2,565 |
6.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,052 |
$2,565 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,052 |
$2,565 |
6.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,796 |
$2,245 |
8.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,796 |
$2,245 |
8.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,052 |
$2,565 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,796 |
$2,245 |
8.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,864.80 |
$3,581 |
2.4× |
| Neck soft tissue (70360) |
$155.20 |
$194 |
1.9× |
| Nm gastric emptying study (78264) |
$732 |
$915 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$389.60 |
$487 |
4.1× |
| Parathyroid imaging (78070) |
$880 |
$1,100 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$160 |
$200 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,052 |
$2,565 |
6.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$728.80 |
$911 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$823.20 |
$1,029 |
1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$823.20 |
$1,029 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$179.20 |
$224 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$194.40 |
$243 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$292 |
$365 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$188 |
$235 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$200 |
$250 |
2.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$212.80 |
$266 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$145.60 |
$182 |
1.8× |
| Ribs bilateral 3 views (71110) |
$218.40 |
$273 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$188 |
$235 |
2.0× |
| Scapula complete (73010) |
$160 |
$200 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$96.80 |
$121 |
4.1× |
| Spine thoracic 3 views (72072) |
$242.40 |
$303 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$799.20 |
$999 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$404.80 |
$506 |
4.2× |
| Unlisted Ultrasound Procedure (76999) |
$389.60 |
$487 |
4.9× |
| Upper Extremity Infant (73092) |
$160 |
$200 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$389.60 |
$487 |
4.1× |
| Us breast unilateral complete (76641) |
$613.20 |
$766.50 |
6.4× |
| Us chest (76604) |
$389.60 |
$487 |
4.1× |
| Us compl joint r-t w/image documentation (76881) |
$528 |
$660 |
5.5× |
| Us ob detailed single fetus (76811) |
$389.60 |
$487 |
1.8× |
| Us ob transvaginal (76817) |
$389.60 |
$487 |
4.1× |
| Us pelvic non ob complete (76856) |
$445.60 |
$557 |
4.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$389.60 |
$487 |
4.1× |
| Us pregnancy ltd (76815) |
$389.60 |
$487 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$389.60 |
$487 |
4.1× |
| Us retroperitoneal complete (76770) |
$424.80 |
$531 |
4.4× |
| Us retroperitoneal limited (76775) |
$361.60 |
$452 |
3.8× |
| Us scrotum and contents (76870) |
$389.60 |
$487 |
4.1× |
| Us soft tissue head/neck (76536) |
$594.40 |
$743 |
6.2× |
| Us transrectal (76872) |
$389.60 |
$487 |
4.1× |
| Us xtr non-vasc lmtd (76882) |
$389.60 |
$487 |
4.1× |
| Wrist 2 views (73100) |
$140.80 |
$176 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$316.80 |
$396 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$176.80 |
$221 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$213.60 |
$267 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$136.80 |
$171 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$182.40 |
$228 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$171.20 |
$214 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$240.80 |
$301 |
3.0× |
| X-ray exam of femur 1 (73551) |
$132.80 |
$166 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$228 |
$285 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$216 |
$270 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$218.40 |
$273 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$139.20 |
$174 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$239.20 |
$299 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$358.40 |
$448 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$164 |
$205 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$166.40 |
$208 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$280.80 |
$351 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$359.20 |
$449 |
3.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$308 |
$385 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$196 |
$245 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$150.40 |
$188 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$169.60 |
$212 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$160.80 |
$201 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$302.40 |
$378 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$188 |
$235 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$172 |
$215 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$239.20 |
$299 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$233.60 |
$292 |
2.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$168 |
$210 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$253.60 |
$317 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$189.60 |
$237 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$205.60 |
$257 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$194.40 |
$243 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$174.40 |
$218 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$189.60 |
$237 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$132.80 |
$166 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$252 |
$315 |
3.1× |
| Xr c-spine 6 or more views (72052) |
$325.60 |
$407 |
3.4× |
| Xr chest 4+ views (71048) |
$203.20 |
$254 |
2.1× |
| Xr finger(s) 2+ views (73140) |
$132.80 |
$166 |
1.7× |
| Xr shoulder 1 view (73020) |
$132.80 |
$166 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$276.80 |
$346 |
2.9× |
| Xr tibia/fibula 2 views (73590) |
$171.20 |
$214 |
2.1× |
| Xr tmj bilateral (70330) |
$217.60 |
$272 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$146.40 |
$183 |
1.8× |